Woman in sensory room holding fiber optics

Snoezelen Therapy for Dementia Patients

Woman in sensory room holding fiber optics

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The world population is ageing and, because of this, the incidence of dementia has risen.  According to the World Health Organization, approximately 50 million people have dementia worldwide, and 10 million new cases are diagnosed every year.  The incidence of dementia is expected to reach 131 million people by 2050.1

  Dementia has a tremendous impact on both the patient, and the family.    Patients with dementia are unable to remember things, have a difficult time solving problems, and can become easily frustrated.  Their sleep-wake cycle may become reversed and, at times, they may even become violent to the ones they love.  Dementia occurs in older people but is not a normal part of the ageing process.

Dementia patients may reach a point where they need to be hospitalized due to behaviors which are not able to be controlled by their caregivers.  Some of these behaviors include agitation, depression, aggression, and apathy.

I have been working on a unit which cares for dementia patients for three years.  During this time, I have learned a great deal about this condition as well as common and not so common treatments.  I have written other blog posts relating to dementia but this post will concentrate on the use of Snoezelen therapy for these patients.

A Snoezelen room is a controlled multisensory environment (MSE).  Equipment in these rooms cause a variety of stimulation including tactile, auditory, olfactory and visual.  Snoezelen rooms should provide a calm and comfortable environment for the patients.  These rooms can be used for patients with autism, brain injuries, developmental disabilities as well as dementia.  MSE’s are not inexpensive to set up.  Associated costs could run from $10,000 to $30,000 and even more if complex, high-end equipment is used.

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Assessing Unmet Needs

The Unmet Needs Model suggests negative behaviors in dementia may result from the inability to communicate one’s needs to caregivers.  There are ways in which we can attempt to learn what these unmet needs are by trial and error.  In the hospital setting, we often talk about the following possibilities that may make the patient uncomfortable.

  • Pain – This one is difficult to assess. There are pain signs such as grimacing.  The patient may also be suffering from a urinary tract infection, or other ailment.
  • Constipation – Keep track of bowel movements. Constipation can be uncomfortable, and is usually easy to treat.
  • Hunger – Offer food. Attempt to learn the patient’s food preferences by speaking to those close to the patient.
  • Thirst – Offer fluids.
  • General Comfort – How the patient is sitting, temperature, clothing, etc.

If these don’t help, the patient may be suffering from boredom.  This is where the Snoezelen room can help.  Always remember, dementia patients are people like us who have a disease and it is important to view them as such.  What works for one patient, may not be effective for another.  Get to know what the patient prefers and keep track of successful interventions.  Always start with the basic needs described above.  If the patient is in pain or uncomfortable due to being constipated, a Snoezelen room experience will likely have little effect on behavior.

Benefits of Multisensory Environments in Dementia Care

Later stage dementia patients are usually unable to seek out enriching and meaningful activities on their own.  In fact, left to their own devises, they would quickly decline.  Most of the time, they are completely dependent on others for their care.  Older people are also less able to perceive sights, sounds, tastes, and smells which increases their risk of sensory deprivation.3

This can have a negative impact on health and wellbeing.4

Some believe that sensory experiences are able to trigger positive memories.  This may promote a feeling of pleasure for the patient.  Think about this in your own life.  I believe we’ve all experienced being taken back in time when we’ve smelled something that triggers a positive time in our lives, or heard a song that takes us back to a happy time.5

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The goal of the multisensory environment is to positively effect the dementia patient using sensory channels that are still intact. 

The three main avenues by which a multisensory experience can be achieved are.

  1. Daily care routines such as bathing, feeding, and administering medications 7

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  1. Sensory enhancements of the patients living environment. This may include special units in long-term care facilities which provide staff specially trained to care for dementia patients, special activities geared towards these residents and involvement of the family.9

  1. Specially designed rooms or MSEs.10

Studies have shown that MSEs can be beneficial for dementia patients.  Some of these benefits include.

  1. Decreased agitation and disruptive behavior.

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I would like to point out that some of the medications utilized to combat aggressive and disruptive behavior can cause agitation.  

  1. Increased alertness14

  1. Increased social interaction, reduced apathy, and better mood.15

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  1. Better communication with others.18

  1. Improved functional performance19

These positive attributes of MSEs leads to a more relaxed, engaged patient who gets along better with his or her peers. 

Research also shows caregivers who utilize MSEs for their dementia patients have better job satisfaction and a better relationship with their patients.

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This leads to improved patient care and reduced caregiver burnout.

Obstacles to Adding a Snoezelen Room to a Facility

Many facilities do not have the financial resources or space to implement a Snoezelen room.  As mentioned earlier in the post, these spaces can get expensive.  The institutions who have these rooms often under-utilize them.  Another problem is deciding how to design such a space.  There is much debate on exactly what to put into these rooms and research is still being conducted in this area. 

Anti-suicide regulations can also hinder certain facilities from adding a Snoezelen room.  This is especially true of psychiatric facilities where dementia patients may end up due to negative behaviors.

Perspectives of an Expert

I have the pleasure of sharing an office with an occupational therapist.  Kendra Munroe, OTR/L works with our patients daily and was the person who designed our sensory room.  Our main piece of equipment is a Vecta which was purchased from TFH Special needs Toys.  This company specializes in sensory-focused equipment and toys which promote learning and living skills.

The Vecta Full Mobile Sensory Station can turn any room into a relaxing, distracting and empowering multi-sensory room. 

According to Kendra, the sensory room “provides a safe and contained spot where the patients can explore”.  She explains that you want to have different things available to engage their senses.  Some examples include music that is tailored to the specific patients tastes, as well as things they can see or touch.  Kendra also believes it is important to include things related to nature. 

We provide weighted blankets by Salt of the Earth as well as quilts, stuffed animals, robotic pets, and a weighted baby doll to provide a realistic sensory experience.

Munroe stated that certain things are often neglected in sensory rooms, specifically regarding the geriatric population.  She mentioned things that provide proprioceptive and vestibular input in particular. “This is why we put a glider in,” Kendra explains.  We purchased a specific glider that locks in place when the patient attempts to stand.  The Thera-Glide safety glider decreases fall-risk and rocks back and forth which is soothing to the patient.

Kendra does point out that there may be dangers involved with sensory rooms.  She emphasizes that we must be trauma-informed with any of our treatment.  We must be aware that small, enclosed spaces may bother some patients.  We also need to be sure there are no objects or equipment available that the patient may throw due to confusion. 

Dementia patients should never be left alone in a sensory room.  They may become confused because the room is unfamiliar to them.  They may damage the equipment, or injure themselves.

Munroe ended by saying that we really didn’t have many guidelines available to us when setting up our sensory room.  We tried to provide a mixture of adult and pediatric sensory experiences that we believed would be most beneficial to our patient population.

Michael Brown pictured with Final Thought written

I am a big supporter of sensory rooms.  My thought is we should utilize all other treatment modalities prior to resorting to medications for dementia patients.  All drugs come with side effects and currently there are no medications indicated for the behavioral and psychological symptoms of dementia. 

Always try to meet the basic needs of the patient before moving on to other therapies.  Assess for pain, hunger, thirst, constipation and comfort. 

As a society, we have a responsibility to care for our ailing population.  This includes the mentally ill.  Unfortunately, none of us are immune from this debilitation condition.  We can all learn about it, and try to limit our risk of developing dementia.  I will continue to write about this subject as I believe it is very important.

If you have any questions regarding Snoezelen rooms or dementia in general please reach out to me.  I have access to some of the best professionals in this area. 

Please take a look at the Sunshine Store for all of your vitamin and nutritional needs.

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

The Passionate Marriage – Keeping Love and Intimacy Alive in Committed Relationships

We have all heard the jokes about married couples: weight gain, no sex, endless fighting. 

It doesn’t have to be this way. 

Why not make one of your goals a commitment to improving your relationship? 

Let’s take a look at some ways to make your marriage exciting, intimate, and fun. 

Why am I writing about this? 

Healthy relationships are one of the many keys to happiness. These include friendships and business associations, as well as intimate relationships.  Humans are social creatures.  We like to interact with others.

This post will concentrate on committed relationships.

Relationships Take Work

The most important thing I want to emphasize is that relationships don’t just get better on their own. Just like anything else, they take work to help them grow. My grandfather always used to tell me “nothing worth doing is ever easy”.  

 

Remember how it was when you first met your partner? Everything was great. You couldn’t wait to see each other. Time spent together was blissful. 

 

As time moves on, you start to realize that this other person is not exactly like you. They do things differently, have different opinions, and may even have habits that drive you crazy. No relationship will ever be perfect. The goal is to work together to function as a happy team. How do you accomplish this? What tools can you use? 

 

Communication

Communication is the cornerstone of a good relationship and, if you don’t learn how to communicate effectively, you will likely have trouble co-existing. Understand that there are different communication styles. Your partner may talk in an entirely different way. Be willing to accept your partner’s method of expression, even if it differs from your own. Communication with your lover is an on-going process and should be a priority. Here are some communication guidelines.

Avoid Anger

Yelling, calling each other names, swearing, and putting each other down are all barriers to constructive communication. Remain calm and civilly discuss the concerning topics. If you have a problem with anger, take some time to cool off before blowing your top. Be patient, compassionate, and kind. Not only will your partner appreciate this, but you will feel better about yourself.

Listen

It is easy to keep talking in an attempt to get your point across. Always remember, your partner may see things in an entirely different way. Many arguments have no right or wrong solution and the best thing you can do to improve communication is to listen!  

 

  • Give focused attention to your partner.  
  • Try to receive their message with acceptance and understanding.  
  • Ask clarifying questions. 
  • Summarize what is being said to show your partner you are listening.
  • Focus on the message, not how it is being communicated.

Think Before You Speak

Do not automatically say everything that comes to mind, especially if it may be hurtful to the other party. Remember, it is not necessary to express everything you are feeling. Ask your partner if they understand what you are communicating and be positive and encouraging. Negative energy is counter-productive.

Resolving Conflict

Conflict is prevalent in all intimate relationships. The goal is not to eliminate conflict but to handle it effectively when it occurs. When our needs are not met, or we don’t receive what we expect, conflict can arise. We all enter into relationships with expectations. Our vision of the relationship might be much different from that of our partner.  

Remember to confront your spouse in a loving way when conflict arises. Don’t keep your frustration hidden as this can lead to resentment. The steps to resolve a dispute can include the following.

 

Decide whether the issue is worth discussing. Although it isn’t a good idea to keep frustrations hidden, we do have to pick our battles. If the problem is small or doesn’t occur often, it may be best just to let it go. 

 

Consider your contribution to the problem. This is important. Is it possible that your actions can change? Most conflicts involve both parties. If you can change, bring this up in the conversation.

 

Consider the timing of the confrontation. Try not to approach your partner when they are tired or in a bad mood. Be loving, honest, and stay focused.  

 

Be willing to forgive. Forgiveness is the first step in rebuilding trust. This is not accomplished by pretending something didn’t happen or just forgetting about it. Forgiveness is a choice to set your partner free.

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Make Time for Each Other

Our lives have become extremely busy. Jobs, kids, activities, meals, and everyday chores can leave us exhausted by the end of the day and it is easy to forget to spend quality time with our partner. The best solution to this problem is to schedule weekly dates. Be proactive and decide to carve out a few hours per week for your relationship.  

These “dates” don’t have to be extravagant. Even going out for coffee is better than nothing. Take some time to connect and enjoy each other’s company without distractions.

 

Spend a few minutes each week talking specifically about your relationship. Are there things you would like to change? What is going right? What needs attention? This will give each of you a chance to discuss how you feel, your needs and expectations in a neutral situation. Remember, always to be positive and respectful. 

Some Common Stumbling Blocks

Sex

One of the most common causes of conflict in a relationship is sex. Unfortunately, men and women often feel differently about this topic. Men are usually more interested in the physical aspects of sex, whereas women are more drawn to the emotional connection. Sexual appetites can also differ substantially. Several factors can affect sexuality. Some of these include.

 

  • Stress
  • Diet
  • Exercise
  • Pregnancy
  • Sexual Dysfunction
  • Guilt
  • Anger
  • Past Abuse
  • Unreconciled relationships

 

It is important to discuss your feelings about sex with your partner. Tell them what you enjoy and what you would rather avoid. None of us can read minds, and your sex life might improve with communication. Remember the factors listed above. Your partner may be dealing with issues that you don’t know about or are unable to understand.  

Money

It is common for couples to argue about money. Again, expectations may be different. If a spender and a saver are in a relationship, frequent problems may arise. There are ways to help with this issue.

 

Create a budget. Everyone should do this. A budget helps give you a spending plan and helps avoid surprises. Take some time with this. Have monthly meetings regarding the budget and make adjustments when necessary. Try to stick to the budget.

 

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Blended Families

This is something I have personal experience with.  My family is pictured above.  Blended families are a common cause of conflict. If this becomes a significant problem, I suggest seeking professional counseling. There are too many factors involved to discuss this here. This topic is a blog post in itself. Keep in mind that the children your partner brought into the relationship are used to a different set of rules and have other expectations. It isn’t their fault. They were just raised differently.

Work Stress

Most of us have jobs that can cause stress at times. Learning how to deal with this can help improve your relationship at home. Here are some tips.

 

Try to refrain from discussing work at home.

 

Learn and practice techniques to reduce anxiety. Take a look at my anxiety post for ideas on anxiety reduction.

Michael Brown pictured with Final Thought written

Relationships can be complicated. They take work and commitment from both parties. There are many tools available to help improve your relationship. My wife and I recently went to a weekend retreat for married couples. I strongly suggest considering attending one of these, especially if you are having issues. A quick Google search will give you plenty of options to suit your needs.

 

Remember, communication is key. Try to listen more and talk less, and you might learn something.  

 

Take a trip together. A surprise getaway may be just what you both need to reconnect.

 

There are many ways to improve relationships and I have only scratched the surface in this post. Be creative, don’t be afraid to do something different, and, most importantly, have fun!  

 

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.