The Sense of Touch
By: Barbara Cavanagh, R.N., B.S.N.
LILIPOH MAGAZINE
In life we generally associate massage with care, affection and the expression of love and compassion. One might assume that every dying person would he grateful for a massage. This is not always so.
The sense of touch is something we need on earth so that we can feel ourselves to be separate beings. As a person nears the threshold of death of the physical body, the sense of touch as therapy is no longer very useful, because it is so dependent on one's presence in the physical body to be perceived. Other senses, those less connected with the physical body, become more important to the dying person.
Because the goal is to ease the way towards death or life, as the person must be left free to choose, the touch that is generally most helpful is one which supports breathing; in, and breathing out. Ultimately the dying person breathes out into the nonphysical, spiritual realm, when it is his or her time.
As an exerciser place your warm hand gently on your own opposite arm, letting the middle of your hand touch first—as gently as a falling leaf. Allow the whole hand to rest there in full contact, radiating its warmth, without pressing down, in a mood of peace and inner quiet. Imagine that you can feel, ever so silently, the ebb and flow of tides under your hand. Then imagine that your hand and arm are one. Your hand hardly moves. It is ever so slightly in the gesture of a wave, or in the gesture of an in-breath and an out-breath.
This is a wonderful exercise to practice on another person's arm, leg, hand, foot, back, belly or chest. Practice first on those who are not ill. It is described here as one quality of touch that can ease breathing. It can also be a refreshing way to hold the hand of another.
Those who have a training in Rhythmical Massage according to the insights of Dr. Ita Wegman, learn specific techniques for easing the breathing. These are varied and can be done by trained practitioners around the chest or on other parts of the body. The duration of treatment is very short, one to three minutes,
The treatments are kept short because we cause the patient to use part of his or her vitality to process or “digest” the stimulation we have created for the skin—that largest sense organ of the body. That's why, as a rule, the treatments should be short, gentle and purposeful. Those who can still communicate generally dislike strong, pressing, “busy” gestures.
What is important is to discover how touch can be helpful and to touch carefully, knowing that very often "less is more." In this way, one can individualize the care of the dying.
Under other circumstances, another kind of treatment can help. This is usually only when the person is not immediately close to the moment of death. Some years ago I had been called to my patient, Peggy R., who was terminally ill with breast and bone cancer. Her family, who respected her desire to avoid addiction to drugs, was now concerned that her suffering was severe, yet she was refusing medication. I came to her house to do a nursing assessment and to collaborate with her doctor.
Peggy looked weary and exhausted and was barely responsive when I arrived. I silently asked her permission to apply some rose oil, hoping it would give some small comfort. I listened for a feeling of a no, and didn't sense any resistance at all. So I proceeded to smooth on a small amount of rose oil all over her body, starting at the neck, going towards the feet. Although there are special home care courses where one can learn the specifics, in general the oil is applied in a very soft, round way, as if putting the oil on an infant's bottom. I only did this on areas that I could reach without disturbing Peggy's position. It took less than ten minutes.
Peggy's color improved, her cheeks became rosy. The rhythmical embrocation treatment had warmed and awakened her. Then I said, "Peggy, now I need to know about your pain."
"What pain?" she replied.
"Why, the pain that you've had all night long, that your family called me here to evaluate."
"I don't have any pain, you took it all away with your oil," answered Peggy.
"How can that be?" I said, astonished.
"I don't know. I feel wonderful."
Peggy spent the next two hours with her family. As she grew tired, she asked to be read the Beatitudes. She liked having her daughter's hand upon her. After awhile she didn't want it. And then she could leave in peace.
In another instance, Diane W., ill with cancer of the kidney, was restless. She felt that she was burning up and wanted air conditioning and fans blowing on her. She had been feeling sad and alone but when anyone touched her, she felt as if she couldn't get enough air. Her grown children wanted to massage her and show their affection, so she could feel their love and support. But she couldn't stand it.
In this situation massage was not helpful at all. As an alternative, I considered the problem Diane was having with temperature and air hunger, and decided to try compresses instead. I prepared some hand towels wrung out completely dry after dipping into a bowl of very hot water with a few drops of lemon bath added. I put one compress on her belly, then one on her chest because that's where she wanted it. I alternated these with compresses on the thighs at other times, covering the compress with a piece of wool. Diane fell asleep, deeply comforted and breathing more easily. The children and I took turns giving these compresses to her daily in the last days of her life.
Barbara Cavanagh is the Executive Director of the School for Rhythmical Massage. She can be contacted at (610) 948-5269.