Massage in the Management of Agitation in Nursing Home Residents with Cognitive Impairment

This was a prospective study designed to examine the potential of massage to reduce agitation in cognitively impaired nursing home residents. Subjects were identified as susceptible to agitation by nursing home staff or by Minimum Data Set (MDS) report. Data was collected during baseline (3 days), intervention (6 days), and at follow-up. Five aspects of agitation were assessed: Wandering, Verbally Agitated/Abusive, Physically Agitated/Abusive, Socially Inappropriate/Disruptive, and Resists Care. At each observation, agitation was scored 5 times during the 1-hour window of observation. Subjects' agitation was lower during the massage intervention than at baseline (2.05 vs. 1.22, P < .001), and remained lower at follow-up. Of the 5 agitated behaviors examined in this study, massage was associated with significant improvement for 4: Wandering (0.38 vs. 0.16, P < .001), Verbally Agitated/Abusive (0.59 vs. 0.49, P = .002), Physically Agitated/Abusive (0.82 vs. 0.40, P < .001), and Resists Care (0.10 vs. 0.09, P = .022). When analysis was restricted to residents with significant levels of agitation at baseline, the observed effects of massage on agitation increased. Massage is an accessible, easily learned intervention that is effective in controlling some types of agitation in elders with cognitive impairment. Massage should be studied further as a nonpharmacological intervention in such patients. (Geriatr Nurs 2009;30:108-117)