Soft massage for pain: an intervention study among older people with multiple illnesses living in care homes

The study is aimed at older people with multimorbidity and pain living in care homes. Multimorbidity means that the person has more than two diagnoses, for example Parkinson’s disease and heart failure. The World Health Organization (WHO, 2004) reports that pain is commonly occurring, extensive, disabling and difficult to diagnose in older people. The physiological explanation is that older people often have a changed perception of primary pain. Expressions of pain can, for example, be motoric anxiety or a state of confusion. Pain is described as a specific symptom where interventions are important for the older person’s quality of life, regardless of the nature of the pain (physical, psychological, social or existential).

Touch has always been described as important and sometimes crucial for how people communicate with each other. In many cultures, physical touch is evidence of affection, security and social belonging. Nursing staff often have specific knowledge and abilities in the creation of relationships and feelings of closeness in care situations through verbal and non-verbal communication (e.g. touch). Research in palliative care (end-of-life care) shows that when touch is offered as soft massage (SM), it has several positive effects, such as increased well-being and symptom relief in anxiety, pain and nausea. Soft massage is a collective term for methods that aim to use soft but firm strokes, light pressure, and circular movements of the skin’s superficial structures. Studies have identified so-called C-tactile (CT) nerves in the skin that specialise in sending signals to the brain during light touch to the skin. These specific nerve fibres that are found in hairy skin connect directly with the part of the brain that controls emotions. Touch that is applied using slow and recurring strokes on the skin stimulates the CT nerves and leads to a pleasant feeling. The aim of the study is to investigate the effects of SM with a focus on pain and well-being in older people with multiple illnesses who are living in care homes.

Scientific research questions:

• What effects does SM have on the autonomic functions of older people with multiple illnesses?
• Does SM have pain-relieving effects in older people with multiple illnesses?
• How do older people experience receiving SM when in pain?
• Does the older person perceive that SM affects well-being, and if so how?

Expected result: Stimulation of CT fibres by touch and SM can have normalising effects on the heart rate and blood pressure and contribute to pain relief, improved sleep and increased well-being compared to a control group.