a Successful Research Project - short report
The research institute of CS Caritas Socialis financed a small study on Shiatsu for people with dementia, in cooperation with the International Academy for Hara Shiatsu in 2018. The challenge of finding a suitable scientific methodology has led to a collaboration with Dr. Kristina Pfeifer an the Shiatsu-Research-Network.
This pilot study was conceived on the basis of a concrete research contract, as there were no or hardly any known and usable research results on the subject of Shiatsu for the elderly and people with dementia. It was necessary to find an open question in order to adequately cover the many possible effects of Shiatsu on dementia. Generating only a few hypotheses and then testing them with a quantitative research logic would not have been able to capture the actual spectrum of effects. Therefore, a methodically triangulating, qualitative and participatory research design was developed for data collection. The leading question was:
To what extent can Hara Shiatsu contribute to the quality of life of residents in old age and especially of those suffering from dementia?
We did a case study, where seven very old and dementia-affected residents received a series of eight Shiatsu treatments from three Hara Shiatsu practitioners on a weekly basis. Depending on the client's degree of mobility treatments were either on the Shiatsu mat, or wheelchairs. Three of them were mainly bedridden, so that their treatments took place in bed. Andrew Couse, Trainer at the International Academy for Hara Shiatsu, was in charge of the strategic and professional design and coordination of the Hara Shiatsu applications. Maria Schwaiger, was responsible for the overall coordination and scientific management of the research project.
By setting up a small research team, consisting of 5 social work trainees, a density of data collection methods could be achieved. These were:
1. Participative observations with logging. 2. Partially structured interviews with clients before and after the 8-partShiatsu series. 3. Photo documentation of Shiatsu treatments. 4. Treatment protocols of the Hara Shiatsu practitioners.
5. Excerpts from internal nursing documentation.
6. Group interview with 13 participants from three location perspectives.
7. EPCA - scale for pain assessment for people with dementia.
The participatory character of the research project was maintained through the best possible inclusion of the subjective perspective of the residents, thus making them more than mere objects of the research. The nursing and care personnel were given the opportunity to experience Shiatsu themselves in advance. The trainees, as a research team, were offered the opportunity to experience Shiatsu themselves after their observations. At a one-day moderated evaluation workshop, all partial results of a working group consisting of 18 partly heterogeneous stakeholders were made available for intersubjective processing and communicative validation. The questions of the evaluation were directed at the level of the individual as well as the institution. Finally, various possibilities for further cooperation were discussed. The results were analysed in an evaluation workshop on the individual as well as on the institutional level.
Preliminary evaluation of Shiatsu's positive effects:
increased levels of relaxation, often continuing for several days after treatment (nursing staff remarked that this also made caregiving easier, especially with bed-ridden residents)
increase of physical and emotional well-being
heightened sense of physical self-awareness
smoother integration of newer residents in the care home situation - less resistence, speedier acceptance of new living conditions
improvements in verbal communication, eye-contact and responsiveness were occasionally observed directly after treatments, indicating that Shiatsu may have a positive impact on stemming cognitive decline. Shiatsu sessions resonated in the memories of residents who were otherwise cognitively challenged in that regard.
observers often had the impression that Shiatsu treatments openned a channel for communication and interaction on a non-verbal level for subjects who were otherwise socially isolated due to their disabilities.
As a result of the universally positive assessment of the research results, the Caritas Socialis expressed the desire for Shiatsu treatments to continue after the termination of the research project and to be offered to the broader population of residents. Demonstrations of Shiatsu and other information events were organised for relatives and interested parties.
Within just a few months 20 residents were regularly receiving Shiatsu. This number has since risen to 30-35 residents with 3 practioners giving treatments on a weekly basis. An atmosphere of close cooperation has developed between Shiatsu practitioners and the CS Caritas management and staff. The caregiving team undertakes the canvasing of potential recipients and the scheduling of treatments. Group consultations with caregiving staff are arranged on a monthly basis, and exchanges of information, feedback and observations concerning individual clients on a more informal level are a central feature of the cooperation between Shiatsu practitioners and staff.
In addition, Shiatsu practioners are able at times to offer Caritas staff insights into difficult cases coming from their own special perspective, and share simple techniques that staff members can easily perform in order to enhance the effects of the weekly treatments.
Shiatsu has become a fixed aspect of the care offering at the Caritas Socialis location Rennweg The institution has expressed the desire to have Shiatsu introduced into two further locations in their care home network. The extension of Shiatsu treatments to these other locations is currently in planning.
In case of closer interest, Maria Schwaiger and Andrew Couse will gladly share their knowledge and experience!