A person's sense of touch may vary and may be affected by their medical diagnosis. If they have had a cerebral vascular accident or an acquired brain injury, their sensation maybe affected. One side maybe more affected than the other. Approach the person from their better side first and then alternate to their affected side. Note their response. Did the person's facial expression change as a result of the sensation. Do they appear more relaxed after the sensation?
Different textures produce various touch sensations like smooth, rough, slippery, furry, fluffy, bumpy, squishy, etc.
Changes in temperature also produce different touch sensations with hot versus cold sensations. We generally are drawn to a temperature range that allows our cells to function. Homeostasis exists at this level. Placing ice on someone can cause someone to pull away from the cold unless it is a hot day and they are trying to cool down. When a person is functioning in ACL 1 Low the use of warm temperatures like from a heated towel maybe very comforting and maybe used to help settle someone before bedtime. Heated towel machines are used in neonatal units to comfort and warm new born babies.
Within ACL 1 Low, you or other caregivers do all of the touching and rubbing.
Alerting cues may include:
- a wet wash cloth to the face and hands,
- a gentle but firm shake of their shoulders,
- rubbing body lotion on their arms and legs,
- oral swab on the gums of their teeth,
- ice on their hands and face,
- hand warmers,
- gently rubbing abrasive, soft, furry textures or vibrators on their arms and hands.
Sensory stimulation that consists of a sequence of touching sensations, tailored to individual preferences, can become a five-minute activity that a family member, friend or volunteer can do when they come to visit.
Stroking with different textures, fabrics and brushes can either excite or calm the person. Be careful not to use a cold hand on the person, which can trigger a startle reaction. Check the warmth of the hands of family members, friends and volunteers. When they are cold, heated towels or warm water may help them too.
Frozen oral swabs may be used to get someone's attention. Once the swab warms up they can be used to clean the mouth and tongue. Gentle massages to the face and cheeks will assist with relaxing the jaw during oral care. Family members can assist with this when they come to visit. If so, they should record it in the visitor's book so that the nursing assistant knows that it has been done.