Saturday, April 3, 2021

As more people get vaccinated, the opportunity to reconnect with others increases; experts talk about why touch is so important

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By Melissa Patrick
Kentucky Health News

After a year of pandemic-forced isolation, when the simple act of touching became dangerous almost overnight, the arrival of highly effective vaccines means it's OK for fully  vaccinated people to touch again — and experts say it's important we do. 
That's because touching is how we show each other compassion and love, and because it is necessary for our physical, mental and emotional health, said Joe D'Ambrosio, a licensed clinical social worker in Louisville.

"Weighing the responsibility that we have to not increase Covid in this pandemic against human needs, I think that is the balance that we have to make," said D'Ambrosio, who is also a licensed marriage and family therapist, a lawyer and an assistant professor at the University of Louisville School of Medicine.

D'Ambrosio said he has encouraged his clients throughout the pandemic to put on a mask and hug the people to whom they are regularly exposed. "I think that we have to be wise, we have to assess each situation and maybe even risk a bit to care for yourself and care for one another," he said. "We can't always live in a bubble. That's not going to work." 

Other opportunities for touch

D'Ambrosio acknowledged that many people are still scared to touch each other, even if they are fully vaccinated. For them, he advises finding other ways to get that tactile experience. For example, he encouraged them to regularly hug their pets, get a massage or take a warm bath and sleep under a weighted blanket.

There is even value in simply hugging yourself, said D-Ambrosio and Jill Cole, massage therapy coordinator at UK HealthCare's Integrative Medicine and Health. As we wait on restrictions in touch and social distancing to be lifted, and "are able to come back together, I think it's important that we think about opportunities for touch," she said. "The first thing we can do is just simply give ourselves a hug. I know that may sound a little hokey, but that is a form of touch." 

Healthline has reported the benefits of giving yourself a hug, including research showing it can relieve pain, help you feel safe and secure, improve your mood and increase self-compassion. The article also offers instructions on how to do it, titled, "Self-Hugging 101." 

Cole also encouraged people to seek out safe, therapeutic massage as part of their self-care during the pandemic. Information about whether a massage therapist is licensed and in good standing with the state can be found on the Kentucky Board of Massage Therapists website, she said. 

"Touch is important because it's inherent to who we are as humans. We have a significant need to receive and to give touch," she said, later adding, "Touch helps us physiologically, it helps us emotionally, it helps us spiritually, it definitely helps us physically."

Technology can also help seniors stay connected to their loved ones. Sheri Rose, CEO of the Thrive Center,  a nonprofit senior-innovation center in Louisville, said it has a pilot program with Louisville's Nazareth Home that uses larger than normal tablet devices that can connect Facebook to Alexa, with the goal of increasing social connectedness between residents and families.

But while such things as artificial intelligence and robotics can help seniors age in place and stay connected, she said, "Nothing will replace the person being there, and that human touch." 

Why touch is important

Touch is required for human survival, just as food and water is, Tiffany Field, director of the Touch Research Institute at the University of Miami, told The Economist, which summarized: "It is the first sense to develop and the only one necessary for survival. We can live with the loss of sight or hearing. But without touch, which enables us to detect such stimuli as pressure, temperature and texture, we would be unable to walk or feel pain. Our skin is the vehicle through which we navigate the world."

As for living in a world where we never shake hands again, as Dr. Anthony Fauci suggested early in the pandemic to slow the spread of the coronavirus, D'Ambrosio said he hopes it never comes to that. 

"When I heard him say that, I thought, 'No, don't say that. Don't, because touching is probably one of the most important things that we could do in life because our skin is the largest organ that we have and there's so much research that shows what touching does to the body, how the body reacts to it," he said.
 
For example, he said touch decreases cortisol levels, a hormone produced in response to stress. It decreases blood pressure, and it lowers a heart rate. It releases oxytocin, a hormone associated with connection and empathy. He also pointed to studies that show an absence of touch in infants can have a negative effect on their growth and their ability as adults to have proper attachment. 

Cole added that research shows massage helps to calm a person's nervous systems, decreases their pain and anxiety and has had some impact on nausea. 

Social isolation, touch and seniors

The pandemic's forced isolation and the lack of touch have been especially hard on those living in long-term care and assisted living facilities.

Tammy Roberts, a licensed practical nurse at Masonic Home Shelbyville, told the story of a lady in her facility who broke down and said she just really needed to be hugged and when Roberts sat down next to her she leaned over and laid her head on her chest and "wrapped her arms around me really tight."

"I do think that is something that each and every one of them needs, a sense of touch. You know, we all do," she said. "I think there is a sense of isolation when you go so long without that human interaction and touch." 

Roberts said some residents  couldn't understand why their family members quit coming to see them, and felt abandoned. When restrictions on visitation were lifted, she said, "Some were very excited, some just couldn't even believe it. You know, it had been so long they just couldn't even believe it."

Kentucky relaxed some of its visitation restrictions at assisted living facilities and other types of group living homes in mid-February, two months after starting vaccinations and giving priority to residents of long-term-care facilities. A month later, it did the same for federally regulated nursing homes, also allowing them to return to group activities and congregate dining. 

WDRB tells the story of the reunion of  a long-term care 
resident at Nazareth Home in Louisville who was finally 
able to reunite with his wife after spending a year apart. 
Even residents who don't have family members are "reconnecting with their buddies. . . . so we're already seeing just the change in mental status, just incredibly, you can just feel it in the air when you walk through," said Karen Venis, chief executive officer of Sayre Christian Village in Lexington. She said, "It just feels so much more like normal, and that's all we're looking for."

Venis said the last year has been "very difficult on all levels" for residents, families and staff. "The connections that are made with family members, and those hugs, are hard for us to fill in those gaps," she said. "We've done as many things as we could to still let love in. We've done virtual visits and window visits, but that sense of touch, there's really nothing you can do to fill that void."  

Laurie Dorough, executive director of Daisy Hill Senior Living in Versailles, said she considers her staff "physicians of the spirit" whose job is to serve, love and minister to their residents. And because of that philosophy and also because they recognized the importance of touch, "We often suited up in PPE and just gave hugs."

Dorough said the new visitation rules have given her residents back their independence, to have fellowship and leave the facility if they choose. "I can definitely tell that the morale in all the residents is much stronger," she said. All her residents have been vaccinated, she said, but as a precaution they ask everyone to wear a mask when socializing unless they are eating.

D'Ambrosio said he understands the public-safety rationale for denying seniors visitation, but wonders about the long-term effects. 

"I watched a number of my clients that I have that are older deteriorate over the year because of loneliness and social isolation and lack of touch. They did not prosper. They deteriorated," he said. "And it wasn't normal aging, it was different than normal aging. It was from the lack of connection, lack of connectivity." 

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