With more hygienists using patient-centered approaches, is it time for you to add compassionate touch to your clinical practice?
Fall weather has arrived in Atlanta and it’s a welcome relief after a long, hot summer. I’m off work today, so I headed to Peachtree City where I visit my nail tech every few weeks for a gel or SNS manicure and a pedicure. The nail tech I see is probably one of best I’ve ever had and I credit her gentle and consistent pampering as a significant health benefit. Her soft smile is always there and when she massages my hands, I melt into the chair.
For those of you who loved Princess Diana as much as I did, many of us recognize how she used the power of touch to smash stigmas. During the 1987 AIDS epidemic, she did something truly shocking to many: she shook hands with an AIDS patient in London. That simple act of kindness and compassion reverberated around the world and calmed public fears at a time when the public feared catching the disease. Her brother, Charles Spencer, described Diana as very real about human contact and that her touch while visiting hospital patients of every kind was electrifying.
These are challenging times for practicing dental hygienists, many of whom are having to compromise quality care by working in “prophy mills” where substandard care is the norm. Instead of being able to focus on patient care, these hygienist-employees are no longer able to establish relationships with patients. Rather, insurance companies, administrators and coding specialists have taken over what happens in the operatory and they’re draining the energy available for purposeful care. For those hygienists who value having adequate time for each patient, modification of protocols is a welcome idea and something a hygienist can get excited about, especially when it results in stronger hygienist/patient relationships.
Effects of healing touch in clinical practice (energy-based)
Hands-on healing and energy-based interventions aren’t new; they’re rooted in Eastern healing practices. In the late 1980s, healing touch arose in the nursing profession and its birth is credited to a founder named Janet Mentgen, RN, BSN. In reading Janet’s bio, she’s been described as an energetically sensitive nurse whose drive was to deepen and expand the connection between nurses and their patients. She used various techniques and modalities and started honing her new skills in 1980. In 1988, she was awarded the Holistic Nurse of the Year award from the American Holistic Nurses Association. Janet revolutionized the medical model to include a clinical approach to energy-based therapy, and her legacy to nursing includes certification to students who wish to bring a holistic approach to healing. Healing touch is compassionate, heart-centered care and it compliments conventional healthcare. In reviewing the literature on healing touch, however, it’s unclear if energy-based therapy as a holistic approach to healing is unjustified by scientific evidence.
Healing touch can come in many forms
Dental hygienists are uniquely positioned in the community to change the dental hygiene model of care to one that focuses more on health, or even science, with less attention single-mindedly to profits. Dental hygiene entrepreneurs are showing us the way with tight budgets but a lot of passion and determination.
I recently talked to Joan Fitzgerald, RDH, BS, who established a home healthcare agency in 2014 dedicated to bringing skilled dental providers into the home healthcare space. Joan uses a patient-centered approach to care by initiating comprehensive dental assessments with her clients/patients and developing care plans that stabilize their oral health. Any urgent needs outside of her scope of practice are referred to a dentist.
Included in her design of patient-centered care is a philosophy of healing, which includes therapeutic touch. Homebound individuals face myriad issues, both medical and environmental, with isolation being a prominent factor. A warm smile, a gentle touch, a listening ear and a hug goodbye all coalesce toward healing even in the most difficult situation, such as patients experiencing sundowning as their dementia or Alzheimer’s diagnoses advance. Appointment times are flexible, allowing for wiggle room on either side to accommodate both a patient-centered care philosophy and the unique aspects of providing in-residence care.
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A trusted colleague, Richard Brooke, once advised Joan to read outside of her area of expertise to gain more perspective and knowledge. She began reading the Holistic Nursing Journal and delighted in the research outcomes in healthcare concentrated in this publication. She strove to include positive outcomes, like therapeutic touch, into her clinical protocols.
Joan is passionate about advancing clinical research demonstrating that direct access to dental hygienists using patient-centered care is both effective and good for dentistry and oral healthcare as a whole. By thinking outside the dental hygiene box, Joan has found an empowering and satisfying work environment. She controls her own schedule and works at her own pace.
Nurses who are certified in healing touch learn how to bring an individual’s energy fields into balance. There are many reported benefits such as decreased anxiety, pain, increased relaxation and a sense of well-being. Research demonstrates that healing touch may also be beneficial for some older adults within long-term facilities as an adjunct for chronic pain. Even though healing touch therapy in nursing isn’t supported by science, palliative dental hygiene care combined with therapeutic touch and the development of research proposals to test outcomes such as a reduction in agitation in dementia patients is worth pursuing.
Compassionate touch and hand massage in dental hygiene care
The power of healing touch is a topic dental hygienists don’t often think about, and in contemporary dental hygiene care, contact between a hygienist’s hand and a patient may be tough to come by. As more dental hygienists transition to community-based settings and away from private dental practices, care provision for older adults and adoption of person-centered dementia oral care practices will integrate non-pharmacologic approaches to meet the psychosocial and behavioral health needs of elders with dementia. Included in the mix of dental hygiene services will be compassionate touch.1
Focused touch, such as hand massage, communicates the intention to connect and meet someone in the moment without some kind of invasive and impersonal procedure. It’s a way to form a bond that deepens the relationship, builds trust and offers reassurance. Elders, especially those with dementia, want to feel cared for by staff who often become a substitute for family. According to caregiving research, caregivers report that focused touch changes how they view an elder from a deteriorating and very demanding patient to seeing the person behind the disease, like oneself.
Hand massage can provide any patient with significant health benefits. It’s quick, relaxing and in elders with dementia, it may be welcomed.1 A five-minute hand massage protocol has been shown to elicit a physiological relaxation response with decreased cortisol levels.1 Massage has also been shown to increase serotonin levels, increase alertness, improve sleep and decrease agitation.1
How can you learn to do a hand massage? All you need to do is enter the words “hand massage technique” into your search engine on your computer (or watch a video on YouTube) and voila! I first learned how to do a hand massage at the Atlanta GA Thomas P. Hinman Dental Meeting when I visited a dõTERRA exhibit booth and I quickly embraced the idea of applying a drop of essential oil in the palm of the hand first and then adding a suitable hand lotion. Here’s one of my favorite YouTube videos, thanks to JoAnn Greene, RDH, from dõTERRA. Visit https://www.doterra.com for additional information on AromaTouch hand technique.
Five minutes of hand massage can reduce anxiety and provide any willing participant with health benefits such as improved finger and wrist range of motion, enhanced circulation and reduction of trigger points. Touch creates a human bond that’s especially needed in our hands-off impersonal world. It can do so much more than words to comfort and reassure. Touching is essential to connecting and creates a healing bond for which there’s no alternative.
"Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around." - Leo Buscaglia