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M.J. Houmann1, J. Jensen2
1Næstved Kommune, Elderly, Næstved, Denmark, 2University College Copenhagen, Physiotherapy, Copenhagen, Denmark
Background: Nine out of 10 patients with dementia develop behavioral and psychiatric symptoms of dementia (BPSD), e.g., anxiety, depression, aggression, and sleep problems. BPSD negatively impacts the person’s functional level, well-being, and surroundings. Pharmaceutical treatment may improve patient outcomes, but severe negative side effects of current pharmaceutical treatments have led to an intensified search for non-pharmacological alternatives. In Denmark, a new physiotherapeutic treatment method (BBAUM) has been developed specifically to reduce BPSD.
BBAUM is inspired by Basic Body Awareness Therapy (BBAT) and like BBAT it aims to improve body- and self-awareness and mental health. In contrast to BBAT, BBAUM uses therapeutic touch instead of active therapeutic movements, as individuals with BPSD are generally unable to participate in active therapy. Moreover, patients and therapeutic practice are approached differently in BBAUM due to the patients’ often severe and progressive brain damage.
To exemplify the treatment concept and the potential benefits we will describe a case study.
BBAUM is inspired by Basic Body Awareness Therapy (BBAT) and like BBAT it aims to improve body- and self-awareness and mental health. In contrast to BBAT, BBAUM uses therapeutic touch instead of active therapeutic movements, as individuals with BPSD are generally unable to participate in active therapy. Moreover, patients and therapeutic practice are approached differently in BBAUM due to the patients’ often severe and progressive brain damage.
To exemplify the treatment concept and the potential benefits we will describe a case study.
Purpose: To investigate the impact of BBAUM in a person with severe dementia and BPSD.
Methods: The subject of this case study was a 72-years-old woman with severe Alzheimer living in a nursing home. The woman was selected because of her severe symptoms of depression, anxiety, aggression, hypersexuality, delusions, and sleep problems. BPSD severity was assessed using observations, interviews with caregivers, and a 24-hour behavioral registration of daily hours of sleep, calmness, anxiety, and aggression.
The woman received BBAUM treatment daily for two weeks in her home, in 20 minutes morning and afternoon sessions, and a 45 minutes session in the evening. Five different BBAUM touches were used. The touches are a combination of deep pressure massage and gentle facilitation in which the therapist works with the person’s vertical axis, center, respiration, body boundaries, feet, and mental presence. Communication during treatment is primarily nonverbal.
Therapeutic effects were evaluated using caregivers' and the BBAUM therapist's daily journal notes, interviews with the caregivers and the woman’s son, and changes in daily hours of sleep, calmness, anxiety, and aggression.
The woman received BBAUM treatment daily for two weeks in her home, in 20 minutes morning and afternoon sessions, and a 45 minutes session in the evening. Five different BBAUM touches were used. The touches are a combination of deep pressure massage and gentle facilitation in which the therapist works with the person’s vertical axis, center, respiration, body boundaries, feet, and mental presence. Communication during treatment is primarily nonverbal.
Therapeutic effects were evaluated using caregivers' and the BBAUM therapist's daily journal notes, interviews with the caregivers and the woman’s son, and changes in daily hours of sleep, calmness, anxiety, and aggression.
Results: We observed improved balance, respiration, and digestion as well as improved initiative, concentration, and verbal communication skills. Significantly, delusions, and hypersexual and aggressive behavior disappeared. The woman presented as being happier, and less stressed and hyperactive. She displayed fewer symptoms of insecure attachment behavior besides an improved ability to cooperate with the caregivers and interact with other people. Furthermore, daily hours of sleep increased by 34% and calmness by 51%, while daily hours of anxiety and aggression respectively decreased by 97% and 100%. These changes in presentation and behavior suggest a higher degree of mental balance, mental resilience, and secure attachment.
Conclusions: Our case study suggests that BBAUM treatment markedly reduced the patient’s BPSD and improved her functional level, mental health, and relational competences.
Implications: BBAUM is a clinically very promising treatment approach that is currently employed in multiple nursing homes across Denmark. However, evidence from clinical trials is highly warranted. The feasibility and potential benefits of BBAUM are currently investigated in a randomized feasibility trial (ClinicalTrails.gov identifier NCT05272501) in Denmark.
Funding acknowledgements: None
Keywords:
Dementia
BPSD
Therapeutic touch
Dementia
BPSD
Therapeutic touch
Topics:
Older people
Mental health
Community based rehabilitation
Older people
Mental health
Community based rehabilitation
Did this work require ethics approval? No
Reason: It was a single case study performed as part of the everyday rehabilitation in the nursing home. Verbal informed consent for the woman’s participation was given by her son.
All authors, affiliations and abstracts have been published as submitted.
