Healing Touch and Therapeutic Touch for Dementia

Because of the limited effectiveness and unresolved safety problems of conventional treatments of Alzheimer's disease and other forms of dementia, researchers are exploring a range of complementary and alternative medical (CAM) approaches aimed at improving memory and cognition, and reducing agitation that often accompanies dementia. This post is offered as a concise review of evidence for two 'energetic' approaches now widely used in nursing homes.

Healing Touch and Therapeutic Touch are widely used

Healing Touch (HT) and Therapeutic Touch (TT) are based on principles of energy medicine in which the healer is believed to influence the ‘energy field’ of the patient resulting in beneficial physiological and emotional changes. Whereas HT practitioners use light touch, TT practitioners typically have no direct physical contact with patients. Open studies and a limited number of double-blind trials suggest that both techniques have beneficial effects on agitated behavior in individuals with Alzheimer’s disease and other forms of dementia.

TT is widely accepted by nurses as an appropriate and effective treatment of agitation in individuals with dementia (Ashfeld 2011). Recent reviews support that there is evidence for beneficial effects of regular TT on reducing agitation in individuals with dementia (Kumarappah 2016; Fei-Fei 2015). In a double-blind study that included mock TT in the control arm, demented individuals with agitation were randomized to receive two brief TT or mock TT treatments daily for 3 days. Those who received TT exhibited significantly fewer behavioral symptoms of dementia, including reduced restlessness and fewer disruptive vocalizations, compared with individuals who received mock TT (Woods, Craven, & Whitney, 2005). Because this short study lasted only 3 days, it is impossible to generalize findings to possible long-term benefits of TT for agitation in demented patients.

In a small pilot study, measures of agitation were significantly improved in 14 demented residential patients who received 3 HT treatments weekly over a 4-week period (Wang 2006). Significantly, diminished need for sedating psychotropic medications was observed in three patients during the active treatment phase, and two residents required dose increases in the first 2 weeks after HT treatments were stopped. In a small sham-controlled study (Ostuni & Pietro, 2000; 2001) (see references below) two weekly 10- to 20-minute HT treatments were administered to nursing home residents with Alzheimer’s disease over a 5-week period. Those who received regular HT treatments had consistent reductions in the frequency of disruptive behaviors, and globally improved emotional and cognitive functioning including enhanced socialization, a more regular sleep schedule, improved compliance with nursing home routines, greater emotional stability, and improved communication with staff. Agitation as measured by the frequency and intensity of outbursts was significantly reduced in the HT group but did not change in the group receiving sham HT. Demented patients who received HT treatments complained of physical distress or discomfort significantly less often compared with patients in the sham control group.

Bottom line

Therapeutic Touch (TT) and Healing Touch (HT) are widely used to reduce agitation in individuals with dementia in nursing homes. Although many studies have reported beneficial effects of both approaches for this condition the significance of findings is limited by study design flaws including lack of blinding in many studies, likely beneficial confounding effects of frequent human contact, small numbers of enrolled patients in most studies, the lack of standardized methods for measuring outcomes, and the absence of sham control groups receiving mock HT or TT treatments in most studies. Large methodologically rigorous studies that include mock treatment arm and standardized outcome measures are needed to further investigate the benefits of TT and HT for agitated behavior in individuals with dementia.