Tag Archives: expressive touch

Touch is a Touchy Subject in Eldercare

Human beings need the connection of touch for wellbeing. Expressive Touch is possible and necessary, even during a pandemic.

The pandemic has made us all wary of getting too close to others, and rightly so.  Shivers might run down your spine thinking about touching someone not related to you.

Touch, meaning holding a hand, offering a hug or a warming shoulder rub.  Can we?  Should we?  Touch, is a touchy subject these days, after all.

People express their fatigue with pandemic-style living.  How many times have you heard, “I’m so over it”?

Imagine how over it elders who live in elder care communities must feel?  Separated from family and friends for a year with a profound absence of expressive touch in their lives.

Elders Need Touch Too

Touch is the first sense to develop in the womb and one of the last to leave us before we die.  Human’s need the connection of touch throughout their life-course, which includes old age.

Yet, studies reveal that older adults lack meaningful touch in their lives, under ordinary circumstances.  Layer in a pandemic, and the effects will be catastrophic.

People delivering care for elders in care communities must touch to provide for basic care needs.  It is impossible to assist with dressing, ambulation and bathing without touch.  This form of touch is task focused instrumental touch.   We are mistaken in thinking that this is the only form of touch needed or wanted by elders.

Consider from a place of empathy what life absent of expressive touch must feel like.  No hugs or soft embraces.  Nobody to sit with and hold hands or stroke your forehead before bed.

When we emotionally connect with the realities of what living life like this could be like, we can safely step out of a comfort zone and make a change in our actions of care.

Consider the difference a gentle shoulder or back rub could make in an elder’s day.  Or, soothing strokes on the forearm or on top of the legs before bed.

It is safe and possible to incorporate expressive touch with instrumental touch in the tasks of caregiving.  Try beginning a bathing event with a soothing back rub.

Click here to learn more about how to formalize expressive touch as a part of your community caregiving protocol.

Next up,  incorporating expressive touch in caregiving is good for the caregiver too!

Julie has worked in Aging Services for over 30 years and has been a Licensed Nursing Home Administrator since 1990. She is a the Director of Grants and Consulting Projects and a Certified Master Trainer with AGE-u-cate Training Institute. In addition, she is an instructor and of Gerontology and Leadership in Aging Services at Northern Illinois University and lives in the Chicago Northwest Suburb of Mount Prospect, IL.

Infection Control and Expressive Touch: We Can Have Both

The healing benefit of expressive touch is lacking in the lives of older adults.

The topic of infection control almost always enters the conversation when I deliver Compassionate Touch training.  This training teaches caregivers the skill of expressive touch.

Hand, back, and foot rubs used to be a part of the care process.  Seasoned nurses consistently confirm this fact.  In contrast,  newer nurses and nursing assistants report that expressive touch was not a part of their training.

This lays the foundation to discuss the reasons why older, frail adults lack expressive touch in their lives.

Glove Culture and Expressive Touch

Infection control is consistently cited by skilled nursing employees as a reason for the lack of expressive touch in the lives of older adults.    Furthermore, employees fear citations from surveyors for not using gloves.

Megan J. DiGiorgio, MSN, RN, CIC, FAPIC  coins the phrase “glove culture”.  In addition to the wasteful use of resources, the over-use of gloves increases disconnection and a lack of trust in caregivers, among other negative outcomes.

Burdsall, Deborah Patterson, MSN, Ph.D.,  identified situations that require the use of gloves.  Touching intact, non-infectious skin of older adults in healthcare settings does not require gloves.

Skilled nursing caregivers do expressively touch their residents.  Indeed, holding a hand or giving a hug communicates how much we care and provides comfort.  We can incorporate more of this excellent medicine of expressive touch in our caregiving practices and still uphold infection prevention standards.

Gloves are not used with Compassionate Touch techniques. I urge those I am teaching to resist the temptation. The benefits of touch would be lost for both the resident and care provider.

Consider evaluating the extent to which gloves are used in your community and understand the unintended consequences.  Even more, it seems like this would be a worthwhile QAPI project.


Julie has worked in Aging Services for over 30 years and has been a Licensed Nursing Home Administrator since 1990. She is a Certified Master Trainer with the AGE-u-cate Training Institute. Through her company Enlighten Eldercare,  she provides training and educational programs on elder caregiving to private and professional caregivers.  She is an instructor and the Interim Director of Gerontology at Northern Illinois University and lives in the Chicago Northwest Suburb of Mount Prospect, IL.