LeadingAge Magazine · January/February 2014 • Volume 04 • Number 01

Embraceable You: How Hugging Promotes Well-Being

January 04, 2014 | by Karen Brannen

This member studied the power of touch with a program that involves residents, staff and family.

Experts have long recognized the “power of touch.” From the early days of infancy through the later stages of adulthood, tactile communication plays a fundamental role in human interaction.

Over the years, studies have shown human touch fosters trust and cooperation, even generosity. It provides a sense of social support and well-being, both physical and emotional. And from my own experiences managing Jefferson’s Ferry, a not-for-profit lifecare community in South Setauket, NY, I’ve seen firsthand how the warmth of simple touching can transcend age and time. No matter how old we get, most of us love to have our hands held, get touched on the shoulder, or just enjoy a genuine, old-fashioned hug.

At the same time, I also know how lonely older people sometimes feel, especially when they have faced the loss of a spouse or don’t receive regular visits from family. We constantly look for ways to improve the lives of our 400 residents. What if they had more opportunities to be touched and hugged, every day? Would they feel happier, and better about themselves? Could we prove it really made a positive difference in their lives? With the support of our board, we decided it was time to test this theory.

In the fall of 2012, Jefferson’s Ferry created a comprehensive program called “Embraceable You.” Participation was to be voluntary, but the idea was to create a study that cut across generational lines, involving not only the independent residents but the staff as well. The study, designed and implemented by Corporate Performance Consultants of Hauppauge, NY, would test whether those who participated in a systematic program of increased touching and hugging would experience a greater sense of “well-being”—a term covering several lifestyle categories, such as “interest in doing things” and “feeling energetic.”

At the beginning of the study, about 200 participants filled out anonymous surveys that collected data about their living experiences, satisfaction with quality of life at Jefferson’s Ferry and overall evaluation of their health. In addition, the frequency of their current casual touching was assessed in terms of “low contact” or “high contact.” To encourage response, residents received a $10 incentive for completing the surveys.

Jefferson’s Ferry staff was then brought into the process, with 48 employees (volunteers known as ambassadors) trained in the types of tactile communication that would be permitted. Examples include: the “A-frame” hug, the “side-by-side hug,” the “shug” (a modified shoulder hug/handshake) or the fist or elbow bump. To avoid awkward or uncomfortable situations, residents were to be provided with “Hug Me Maybe?” buttons. By wearing the buttons, residents indicated their willingness to participate and receive hugs.

Embraceable You was launched in January 2013, in recognition of—what else?—National Hug Day. This unofficial holiday, January 21st , was started in 1986 by Kevin Zaborney, a Michigan pastor who felt that Americans were generally embarrassed to show their feelings in public and hoped that a national day of hugging might help change all that. The date was chosen because it fell between the winter holidays and Valentine’s Day, a time of the year when people are generally thought to be at their emotional low.

We initiated the program with a bang. During dinner one evening, I announced the program, while a member of our staff, Gina, crooned the old George and Ira Gershwin tune, “Embraceable You.” But after singing her opening verse, Gina—in a pre-planned “rebuff” of my introduction—tossed aside the classic song in favor of a flashy, upbeat adaptation of the recent pop hit by Carly Rae Jepsen, “Call Me Maybe.” The dining room was suddenly flooded with staff members dancing and singing “Hug Me Maybe,” as Gina led a flash mob of dancers around tables of delightfully surprised residents, many of them smiling, clapping to the contagious beat, putting on their “Hug Me Maybe” buttons—some even jumping up to join the dancers.

Here’s a video showing a taste of the residents’ reaction:

So began “Hug Week.” During the next five days, residents were given a token for every hug they received from the Hug Ambassadors, who wore five different colored T-shirts. When residents got a hug, they received a token matching the color of the Ambassador’s T-shirt. Residents were encouraged to acquire a token a day for each of the five colors. The tokens were subsequently redeemed for raffle tickets, and at the end of the week we held a drawing during which residents could win an iPad or similar prize of their choice.

As the week went on, the number of hugs grew and more residents redeemed tokens every day. People felt increasingly comfortable coming up to staff and finding ways to ask for a hug. We gave out cameras to residents so they get pictures of each other hugging. They formed a kind of “hug paparazzi,” catching each other in the act of hugging. By the end of the week, we had accumulated some 1,400 hugs.

Then, during the first week in February, a second anonymous questionnaire was distributed to residents, asking questions similar to the first one: self-reports regarding their health and emotional well-being; perception of the quality of life at Jefferson’s Ferry; and frequency of casual physical contacts. In addition, the survey asked about whether residents participated in the Embraceable You program, and included open-ended questions requesting feedback about the program activities.

What did we find?

First, while the study was never intended to be a formal clinical trial, we did find substantial anecdotal evidence supporting the idea that higher touch leads to a greater sense of well-being among our seniors. Over the course of the program, two-thirds of respondents reported “low contact” (one or two instances a day of casual physical contact) and one-third reported “high contact” (three or more instances a day).

The February survey results showed some significant differences between the percentages of low- and high-contact residents who reported positive indications of well-being:

  • 88% of high-contact residents expressed “interest in doing things,” compared to 77% of low-contact residents;
  • 97% of high-contact residents said they were “NOT feeling depressed or hopeless,” compared to 87% of low-contact residents;
  • 71% of high-contact residents reported they were “sleeping well,” compared to 50% of low-contact residents;
  • 66% of high-contact residents reported “feeling energetic,” compared to 44% of low-contact residents; and
  • 93% of high-contact residents said they were “able to concentrate well,” compared to 81% of low-contact residents.

At the same time, there were only slight increases in the percentage of high-contact residents reporting positive indications of well-being between the first survey and the second. One exception was “not feeling depression,” where the percentage jumped from 86% to 97 %. Almost everyone, whether they participated in the program or not, said they felt good about themselves. And there were virtually no differences among participants and non-participants in their high degree of satisfaction with quality of living at Jefferson’s Ferry.

Individual comments about the program ran the spectrum, from highly positive to somewhat critical. A number of residents suggested that the timing of a program encouraging hugging could be better—that is, not during flu season. A few said the program seemed contrived and questioned whether residents actually became involved with each other. Many others, however, were enthusiastic, saying the program was “fun,” “enjoyable” and “uplifting.” One resident said, “I love being hugged! I enjoyed the closeness to staff!” Another person called the program a “good bit of midwinter madness to dispel the seasonal blahs.”

Ultimately, the relationship between touch and well-being remains complicated. It’s not always evident, for example, which behavior supports the other: Does a higher level of hugging lead to higher well-being, or do those who have higher sense of well-being touch people more? How do we account for individual differences—the fact that some people may simply prefer being touched less? Furthermore, it’s often difficult to isolate the impact of hugging from the other positive communication that may come with a hug, such as conversation, eye contact or laughter.

Despite these limitations, it’s clear that Embraceable You achieved a measureable impact on the well-being of Jefferson’s Ferry residents. Supporting the emotional well-being of our resident community is integral to the positive aging experience, so it’s important to know that people who like to be hugged feel an increased sense of well-being when they are touched.

Besides establishing this baseline study from which to build, we discovered something else: How much our success hinged on the involvement of Jefferson’s Ferry staff. It was essential to introduce hugging into the culture of the whole organization. Ultimately, Embraceable You “was a way to create engagement at every level,” notes my colleague, Ellen Cooperperson, the CEO of Corporate Performance Consultants. “It collapsed the hierarchy among the residents, staff and management.”

We realized how critical it was to support our staff, providing the training needed to give appropriate hugs—and know who wanted to be hugged. We also discovered the importance of intergenerational communication within a community of older adults. Indeed, by creating the contemporary “Hug Me Maybe?” song, we linked the contemporary world of young staff members to the “Embraceable You” Jazz Age world of our resident seniors. The staff took ownership of our “launch party” presentation, rehearsing during free time, dancing, playing, bonding, and enticing other volunteers who had been hesitant to join the fun. Then the residents started dancing too. They came in with their own flash mob. These people’s lives were changed, and the whole, hugging community was happy.

In the end, Embraceable You was just a beginning—the first step in a more holistic approach to caring for our residents. For example, we’re in the process of changing the way we bathe residents in Skilled Nursing. Bathing will become a nurturing spa experience, with oversized fluffy bath towels and robes that come right out of the warmth of a dryer. We have incorporated mindful touch into the day- to-day life here to enhance the residents’ overall experience. As a yoga enthusiast, I have begun teaching chair yoga to interested residents. And finally, we have built an awareness of tactile communication into Jefferson’s Ferry orientation program, so all new employees understand its importance to our community—right from the start.