The effect of foot massage on agitation in people with dementia living in residential care.

INTERVENTION: Foot massage involving long gliding, rhythmical strokes of the entire foot and ankle, and light pressure massage by a certified therapist in the privacy of the participant's bedroom. The intervention consists of 5 minutes massage for each foot, 5 times a week (Mon‐Fri) from 1pm‐4pm (at a standardized time for each individual) for a period of 3 weeks. After completion of the first treatment arm of the study and after a wash out period of three weeks, participants will then be exposed to the opposite treatment arm and the protocol repeated, that is, those in the first foot massage condition will then move to the quiet presence condition and vice versa. CONDITION: Agitated behaviours in people with dementia PRIMARY OUTCOME: Measure of Agitation using Pittsburgh Agitation Scale (PAS) and Cohen‐Mansfield Agitation Inventory (CMAI). SECONDARY OUTCOME: Measure of Depression using the Geriatric Depression Scale (GDS) Measure of Emotion and Discomfort using Observed Emotion Rating Scale (OERS) and Discomfort Scale for Dementia of the Alzheimer's Type (DSD). Measure of physiologic stress by monitoring blood pressure and heart rate using an Omron HEM‐7070 electronic sphygmomanometer and body temperature using a No Touch Temporal Artery Thermometer. INCLUSION CRITERIA: 1) informed consent (i.e., authority received from resident’s themselves and/or relatives and health attorneys to join the research) 2) permanent residence in one of the four chosen residential care facilities in the Brisbane area of South East Queensland for at least 2 months 3) two feet, excluding artificial legs 4) no specific medical‐related contraindications (e.g., recent surgery to the area, vessel embolism, peripheral neuropathy, painful bunions or acute illness) 5) a diagnosis of dementia, or met the criteria for probable dementia of Alzheimer’s type as per DSM‐IV 6) a Mini Mental State Exam (MMSE) score of < 18 indicating moderate to severe dementia 7) a documented history of agitation on nursing or medical records within the previous two weeks 8) a score of >3 points on the PAS 30 during each day over a period of one week. (the screening component of the PAS is used here and the full observation is used in the data collection)