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Regular
acupressure can significantly reduce agitated
behavior in dementia
Acupressure can
significantly reduce agitated behaviour in older
patients with dementia, according to a study
published in the February issue of the UK-based
Journal of Clinical Nursing.
Researchers at the
National Yang-Ming University in Taiwan found that
providing 15-minute treatment sessions twice a day
for five days a week yielded considerable benefits,
including reductions in verbal and physical attacks
and wandering.
But once the
four-week treatment period ended, agitation levels
started
to rise again, suggesting that acupressure
needs to be provided on an ongoing basis.
20 patients were
studied over six weeks, including one week before
the treatment started and one week after it
finished. All lived in dementia special care units
at a long-term care facility.
70 per cent of the
patients suffered from severe behavioural
disturbances, with a further five per cent suffering
from extremely severe impairment. The remaining 25
per cent were classed as medium.
An average
pre-treatment score of just over 79 was recorded on
a specialist scale developed to measure agitation
levels. After four weeks' treatment this had fallen
to just under 60.
Pre-treatment
agitation was highest in the 65-59 and 80 plus age
groups (82 and 97 respectively) and in males (83).
"Agitated
behaviour in people with dementia is a major concern
for caregivers" says co-author Professor Li-Chan Lin
from the Institute of Clinical Nursing at National
Yang-Ming University, Taiwan. "It can endanger
patients and others, make it necessary for them to
be moved from familiar surroundings and demoralise
and psychologically distress caregivers.
"People are living
longer and, as a result, we face increased numbers
of people with dementia. It is very important that
we find interventions that enable us to provide more
effective care for them, both in their own home and
in long-term care facilities."
During the study,
carried out with colleagues from the University,
different types of agitation were measured on a
specialist scale.
In week one,
before the acupressure treatment began, physical
attacks were given an average score of 5.53. These
included pushing, beating, scratching and pinching.
Agitation levels
were measured daily and by week two, when the
treatment began, the physical attack score had
fallen to 1.46. By week five, the last week of
treatment, the score had fallen to 0.53. In week
six, when the treatment had stopped, the figure rose
to 2.17.
Verbal attacks,
which included repeated questioning and shouting,
showed a pre-treatment score of 2.81 in week one,
0.54 in week two and 0.29 in week five. By week six
it had risen to 1.36.
Similar patterns
were recorded for non-physical and non-verbal
agitation, which included wandering, stealing,
undressing and tearing things.
Wandering
aimlessly was measured using pedometers. This
reduced from an average of 5,368 steps a day in week
one to 2,611 in week five. By week six it had risen
again to 3,374.
Patients received
acupressure based on five key pressure points –
Fengchi (GB 20), Baihui (Du 20), Shenmen (He 7),
Niguan (Pe 6) and Sanyinjiao (Sp 6) – after a short
warm-up session which consisted of holding, rubbing
and pressing the palms and finger joints on both
hands.
Each acupressure
point was pressed for two minutes using three to
five kilograms of pressure.
"Our study showed
that providing patients with acupressure twice-daily
for five days a week significantly reduced agitated
behaviour and wandering" says Professor Lin.
"This has
important implications for the future care of
dementia patients as it provides an effective option
that, following training, can be carried out at home
or in long-term care facilities."