Exploring nurses’ experiences of using hand massage to alleviate anxiety for individuals with dementia in residential settings

Patients with dementia living in residential settings may have complex health needs and have reduced capacity to communicate these needs. In such circumstances, attention to presence and touch and more specifically hand massage gains greater significance for their wellbeing. Short periods of calming comforting touch can reduce anxiety. This research explored the experiences of nurses who use hand massage for this purpose in residential settings. A qualitative descriptive approach was employed and data was collected from semi-structured interviews held with eleven nurses working with patients with dementia in five residential care settings. The findings revealed that hand massage can be effective as an intervention to alleviate anxiety. There was evidence of the benefits for patients with dementia not only as a direct intervention using soothing and rhythmic touch but also in opening doors and creating opportunities for communication between the giver (the nurse) and the recipient (the patient). This research echoes other findings, showing that although people experiencing dementia may lose the capacity to articulate verbally, they retain ability to communicate nonverbally. There was also evidence that the act of giving hand massage benefitted the nurse participants. Engaging in hand massage enhanced their self-awareness and reflection on ways of caring. Being able to “tune in”, be present to the experience of touching hands gave a sense of connection on an emotional and physical level. Participants felt they were caring for patients in meaningful and tangibly beneficial ways. In some instances, hand massage had the effect of calming the collective atmosphere of the room in which the intervention was being given.This sense of atmospheric ease was noted by staff, visitors and families. Of course, participants experienced challenges in the delivery of hand massage. Integrating hand massage into daily routine activities was met by resistance from some staff. Increased paperwork, audits, safety checks etc. arising from nationally designed standards meant that there was rarely protected time in which participants felt free to stop and offer hand massage. Changes in organisational attitudes and routines are therefore seen as necessary to ensure that the potential benefits of hand massage can be exploited.