Touch massage for dementia

Findings by SBU Alert

Version: 1

Technology and target group

Touch massage can be used as a general term to cover, eg, tactile stimulation, peripheral tactile nerve stimulation, tactile massage, aromatherapy massage, hand massage, expressive physical touch, and effleurage. Touch massage is given to patients, eg, with dementia, as a complement to other treatment and nursing care, as a part of daily care activities. The aims of treatment are to give patients a greater sense of well-being, reduce stress, and relieve pain, thereby decreasing anxiety and aggressive behaviors in the patient. Touch massage may be applied to different areas of the body and carried out by staff or family carers. The frequency and length of massage treatment varies, and the potential target group is large.

Patient benefit

The effects of touch massage, mainly hand massage, have been investigated in a few small, short-term studies. Long-term studies have not been reported. One controlled study of 16 patients has been reported. The results suggest that massage can have positive effects on depression, anxiety, mood, activity, contactability, and some memory functions. Three studies using a pretest-posttest design with no control groups have been identified. One of these reported significant effects as regards a lower frequency and intensity of hitting, yelling, grabbing, and trying to get to another place. One study reported fewer anxious behaviors after intervention and two studies reported lower pulse rates after each massage session as compared to before the sessions. In another study addressing the effects on agitated behavior in severe dementia, massage yielded conflicting results. In summary, it appears that massage may have positive effects in people with dementia. However, the studies are too small to draw firm conclusions.

Ethical aspects

In treating patients with low autonomy, as is the case in dementia, the concepts of "free will" and consent are central issues that concern the patient and family. Voluntary participation is essential so that massage is not perceived as intrusive and offending by the patient nor obligatory for the caregiver.

Economic aspects

There are no economic studies on the effects of massage.

Scientific evidence

There is poor* scientific documentation concerning the effects of touch massage for dementia patients. There is no* scientific documentation on the costs or cost effectiveness.

Since knowledge on the effects and costs for massage is very limited, large multicenter studies should be conducted to assess massage before it is adopted by the health services as routine care.

*This assessment by SBU Alert uses a 4-point scale to grade the quality and evidence of the scientific documentation. The grades indicate: (1) good, (2) moderate, (3) poor, or (4) no scientific evidence on the subject.

This summary is based on a report prepared at SBU in collaboration with Assoc. Prof. Mona Kihlgren, Centre for Nursing Science, Örebro University Hospital, Örebro, Åsa Krusebrant, RN, MSocSc, Caring Edu., The Swedish Red Cross University College of Nursing, Stockholm, and Kirsti Skovdahl, MS, doctoral student, Centre for Nursing Science, Örebro University Hospital, Örebro. It has been reviewed by Prof. PO Sandman, Department of Nursing Science, Norrland University Hospital, Umeå and Prof. Kenneth Asplund, Department of Caring Sciences, Mid Sweden University, Sundsvall.

The complete report is available in Swedish only.

Alert is a joint effort by the Swedish Council on Technology Assessment in Health Care (SBU), the Medical Products Agency, the National Board of Health and Welfare, and the Federation of Swedish County Councils.

References

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