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Massage Today
September, 2013, Vol. 13, Issue 09

The Rewards of Working with Dementia Patients, Part 2

By Ann Catlin, LMT, NCTMB, OTR

In my last article, I compared four types of dementias: Alzheimer's disease, vascular dementia, Lewy body dementia and frontotemporal dementia. Now, I'll explore how touch can improve the quality of life for the person living with the disease.

Touch deprivation in old age is real. Simington (1995) relates that older persons report that touch conveys fondness, security, closeness, warmth, concern and encouragement, and makes them feel an increased sense of trust and well-being. They report that touch helps them to develop close, trusting relationships with staff and other residents. As tactile sensitivity decreases, the need to receive expressive touch may increase. Nature can be cruel however, and the elderly person often may have no one to provide this increased touch. The children are gone and the partner has died. One elderly woman put it this way, "Sometimes I hunger to be held. But he is the one who would have held me. He is the one who would have stroked my head. Now there is no one. No comfort."

Touch is one of our most basic human needs throughout our life. Clearly our situation, age and condition changes, but the need for human contact does not. As Simington pointed out, as the body or mind declines, the need for human touch may increase as we search for reassurance and comfort.

dementia patient - Copyright – Stock Photo / Register Mark Touch in the form of gentle and sensitive massage or attentive holding has the power to enhance physical, emotional and spiritual well-being. A hand massage, back massage or simply holding a person's hand has the power to elicit positive, life-affirming feelings and responses. Touch becomes a language of the human heart and a remembrance of one's place in the world.

An underlying principle is that we each have within us a compassionate presence. Sensitive massage and focused touch are mediums used to offer the gift of this natural presence.

Unique benefits of sensitive massage and focused touch:

  • Increased body awareness increasing a sense of self and alertness.
  • Reassurance and trust, diffusing overwhelming confusion or anxiety.
  • Builds a bridge of connection with people and activities in immediate surroundings.
  • Helps to calm agitation often based in fear and confusion.
  • Eases the effects of isolation, loneliness and boredom.
  • Acknowledges and affirms the individual within encouraging feelings of worthiness and well-being.
  • Reduces pain leading to improved physical comfort and sleep quality.

Hands reflect the landscape of a person's life. When you touch someone's hands with compassion and sensitivity, you acknowledge their whole life experience. In our society, we touch hands as an accepted means of interaction to greet one another, offer support and to show affection. Since touching the hands is so familiar, hand massage may be gladly accepted by your care partner. Evidence suggests even a simple ten-minute hand massage can go a long way in helping people with dementia feel calmer and more connected with others and their immediate environment.

Suzuki (2010) explored the effects of hand massage on physical and mental function and behavioral and psychological symptoms among elderly patients with dementia. The group received a consistent hand massage protocol a total of 30 times each for 20 to 30 minutes between 4p.m. and 5p.m. Both aggressive behaviors and stress levels decreased significantly after six weeks.

The story of Mrs. A is paraphrased from the Suzuki Study. Mrs. A was an 84-year-old woman with AD. She had delusions that people were stealing things and was easily angered. She needed partial care for activities of daily living and used a wheelchair. Short-term memory impairment was evident, but she was relatively competent in communicating. She enjoyed hand massage and would come over in her wheelchair to ask, "are you doing massage today?" From about the fourth week of intervention, she said, "the circulation in my hands is better and it's nice having warm hands. I always used to wake up in the night, but these days I've been sleeping right through till the morning, and it's because of this massage."

After 6 weeks of hand massages, Mrs. A. showed slight improvement in motor function and she was much calmer and better at communicating. Paranoid delusional symptoms disappeared and she showed a decrease in wandering and aimless activity compared with before the intervention. She went from being quick to anger to smiling more frequently after the massage. She started being able to sleep through the night after receiving the massage and nurses noted a decrease in anxiety.

Dr. Allen Powers, author of Dementia Beyond Drugs and an advocate of touch in dementia care, adds to the conversation: "Modalities like massage ... can provide a balm for anyone who is in need of more human connection. I will confess that I have occasionally ordered moisturizing creams twice as often as needed for people with dementia who are disengaged merely to increase the frequency of hands-on contact."

References:

  1. Power, A. (2010) Dementia Beyond Drugs, Health Professions Press, Baltimore, MD 21285
  2. Suzuki, M et al (2010) Physical and Psychological Effects of 6-Week Tactile Massage on Elderly Patients with Severe Dementia. American Journal of Alzheimer 's disease and Other Dementias, December, Vol. 25 no. 8, 680-686.
  3. Simington, Jane, RN, PhD (1995) The Power of Expressive Touch, Humane Medicine Journal, Vol. 11 No. 4.

Click here for more information about Ann Catlin, LMT, NCTMB, OTR.

 

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