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Family Caregiver, Hospital Professionals, Senior Care Professionals

The Healing Power of Touch. Why are we Depriving our Elders?

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It the first sense to develop in the womb and one of the last ones to go during the dying process.

It is one of our most fundamental human needs.  It remains for a lifetime.

As we experience decline of the body or mind due to aging or illness, the need for human touch may be accentuated in the search for reassurance,  comfort, and connection.

Is Touch Deprivation Real?

Touch deprivation in old age is very real, especially for the medically frail elder, persons living with dementia, and older adults living alone.  Despite their need for touch and being especially receptive to touch, they are often the least likely to receive healing or expressive touch from health care providers or family members.  Studies have confirmed that nursing students have been shown to experience anxiety about touching older adults.  This anxiety, along with demands on staff time and duties, lack of training on distinguishing the differences between effective and ineffective touch, and simply society’s fear of touching ill and frail elders has led to wide-spread touch deprivation in our aging adult population.

Touch deprivation leads to feelings of isolation, anxiety, poor trust in caregivers, insecurity and decreased sensory awareness.  These kinds of distress can lead to behavioral responses or expression.

“It is well known in professional circles that young nursing students tend to avoid touching elderly patients, and especially the acutely ill…touching as a therapeutic event is not as simple as a mechanical procedure or a drug, because it is, above all, an act of communication….the use of touch and physical closeness may be the most important way to communicate to acutely ill (and aged) persons that they are important as human beings.” 

-Ashley Montagu, Touching: The Human Significance of the Skin

Physiological Effects of Touch

Healing, compassionate touch tilts a person’s response away from stress towards well-being.

Touch stimulates the production of oxytocin, a chemical in our brain that leads to feelings of closeness and security.  When oxytocin is released, feelings of safety, caring, trust and decreased anxiety take place in a person’s body.  Oxytocin has often been referred to as the “care and connection” hormone.  Simply put, when your brain releases oxytocin, you feel good!

At the same that oxytocin is released, another chemical is decreasing when we experience healing touch.  Cortisol is a hormone that increases when we are stressed.  Studies show that cortisol levels decrease after even five minutes of skilled touch.  Apart from the physical relaxation, skilled touch increases our emotional well being.

Is the Tide Changing?  

“The most important innovation in medicine to come in the next 10 years: the power of the human hand.” – Dr. Abraham Verghase

We are witnessing transformational shifts in dementia care across the globe.   No longer is status quo acceptable, as we now understand the importance of person-centered care, the meaning of life enrichment and our responsibility to create moments of joy and purposefulness.

We have the opportunity to get back to the basics of human needs with effective, feasible and transformative tools that are literally in our hands.

Pam Brandon is President/Founder of AGE-u-cate® Training Institute and worked with leading Touch expert, Ann Catlin, ORT, LMT in the development of Compassionate Touch® program for eldercare providers, hospitals, practitioners and families.  Pam is a passionate advocate for creating positive change in aging care.  Pam may be reached at pam@AGEucate.com

To learn more about the Compassionate Touch program visit www.AGEucate.com

 

Family Caregiver, Hospital Professionals, Senior Care Professionals

Suicide and Older Adults – Risk Factors and Warning Signs

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September is National Suicide Prevention Month. This year, World Suicide Prevention Day will be observed on September 10.  The following information will help readers understand risk factors and warning signs of suicide in older adults.  

Suicide is a serious public health issue and an immeasurable tragedy for the surviving families, friends, and communities. Many of us may not realize that older adults are at particularly high risk for suicide. According to the Centers for Disease Control and Prevention (CDC), adult males age 65 and up, were the group with the highest suicide rate in 2016. Older adults appear to have a unique set of factors that place them at high risk for suicide. 

Suicide is often related to mental health conditions, such as depression, anxiety, and substance use disorders; particularly if undiagnosed or untreated. A mental health condition alone; however, is not necessarily an indicator of suicidal behavior. It is estimated that over 50% of people who die by suicide do not have a known mental health condition. Furthermore, many people with diagnosed mental health conditions engage in treatment and are able to live full lives. There are many other risk factors in addition to mental health conditions, including: 

  • Brain injuries or disorders 
  •  Prolonged exposure to stress 
  •  Chronic pain 
  •  Life and role transitions 
  •  Access to lethal means 
  •  History of abuse or neglect 
  •  A family history of suicide 
  •  Previous suicide attempts 

After contemplating this list, we can see how several risk factors may be elevated for older adults, specifically the area of life and role transitions. Older adults typically experience changes in their function and the roles they serve in their family or community. They may also experience the death loved ones, health decline, and loss of independence. Older adults face unique challenges, including functional decline, fear or becoming a burden, and concerns about long-term care and loss of independence. 

Older adults are typically more isolated, more frail, more likely to have a plan, and more likely to use lethal means when attempting suicide; therefore, a suicide attempt is more likely to end in death for an older adult than for a younger adult. That being said, suicide CAN be prevented! Some of the warning signs include: 

  •  Marked change in behavior or entirely new behaviors 
  •  Increased use of drugs or alcohol 
  •  Feelings of hopelessness and/or helplessness 
  •  Talking about suicide or not wanting to live 
  •  Isolating from family and friends 
  •  Visiting or calling people to say goodbye 
  •  Giving away prized possessions 

If you observe these warning signs, or if you or someone you know is thinking about suicide, please contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). 

Let’s observe National Suicide Prevention Month by increasing awareness and reducing stigma! 

Author: 

Dr. Gabriela Frederick is a Clinical Psychologist, with a geriatric specialization. She is a Certified Master Trainer for AGE-u-cate Training Institute and is dedicated to improving care and services for older adults. Dr. Frederick may be reached at Gabriela@AGEucate.com 

References: 

American Foundation for Suicide Prevention (AFSP) https://afsp.org/about-suicide/suicide-statistics 

Centers for Disease Control and Prevention (CDC): Data & Statistics Fatal Injury Report for 2016. https://www.cdc.gov/injury/wisqars/fatal_injury_reports.html 

Mental Health America (MHA) http://www.mentalhealthamerica.net/preventing-suicide-older-adults 

National Institute of Mental Health (NIMH) https://www.nimh.nih.gov/health/statistics/suicide.shtml 

Family Caregiver, Hospital Professionals, Senior Care Professionals

Down Syndrome and Alzheimer’s – the Challenges of Diagnosis

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Research confirms that by the age of 40, almost 100% of persons with Down syndrome who die have changes in the brain associated with Alzheimer’s disease (AD).  Understanding this link and the challenges of a diagnosis of AD in persons with Down syndrome is important for families and healthcare professionals.

Down Syndrome occurs when a person has three copies of the 21st chromosome instead of the normal two copies.  Studies show that one of the main genes responsible for AD is on the 21st chromosome and is more active in persons with Down syndrome.  Because of this extra copy of the Alzheimer gene, virtually 100% of people with Down syndrome will develop the plaques and tangles in the brain associated with AD, but not necessarily the same memory loss.  Although research is not complete, it is estimated that about 50% of persons with Down syndrome will develop the characteristic memory problems of AD before age 50.

Testing for AD in persons with Down syndrome is often challenging.  Diagnosis of AD is difficult for a number of reasons:

  • Persons with Down syndrome are susceptible to hypothyroidism and depression, which are both reversible conditions but often go untreated and can be mistaken for AD.
  • Side effects of medications taken for either of these conditions can also mimic AD.
  • Normal AD skills testing are often not applicable for persons with Down syndrome simply because of learning differences.
  • Communication skills of persons with Downs syndrome may affect the results of assessment testing.

Families need to watch for signs of AD, especially as their loved one reaches middle age years.  Diagnosis is important, but also education, resources, and support are especially critical for care partners.  Learning to better respond to surprising new behaviors will prepare families for AD symptoms, such as changes in judgment,  processing speed, memory recall, to name a few.

Care partners, either family or professionals, need to have access to new communication tools, understand that care processes will need to be adjusted as well as home or residential changes to their living environment.  Staff and family training will help care partners better serve their residents and loved ones.

Person-centered care approaches to help persons with Down’s syndrome who have developed AD is key to maintaining a loving, trusting environment, where they feel loved, valued and are treated as individuals.

Pam Brandon is President and Founder of AGE-u-cate® Training Institute and a passionate advocate for culture change, improving the quality of life of aging adults, and transformative training for professional and family care partners.  She is the creator of the internationally recognized Dementia Live® simulation experience and collaborated with expert Ann Catlin on the transformational Compassionate Touch® training.  

References:

http://Dementia.org.au

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Compassionate Touch®, Dementia Live, Senior Care Professionals

The Transformative Power of Music in Ageing Care

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By Sue Silcox, AGE-u-cate® Training Institute, Australia

Does anyone remember the banning of public music in Iran? Back in 1979 Ayatollah Rubollah Khomeini banned all music from radio and television in Iran. He likened it to opium and said it “stupefies persons listening to it and makes their brain inactive and frivolous.” (New York Times, 1979).

I remember it happening and being horrified by the ban. Every culture has music and it has always been such a blessing for me. From the first music I heard my parents play, the first record I ever bought (Cathy’s Clown, The Everly Brothers) to using Spotify now when I take Ageless Grace® classes locally, I am thankful for what it brings me.

How amazing that a study in 2001 from Leicester University, UK, found that babies recognise the music they heard in the womb even twelve months later. In this study, mothers played a single piece of music repeatedly during the third trimester. A year after birth, the infants recognised and turned towards that sound, preferring it to a similar sounding piece of music, even though they had not heard the music in the interim. Music certainly has power!

I’m one of the first baby boomers so I’ve had the pleasure of listening and moving through music styles such as pop, rock and roll, country music and jive, twist just for a start. I also have the remembrance of swing and big band as my parents would dance together or get us to dance with them. Many a tune brings a memory of the old HMV turntable my aunt had. She would play her favourite artist, in particular Nat King Cole and I wonder how many of my preferences have been influenced by those early sounds.

For me, to be without music as I age would be like living in the dark ages. Although I like to move my body to contemporary music I also find myself emotionally transported as I listen to music I love. A 2017 study found that physical exercise done to music showed greater increase in cognitive function than just exercise alone, and may be of benefit in delaying age-related cognitive decline. It also makes changes to the brain structure. My love and use of music and exercise seems to be validated! Music should be also be considered a drug therapy, providing benefits linked to reward, motivation and pleasure. (Howland, R. H, 2016).

In Australia the Arts Health Institute brought a music and memory program to aged care, now overtaken by the music enrichment program, “Music Remembers Me” in aged care. Perhaps we also need to encourage movement during the music enrichment program.

Whether music is enjoyed on its own or shared, it can be an intensely special time for the listener. Now it seems the joy of the music can provide considerable benefit to our ageing and dementia communities.

Sue Silcox leads AGE-u-cate® Training Institute, Australia and is a Certified Master Trainer for Dementia Live®, Compassionate Touch®, and other AGE-u-cate programs.  She lives in Brisbane, Queensland.   She may be contacted at sue.silcox@ageucate.com

References:

Kifner, J. 1979. Khomeini Bans Broadcast Music, Saying It Corrupts Iranian Youth. New York Times. Retrieved from https://www.nytimes.com/1979/07/24/archives/khomeini-bans-broadcast-music-saying-it-corrupts-iranian-youth.html

BBC News, July 2011. Babies remember womb music. Retrieved from http://news.bbc.co.uk/2/hi/health/1432495.stm

Ken-ichi et al. (2017). Physical Exercise with Music Reduces Gray and White Matter Loss in the Frontal Cortex of Elderly People: The Mihama-Kiho Scan Project. Frontiers In Aging Neuroscience, Vol 9 (2017), doi:10.3389/fnagi.2017.00174/full

Howland, R. H. (2016). Hey Mister Tambourine Man, Play a Drug for Me. Journal Of Psychosocial Nursing & Mental Health Services, 54(12), 23-27. doi:10.3928/02793695-20161208-05