If a regular customer comes in they can tell by the way my mom looks how she feels.Even then they will simply pat her hand or shoulder. On a real good day they will hug her. If someone new starts to shake her hand,then I tell them that she has medical problems and cannot shake hands due to the pain.Mom laughs at me and calls me her guard dog and in a way I guess I am and proud to be that. If you tell someone you have a problem that prohibits strong handshakes or any handshakes,most people will understand.