Have you ever heard of skin hunger?
This phrase came up during a presentation by Dr. Melita Belgrave, a fellow music therapist, at a recent meeting of the Kansas City Partnership for Caregivers. We have an innate need for physical contact with other human beings, and “skin hunger” refers to the problem we have when we don’t get enough. It’s a rather stark phrase that describes the problem exactly, and it’s an especially significant problem for older adults.
Just a few minutes ago, I put my baby daughter to bed. She has a cold, and she was having a hard time falling asleep on her own, so I rocked her to sleep, stroking her hair and humming quietly. When Alice was first born, we held and rocked and cuddled her constantly. As research dating back to 1959 and Harry Harlow’s infant monkeys has shown, babies need physical touch for healthy development. I don’t know of anyone who would deny this these days.
That need for touch continues for adults, but many people wouldn’t identify that as a major issue for themselves. Most of us have little problem getting the touch we need, whether from cuddles and hugs with our families, pats on the back from our co-workers, or simple handshakes with business acquaintances. Sure, we get a sense of what it’s like to long for another’s touch when our kids leave home or our spouses are away, but most of the time, we probably get the physical human contact we need.
This physical touch can be more difficult to come by in one’s later years. Your spouse dies, and your kids and grandkids live too far away for the frequent hugs and kisses you used to get from your loved ones. If you’re living at home, you just might not be around other people all that much. If you live in a nursing home or other senior living facility, the people caring for you are employees – professional caregivers – and they might feel uncomfortable giving hugs to the residents or perceive affectionate touch as somehow undignified for the resident. (Not to mention that some facilities might be afraid of litigation for inappropriate relationships.) On top of that, you might be in a wheelchair or behind a walker or otherwise less accessible to folks, or you might be in pain when people touch you or bruise easily or have wounds on your skin or look “scary” or “gross” to those kids visiting from the preschool or…. the list goes on. Simple, affectionate touch is harder to receive.
Even family members can shy away from hugging or kissing a family member who looks so much weaker or sicker than they did in years past. Whether it’s distaste for the person’s condition or fear of harming the other person or just the awkwardness of hugging your father-in-law, the older person isn’t getting the physical contact they need. This is skin hunger.
As people in eldercare learn about this problem, more and more professionals are making concerted efforts to give affectionate touch the people they work with. Still, it can feel awkward or unprofessional or out-of-the-ordinary. What to do?
- Use songs that encourage physical closeness. You can listen to a recording (or live musician) or sing to or with your loved one. Some of my favorites are “Cuddle Up a Little Closer,” “Side By Side,” “I Wanna Hold Your Hand,” “Love Me Tender,” and “Precious Lord, Take My Hand.”
- Dance together. All you have to do is stand up and move to the beat. Or, remain seated, hold your older person’s hand, and sway in time to the music. Or, gently pat his knee to the beat. All of these provide touch, and you can be very gentle.
- Provide hand-over-hand assistance with playing an instrument with recorded music, being sure not to cause pain or move someone else’s hands or arms in an unnatural way.
Of course, you must be cautious about physical touch in a few ways:
- Cultivate an awareness of your older person’s aches and pains. Watch for non-verbal communication of discomfort or pain.
- Ask the older person if the touch you are providing is okay. Err on the side of gentleness.
- Be aware of avoiding wounds and skin tears.
- Use good personal hygiene and hand-washing to prevent the spread of infection.
Touch is something that people need, and there are plenty of ways to provide touch that aren’t inappropriate or icky or painful. Music can help facilitate that and help to overcome the awkwardness of interacting in a new way.