Learn to reduce pain and other distress at the end of life through simple skills you can begin using TODAY

with our new one-of-a-kind program by award-winning specialists in end-of-life care!

Are you a massage therapist, EOL doula, home health aide, hospice volunteer, or other nonmedical healthcare worker called to serve people with advanced illness? 

Do you sometimes feel powerless to help your clients feel better?

What if you could learn skills TODAY that would improve your ability to make a meaningful difference in the lives of the clients you serve?

Palliative Positioning is a 1.5 hour online program with proven strategies to help reduce pain and other common symptoms at the end of life. By the end of this program, you will know how to:

  • Anticipate the most comfortable positions for people with a variety of common symptoms;

  • Use items in the home or care facility to improve comfort for clients seated in a chair, recliner, sofa, or wheelchair;

  • Use items in the home or care facility to improve comfort for clients in a recumbent or semi-reclining position in bed;

  • Assist clients to get comfortable in a side-lying or side-leaning position;

  • Work with your client to adapt positioning for ongoing changes in condition;

  • Support loved ones with tips to improve their comfort at the bedside.

WHY is palliative positioning SO important for people with advanced illness?

  • People with advanced illness spend an increasing amount of time in a chair, recliner, or bed – up to 16-20 hours per day during late decline. Most are bedbound at the end of their lives and unable to reposition themselves for comfort.
  • People lose muscle mass and adipose tissue at the end of life. This loss of natural padding increases the risk of musculoskeletal pain and skin breakdown.
  • Good positioning can have a significant impact on common symptoms at the end of life, including shortness of breath, anxiety, swelling, and pain. 


"We have personally experienced a patient's pain score dropping from an 8 to a 2 out of 10, just with skilled positioning and propping."

Susan Gee and Cindy Spence,
Co-creators of Final Touch Training and Palliative Positioning

Who are we?

We are daughters, sisters, wives, mothers, learners, teachers, and massage therapists with more than 40 years of combined experience in the field of palliative massage. We've provided more than 8,000 massages for people with advanced illness and have taught hundreds of therapists and other healthcare workers to provide compassionate, skilled, nonmedical support for people at the end of life. 


Here is what students say about our 20-hour live course:

“This powerful class was so beautifully presented. I feel prepared and supported as I take a deeper dive into this work that has been calling me for a while now.”

Christina H., LMT from Dallas, TX

“Instructors were knowledgeable, interesting, energetic, passionate, authentic, nonjudgmental."”

Colleen C., RN, LMT from Chicago, IL

“The instructors are extremely organized and informative. Their compassion and passion for this work are unmatched.”

Jamie E., LMT from Green Bay, WI

The lessons we share in our new digital course, Palliative Positioning, are born of thousands of encounters with patients and their caregivers who have taught us how to make them comfortable. These are simple skills that anyone can learn and put to everyday use, helping clients and loved ones feel better immediately!

Course Instructors

Cindy Spence

Cindy Spence has been a massage therapist specializing in palliative care since 1999, after her father-in-law’s dying wish for gentle touch inspired her to attend massage school.  A longtime pancreatic cancer survivor, Cindy believes in the pursuit of optimal wellbeing at all phases of life, particularly during serious illness and the dying process. Her training includes a master’s degree in public health, continuing education from MD Anderson Cancer Center, and certification in the Vodder technique of Manual Lymphatic Drainage. She has extensive home hospice experience in the Dallas area and has been employed since 2017 at the world-class T. Boone Pickens Hospice Inpatient Center. She is a recipient of the Irene Smith Palliative Care Award and the author of the book Palliative Touch: Massage for People at the End of Life. With Susan, Cindy created and teaches a 20-hour live course for massage therapists and other healthcare providers.

Susan Gee

Susan Gee is Board Certified in Therapeutic Massage and Bodywork and has completed a 300-hour oncology massage certification at the Peregrine Institute of Oncology Massage Training. She is a Certified Manual Lymphatic Drainage Therapist in the Vodder technique and the owner of Progressive Massage Therapy. Susan is contracted with Dierksen Hospice to provide massage for hospice patients in their homes and care facilities. She has worked as an independent contractor for Vista Care Hospice and VITAS Innovative Health Care in Dallas and is co-creator, with Cindy, of Final Touch Training, dedicated to offering top-notch education for care providers serving people with life-limiting illness. Susan is the creator of two 3-hour digital courses on gentle-touch massage, A Guide for Caregivers and A Guide for Massage Therapists.

Would you like to learn to use items found in the client's home to make them more comfortable, no matter where they spend their time – bed, wheelchair, or recliner? These are skills that we teach in our 20-hour live course. But we want the information to be available to MORE people. People just like YOU!

Enroll Now

Here's what's inside Palliative Positioning

    1. Introduction

    2. Before You Get Started, a Message from Susan and Cindy

    1. Session 1: Materials for Positioning

    1. Session 2: General Principles of Positioning

    1. Session 3: How to Position Clients on a Sofa, Chair, or Wheelchair

    1. Session 4: How to Position Clients in a Reclining Chair

    1. Session 5: How to Position Clients in a Regular Bed

About this course

  • $47.00
  • 14 lessons
  • 1.5 hours of video content