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“Mãos de Conforto” (Hands of Comfort): A novel non-pharmacological intervention to ease agitation in elderly persons with dementia

Published online by Cambridge University Press:  15 February 2023

Miguel Julião Open the ORCID record for Miguel Julião [Opens in a new window] ,
Eduardo Bruera Open the ORCID record for Eduardo Bruera [Opens in a new window] ,
Carina Silva ,
José Calado ,
Mário Cruz ,
Marília Vaz  and
Bianca Sakamoto Ribeiro Paiva Open the ORCID record for Bianca Sakamoto Ribeiro Paiva [Opens in a new window]
Miguel Julião*
Affiliation:
Department of Palliative Medicine, Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Rio de Mouro, Portugal Inválidos do Comércio IPSS, Lisboa, Portugal
Eduardo Bruera
Affiliation:
Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Carina Silva
Affiliation:
Inválidos do Comércio IPSS, Lisboa, Portugal
José Calado
Affiliation:
Inválidos do Comércio IPSS, Lisboa, Portugal
Mário Cruz
Affiliation:
Inválidos do Comércio IPSS, Lisboa, Portugal Escola de Psicologia e Ciências da Vida, Universidade Lusófona, Lisboa, Portugal USF Tapada, ACeS Sintra, Sintra, Portugal
Marília Vaz
Affiliation:
Inválidos do Comércio IPSS, Lisboa, Portugal
Bianca Sakamoto Ribeiro Paiva
Affiliation:
Research Group on Palliative Care and Health-Related Quality of Life, Barretos Cancer, Hospital – Barretos (SP), São Paulo, Brazil
*
Author for correspondence: Miguel Julião, Department of Palliative Medicine, Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Rio de Mouro, Sintra 2635-364, Portugal. Email: migueljuliao@gmail.com
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Abstract

Behavioral symptoms associated with dementia, such as agitation, are frequent and associated with well-known negative consequences for patients, their carers, and their environment. Pharmacological treatments for agitation using sedatives and antipsychotics are known to have several undesirable side effects and modest efficacy. Non-pharmacological alternatives are recommended as first-line options for agitation in persons with dementia with few side effects, but there is limited evidence of efficacy. We developed a novel and simple non-pharmacological alternative for agitation in dementia residents based on a Brazilian intervention using warm water surgical gloves used in patients with COVID-19 in intensive care units during the pandemic. We coined it “Mãos de Conforto” – Hands of Comfort. We report a series of 7 cases in 3 residents with dementia who whore Hands of Comfort.

Keywords

Non-pharmacological interventionWarm water glovesAgitationElderlyDementia
Type
Case Report
Information
Palliative & Supportive Care , Volume 21 , Issue 5 , October 2023 , pp. 946 - 952
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Copyright
© The Author(s), 2023. Published by Cambridge University Press.

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References

AGS Choosing Wisely Workgroup (2014) American Geriatrics Society identifies another five things that healthcare providers and patients should question. Journal of the American Geriatrics Society 62(5), 950–960. doi:10.1111/jgs.12770CrossRefGoogle Scholar
Bruera, E, Sweeney, C, Willey, J, et al. (2003) Perception of discomfort by relatives and nurses in unresponsive terminally ill patients with cancer: A prospective study. Journal of Pain and Symptom Management 26(3), 818–826. doi:10.1016/S0885-3924(03)00286-0CrossRefGoogle ScholarPubMed
Cerga-Pashoja, A, Lowery, D, Bhattacharya, R, et al. (2010) Evaluation of exercise on individuals with dementia and their carers: A randomised controlled trial. Trials 11, . doi:10.1186/1745-6215-11-53CrossRefGoogle ScholarPubMed
Chen, RC, Liu, CL, Lin, MH, et al. (2014) Non-pharmacological treatment reducing not only behavioral symptoms, but also psychotic symptoms of older adults with dementia: A prospective cohort study in Taiwan. Geriatrics & Gerontology International 14(2), 440–446. doi:10.1111/ggi.12126CrossRefGoogle Scholar
Cohen-Mansfield, J and Billing, N (1986) Agitated behaviors in the elderly. I. A conceptual review. Journal of the American Geriatrics Society 34, 711–721. doi:10.1111/j.1532-5415.1986.tb04302.xCrossRefGoogle Scholar
Cooper, C, Marston, L, Barber, J, et al. (2018) Do care homes deliver person-centred care? A cross-sectional survey of staff-reported abusive and positive behaviours towards residents from the MARQUE (managing agitation and raising quality of life) English national care home survey. PLoS One 13(3), . doi:10.1371/journal.pone.0193399CrossRefGoogle Scholar
Costello, H, Walsh, S, Cooper, C, et al. (2019) A systematic review and meta-analysis of the prevalence and associations of stress and burnout among staff in long-term care facilities for people with dementia. International Psychogeriatrics 31(8), 1203–1216. doi:10.1017/S1041610218001606CrossRefGoogle ScholarPubMed
Cunha, S, Santos, M and Formenton, V (2021) Técnica em enfermagem de São Carlos ‘ampara’ mão de paciente intubada com luvas cheias de água morna. g1. https://g1.globo.com/sp/sao-carlos-regiao/noticia/2021/03/23/tecnica-em-enfermagem-de-sao-carlos-ampara-mao-de-paciente-intubada-com-luvas-cheias-de-agua-morna.ghtml (accessed 15 December 2022).Google Scholar
de Oliveira, AM, Radanovic, M, de Mello, PC, et al. (2015) Nonpharmacological interventions to reduce behavioral and psychological symptoms of dementia: A systematic review. BioMed Research International 2015, . doi:10.1155/2015/218980CrossRefGoogle ScholarPubMed
Draper, B, Snowdon, J, Meares, S, et al. (2000) Case-controlled study of nursing home residents referred for treatment of vocally disruptive behavior. International Psychogeriatrics 12, 333–344. doi:10.1017/S1041610200006438CrossRefGoogle ScholarPubMed
Finkel, S (2000) Introduction to behavioural and psychological symptoms of dementia (BPSD). International Journal of Geriatric Psychiatry 15(supplement 1), S2–S4. doi:10.1002/(sici)1099-1166(200004)15:1+<s2::aid-gps159>3.0.co;2-33.0.CO;2-3>CrossRefGoogle ScholarPubMed
Fjelltun, AM, Henriksen, N, Norberg, A, et al. (2009) Functional levels and nurse workload of elderly awaiting nursing home placement and nursing home residents: A comparative study. Scandinavian Journal of Caring Sciences 23, 736–747. doi:10.1111/j.1471-6712.2008.00672.xCrossRefGoogle ScholarPubMed
Gauthier, S, Rosa-Neto, P, Morais, JA, et al. 2021 World Alzheimer Report 2021, Abridged version: Journey through the diagnosis of dementia. London, England: Alzheimer’s Disease International, .Google Scholar
Gill, SS, Bronskill, SE, Normand, SL, et al. (2007) Antipsychotic drug use and mortality in older adults with dementia. Annals of Internal Medicine 146(11), 775–786. doi:10.7326/0003-4819-146-11-200706050-00006CrossRefGoogle ScholarPubMed
Harrad, R and Sulla, F (2018) Factors associated with and impact of burnout in nursing and residential home care workers for the elderly. Acta Biochimica 89(7-S), 60–69. doi:10.23750/abm.v89i7-S.7830Google ScholarPubMed
Kar, N (2009) Behavioral and psychological symptoms of dementia and their management. Indian Journal of Psychiatry 51(Suppl1), S77–S86.Google ScholarPubMed
Livingston, G, Kelly, L, Lewis-Holmes, E, et al. (2014) A systematic review of the clinical effectiveness and cost-effectiveness of sensory, psychological and behavioural interventions for managing agitation in older adults with dementia. Health Technology Assessment 18(39), 1–226. doi:10.3310/hta18390CrossRefGoogle ScholarPubMed
Melo, L (2021) Técnica da ‘mãozinha,’ criada por enfermeira para dar conforto a pacientes com Covid, viraliza: ‘Foi em momento de desespero’. g1. https://g1.globo.com/rj/rio-de-janeiro/noticia/2021/03/23/tecnica-da-maozinha-criada-por-enfermeira-na-zona-norte-do-rio-para-dar-conforto-a-pacientes-com-covid-viraliza-foi-em-momento-de-desespero.ghtml (accessed 15 December 2022).Google Scholar
O’Connor, CM, Clemson, L, Brodaty, H, et al. (2014) Use of the Tailored Activities Program to reduce neuropsychiatric behaviors in dementia: An Australian protocol for a randomized trial to evaluate its effectiveness. International Psychogeriatrics 26(5), 857–869. doi:10.1017/S1041610214000040CrossRefGoogle ScholarPubMed
Pelletier, IC and Landreville, P (2007) Discomfort and agitation in older adults with dementia. BMC Geriatrics 7, . doi:10.1186/1471-2318-7-27CrossRefGoogle ScholarPubMed
Royal College of Nursing, Dementia (2006) Supporting people with dementia and their careers in health and social care. London, UK: National Institute for Health and Clinical Excellence. http://www.scie.org.uk/publications/misc/dementia/dementia-guideline.pdf?res=true (accessed 15 December 2022).Google Scholar
Schneider, LS, Dagerman, K and Insel, PS (2006) Efficacy and adverse effects of atypical antipsychotics for dementia: Meta-analysis of randomized, placebo-controlled trials. The American Journal of Geriatric Psychiatry 14(3), 191–210. doi:10.1097/01.JGP.0000200589.01396.6dCrossRefGoogle ScholarPubMed
Watt, JA, Goodarzi, Z, Veroniki, AA, et al. (2019) Comparative efficacy of interventions for aggressive and agitated behaviors in dementia: A systematic review and network meta-analysis. Annals of Internal Medicine 171(9), 633–642. doi:10.7326/M19-0993CrossRefGoogle ScholarPubMed
Woodhead, EL, Northrop, L and Edelstein, B (2016) Stress, social support, and burnout among long-term care nursing staff. Journal of Applied Gerontology 35, 84–105. doi:10.1177/0733464814542465CrossRefGoogle ScholarPubMed
Yang, MH, Lin, LC, Wu, SC, et al. (2015) Comparison of the efficacy of aroma-acupressure and aromatherapy for the treatment of dementia-associated agitation. BMC Complementary and Alternative Medicine 15, . doi:10.1186/s12906-015-0612-9CrossRefGoogle ScholarPubMed