Caregivers Can Use Acupressure to Help Dementia Patients Sleep Better
Editors note: the following contribution comes to us from our Director of Nursing, Jennifer M. Jarrett RN LAc OMD
There are many of us, in all different stages of our lives that have had difficulty sleeping at night. Whether because of worries, hormones, medications, or stress, not getting enough sleep can wreak havoc on our bodies. Our immune system can be affected, it can cause us to gain weight, and it can just plain and simply negatively affect our mood and ability to adapt to life’s daily challenges.
It is very common in persons with Alzheimer’s or other types of Dementia, to have difficulty falling asleep or remaining asleep. These people can have “sundowners” which means that later in the day or evening they become agitated and increasingly confused as their Dementia symptoms worsen.
Acupressure is a safe, non-drug modality that we, as caregivers for those with Dementia, can use to help our patients sleep better. Using similar principles to Acupuncture, Acupressure is more readily accepted because it is a hands on technique that does not use needles. The caregiver can use their fingertips to gently massage a few specific places on the forearm of the patient.
The two points that are easiest to use and least intrusive to the patient are He 7 and Per 6, which are referred to as “Spirit Gate” and “Inner Gate” in Chinese Medicine. (The spirit relates to the mood of a patient, if you will, as opposed to having a religious connotation.) These points are known to relieve anxiety, treat insomnia, and calm agitation and nervousness.
These Acupressure points are best treated when the patient is lying in bed getting ready to go to sleep. After you get the permission of the patient to touch them, sit down next to them and take their forearm into your non-dominant hand while using the dominant hand to massage the points.
He 7 is located on the underside of the wrist on the first crease where the hand meets the wrist. There is a bony protuberance at the pinky side of that crease and the point is just medial (towards the middle) to that bony protuberance. If you start at the outside (pinky side) of the inner wrist, and run your finger over that bony protuberance (toward the thumb side of the wrist), your finger will land in what feels like a divot or a hole. That is the point (He 7).
Per 6 is located on the underside of the wrist as well. If you locate the center point of the inner wrist, on that first crease where the hand meets the wrist, move up (toward the inner elbow crease) approximately 3 finger widths. That is the point (Per 6). There are small tendons there and the point is just between the two tendons that you can see and feel. Because of the location of these 2 points, it is more comfortable to use your thumb to massage the point, while your other fingers are on the opposite side of the wrist, helping you to apply the pressure.
After you locate each point, gently massage each one (one at a time and it doesn’t matter which one you massage first) using either a steady pressure or you can use a circular massaging movement staying on the point. You don’t want to cause pain, but usually the person will report a type of sensation that can be described as a gentle, "good hurt", or a strong pressure sensation. When using this technique on a Dementia patient, it will be particularly important to be sensitive about how much pressure you are applying. They may not be able to be entirely in touch with what you are doing, and may not be able to accurately describe whether it hurts "good," or is too much pressure. Go slowly and increase the depth of the pressure as tolerated.
Massage or hold the gentle pressure on each point for 3-5 minutes. Encourage the person to take a few slow deep breaths and close their eyes and relax.
Sleep medications are not without side effects and can be particularly troublesome for elderly patients and patients with Dementia. They can cause drowsiness at the wrong time, which can increase the likelihood of falling and contribute to difficulty in performing self-care and activities of daily living.
This acupressure technique is safe and easy and very effective at helping your Dementia patients get to sleep and remain asleep for longer periods of time.