GERIATRIC MASSAGE: WHY TOUCH IS SO IMPORTANT AS WE AGE BY Douglas Nelson, L.M.T.

​Touch is fundamental to our human existence, in ways that are remarkable and exceedingly powerful. Massage therapy, our chosen discipline, comprises an astonishing number of approaches and techniques; but the one common underlying principle that affects almost all approaches is the power of human touch and its effect on the recipient. Touch is so primary to our existence that even our language is filled with references to sensory experiences. We find a story “touching,” a friendly person “warm and embracing,” while someone who is unfriendly, we deem as “unfeeling.” In many ways, touch seems to be a sense that is fundamental to human existence in ways that supersede perhaps every other sense. There are people who live complete and full lives without the sense of seeing, hearing, smelling or tasting. I believe that complete loss of the ability to experience touch would be devastating in ways the loss of any other sense could not quite equal. In this article, I will explore what the science might tell us about the importance of touch and its importance as we age. Touch Mitigates Social Isolation When I recently reviewed a representative of one of the Massage Therapy Foundation’s community service grants, I was inspired to think more deeply about the power of touch and its application to seniors. This community service grant, made possible by a gift from BIOTONE, was awarded to a retirement community, Friends Village at Woodstown (FVAW), in Woodstown, New Jersey. The grant enabled FVWA to launch a new program, Comforting Connections, providing seniors with therapeutic geriatric massage over a 12-month period. A focus on the application of touch to senior citizens will become increasingly important as this demographic continues to increase: 10,000 Americans turn age 65 each day. FVAW residents are adults over the age of 62 with a disability that prevents them from living independently, including memory support residents with a disability involving memory loss. Residents receive therapeutic massage to decrease pain, anxiety and social isolation, and improve communication with caregivers. Most seniors at FVWA utilize their fixed income to pay for their health care and residential needs and would not normally have access to the benefits of therapeutic massage this program provides. One often overlooked issue of aging is social isolation and loneliness. For many seniors, social isolation increases as they deal with the psychological impact of changing societal roles. Many seniors suffer multiple life changes dealing with loss: loss of a spouse, loss of identity through meaningful work, or the inability to connect socially with others by belonging to various clubs and organizations. The loss of social connections may have serious health implications, as social isolation is directly connected to both a decrease in the quality and length of life[1]. The effects of social isolation and loneliness are far-reaching, both physically and psychologically. In the physical realm, for example, in the last few years there has been a much greater awareness of the devastating effects of inflammation on multiple conditions such as arthritis, metabolic syndrome and chronic pain. Would it surprise you to know that individuals who experience social isolation have an increase in proinflammatory substances such as cytokines[2]? The presence of increased proinflammatory substances may increase the likelihood of depression, which then overlaps and negatively affects a host of other physical conditions. Touch Keeps Us Connected Our hope is that, through the power of touch, some of these negative effects can be mitigated. Is it possible for touch to communicate a deeper sense of social connection? There is good reason to think it can. In one study, researchers explored whether emotions typically connected to pro-social behavior — gratitude, love and sympathy — can be communicated through touch[3]. The results show the power of communication through touch. Subjects in the study were touched on the arm by a person they did not know and had no visual contact with, and were then asked to identify the emotion being communicated. The emotions they could choose from were anger, fear, disgust, love, sympathy and gratitude. Subjects accurately perceived prosocial emotions at rates far greater than chance alone and comparable to the accuracy of communicating emotions via facial displays or vocal intonation, both of which have been well studied. The researchers then questioned whether it was possible to discern the emotions from just watching people being touched. Playing the video recordings of subjects being touched in the first phase, observers, with accuracy, were able to correctly determine the emotion communicated by the touch just by observing it. It seems the power of touch can be both felt and observed. Geriatric Massage: Touch in Elder Care In the Massage Therapy Foundation’s Community Service Grant I previously mentioned, the population being served was in a residential facility for elder care. As you might imagine, facilities for the elderly face numerous challenges in caring for their residents. Can geriatric massage be of help? In one literature review[4], various research studies have shown that people in residential care settings who receive massage sleep better, need less restraint and less medication, and have an improved psychosocial experience. This is a substantial benefit to all concerned — the resident, family and facility. Another study[5]explored the use of MultiSensory Stimulation (visual, auditory, tactile, and olfactory) in a nursing home setting. For the tactile component of sessions lasting 25 minutes, participants received a 10-minute hand massage. Sessions were three times per week for a total of four weeks. The results? While the control group showed no changes, the intervention group showed statistically significant changes in both scores related to depression and anxiety. In another study of the elderly in long-term care[6], participants were given both hand and foot massages as the touch intervention. To assess results, a Likert scale was used to explore subjects’ emotional responses. Additionally, the researchers also performed an electroencephalogram (EEG) on the subjects, which measured electrical activity in the brain. While both the hand and foot massage had positive effects on the subjects as measured by the Likert scale, there were differences in the part of the brain affected by each. The left insular cortex was more affected by hand massage, while the right and left posterior cingulate cortex was more involved in the foot massage. Each of these brain regions has a slightly different function as to processing positive emotions. So, massaging different parts of the body affects slightly different brain regions. Over time, more evidence may help us design sessions to affect specific areas of the brain. At every phase of life, touch is an incredibly powerful tool for many of the challenges we, as a society, currently face. The application of geriatric massage to caring for the elderly is but one example. As massage therapists, we are uniquely positioned to address this need. About the Author Douglas Nelson, LMT, BCTMB, wrote this article for MASSAGE Magazine on behalf of the Massage Therapy Foundation (MTF). Nelson is president of the MTF, which advances the knowledge and practice of massage therapy by supporting scientific research, education and community service. Nelson began his career in massage therapy in 1977 and maintains an active clinical practice. He has served as a neuromuscular consultant to NBA and NFL teams, as well as high-level musicians. His book, The Mystery of Pain, was publishing by Singing Dragon in 2013. His articles for MASSAGE Magazine include “This is How Massage Research Contributes to Professional & Personal Growth.”