Elder care with a human touch

French method in spotlight for treating patients with dementia

by Sawako Obara

Kyodo

Humanitude, a caregiving method developed in France that emphasizes eye contact, touch and verbal communication to convey respect for the patient as a human being, is gaining attention in Japan for treating patients with dementia.

Tokyo Medical Center in Meguro Ward, one of the hospitals adopting the Humanitude method, provides seminars for caregivers to expand its use.

In a videotape shown at one such seminar, two nurses took a female patient with dementia to a shower. One nurse approached the woman from the front, looked at her at eye level and kept speaking to her gently while the other nurse washed her body with warm water.

The woman in her 70s, who was said to have screamed and refused to take a shower, was cooperative and remained calm, and even said that “the water temperature feels good.”

The approach, with its name deriving from “human” and “attitude,” was developed about 30 years ago by Yves Gineste, who taught physical education, and his colleagues based on the philosophy of “what is humanity.”

The four basic pillars in the method are to look into the eyes of the patients, talk to, touch and help them stand upright.

More specifically, particularly for elderly people with dementia, this means approaching from the front to avoid startling the patients, who tend to have a narrow range of vision; looking at them at eye level; telling them the procedures being conducted even if there is no response; avoiding gripping the patients’ wrists from above; and helping them stand upright or walk.

There were remarkable scenes in the videotape that were taken in February last year when Gineste visited Tokyo Medical Center.

He took care of a female patient in her 80s who had been unable to speak and was bedridden for half a year with crooked joints. While gently talking to her through an interpreter he helped her with personal care. After about one hour, she stretched her arms and legs by herself, and even said, “Thank you.”

In another example given at the seminar, a female patient unable to eat due to mouth inflammation would react violently every time the nurses tried to apply medicine. But when they tried with the Humanitude approach, the woman in her 80s opened her mouth to let them put on the ointment. She even started applying the medicine by herself from the next time, and was able to eat by herself after a week.

The medical center introduced the Humanitude method in response to an increase in dementia patients who are hospitalized for other illnesses. Such patients can’t comprehend why they are there and what kind of medical treatment they are undergoing.

“Anybody can learn from these techniques to convey gentleness and kindness,” said Miwako Honda, a doctor at the center and a speaker at the seminar.

While some may wonder if the method is time-consuming, Honda said: “Since the method enables us to get the patients to cooperate, in the end the tasks can be done in a short period. It also makes the job more satisfying for the nurses and caregivers.”

In France, the Humanitude approach is even starting to be introduced by some in the service industry, she said.

Apart from Humanitude, there are other methods from overseas for caring for dementia patients, such as Validation Therapy in the United States, which focuses on accepting and “agreeing” with the patient, and the Swedish Taktil Care, which uses hand massages to help patients calm down.

Naoko Tsumura, an associate professor of clinical pedagogy at Kansai University of Welfare Sciences, said: “People with dementia respond sensitively to how they are being treated. It’s important for the caregiver to convey the feeling that ‘I accept who you are and share your pain.’ “