Massage therapy for management of agitation in nursing home residents with cognitive impairment

This was a prospective study of massage in the management of agitation in cognitively impaired nursing home residents. Methods - Subjects were identified as susceptible to agitation by nursing home staff or by Minimum Data Set (MDS) report. Subjects served as their own controls; data was collected during baseline (3 days), intervention (6 days) and at 7 and 14 day follow up. Agitation was measured with a scale using 5 MDS items: Wandering, Verbally Agitated/Abusive, Physically Agitated/Abusive, Socially Inappropriate/Disruptive, and Resists Care. Nursing home staff identified the hour when each subject was typically agitated; that hour was used for observations (whether or not the subject was agitated on the day of observation). On each day of observation, agitation was scored over a one-minute period five times during the one-hour window of observation. Results – Subjects' agitation was significantly lower during the massage intervention than at baseline (2.58 vs. 1.71, p < .001), and remained lower at follow up. Of the five agitated behaviors examined in this study, massage was associated with significant improvement for three: Wandering (0.58 vs. 0.16, p = .009), Verbally Agitated/Abusive (0.87 vs. 0.53, p = .024), and Physically Agitated/Abusive (0.85 vs. 0.71, p < .001). Baseline levels of agitation were low, as the period of observation was predetermined by prior patterns of agitation. Conclusions – Massage is an inexpensive, easily learned intervention that is effective in controlling some types of agitation in elders with cognitive impairment. Massage should be studied further as a non-pharmacological intervention in such patients.