Effects Of Touch And Massage Care In Advanced Alzheimer Patient: A Pilot Case Report

Objectives: In the advanced stages of Alzheimer disease (AD), communication abilities are lost, and the patient is expressionless, cannot make utterances or move independently, and, in many cases, is bedridden. Though touch and massage have usually been used as one of the occupational therapy intervention methods for various terminally patients, little has been studied about its effect on advanced AD patients.Methods: The patient was a woman in her late 80s with the most severe level of care need and dementia due to AD. Once a month, over 5 months, unscented jojoba oil was applied to the patient's hands while she was seated on a wheelchair with her hands on a table, and she received 10 minutes of touch and massage care on each hand, for a total of 20 minutes. Salivary amylase activity was measured just before and immediately after every intervention session as a non-invasive indicator which reflects psychological stress.Results: The average salivary amylase values before and after the 5 times that the patient received the touch and massage care were 185.6 KIU/L (SD = 44.5) and 112.8 KIU/L (SD = 38.3), respectively. A significant decrease was observed (P = 0.043). As for the patient's appearance during the sessions, when she was helped to move her arms onto the tabletop, her arms and legs sometimes stiffened, and she flexed them intermittently, however, the stiffening diminished after the massage began.Conclusions: Since this was a pilot case study with a single patient, the results cannot be generalized. However, the study showed that touch and massage care could provide pleasant stimulation for an advanced AD patient with verbal communication difficulties and offered the possibility of reducing physical and emotional stress; therefore, it provides important clues for the future occupational therapy intervention and care of advanced AD patients.