I recently read the novel Even the Dogs, which is a fascinating insight into the lives of homeless and vulnerable people. The author Jon McGregor describes the stark realities of living on the edge of society, but what is most striking are his references to the importance of touch. He writes about how infrequently positive touch occurs in his characters’ lives, and describes one experience of a consultation with a nurse:
“…changing your dressing or taking your blood pressure or listening to the crackling in your lungs, they got to touch you with their clean soft hands… it helps”.
Touch is so important to all of us but perhaps we only truly value it when it is gone. A friend whose husband died some years ago described to me how much she missed holding his hand and feeling physically close to someone. She said: “no one really hugs me anymore”.
These comments made me reflect on how we use therapeutic touch in nursing.
It is well known that long-term conditions such as dementia can create barriers to touch. The Alzheimer’s Society has suggested that many people with advanced dementia living in care homes have little contact with staff other than for personal care or help with eating and drinking.
However, there are initiatives aimed at addressing this. I was inspired by an article in Nursing Times a few weeks ago, which describes an intervention called Namaste Care. This structured programme of sensory activities aims to improve end-of-life care for people in nursing homes who have advanced dementia by giving them pleasure and helping them connect with others. Touch is a crucial part of this initiative, but the authors faced challenges in introducing it in homes.
“At first, staff found it strange to take off their gloves to give hand massages, but they are now starting to understand the importance of skin-on-skin contact when attempting to connect with residents, and that gloves should only be worn when there in a risk of contamination or transmitting infection”.
We all need to think about the barriers we create between ourselves and our patients that prevent the use of therapeutic touch. We also need to be aware of unpopular patients - those people we would rather avoid, and guard against this affecting the care we give them.
Just spending a little more time over washing and drying patients’ feet, combing their hair or applying moisturiser to their hands could make an enormous difference - even if it just for that moment and, in the case of those with dementia, quickly forgotten.