Dementia

-different types of Dementia Know them

Sensory types

-seeker: want more flavor, texture, noise, more good sensations

-By stander: Don’t notice what others notice, louder, brighter, smellier to notice, easily going, seem oblivious, need intense to sense information

-avoiders: love order & routine, like plans, don’t want new sensory experience, very little sensory input

-sensors: notice most sensory input, comment on sensations, easily distracted, sensitive, notice lots of details,

-sensory-based treatment for dementia, yay, we want it to help with agitation

-7.4 million Americans have dementia, which may increase because of the growing # of adults aged 65

-Alzheimer’s is the leading cause of death in the US

-Caregivers of people with dementia report high to very high emotional distress (59%) and physical stress (38%)

-41.1% of nursing home residents have some form of dementia

-One of the most common symptoms is mood and behavioral changes (aggression, lethargy, wandering)

-cost of managing the disease in 2026 is 409 billion per year, may increase to 1 trillion by 2050

Dunn’s models of sensory processing

-neurological threshold

-high threshold (more input to notice)

-low threshold (less input needed to notice)

Self regulation

-passive

-active

Behavioral Symptoms in Dementia

-if not enough stimulation (higher thresholds)

—passively managing: lethargic, fatigued

—Actively managing:

-if too much (lower thresholds)

—Passively: look overwhelmed, picky eaters, easily distracted, vocal about dislikes

—Actively managing: wandering or seeking to leave: content to be alone, can become aggressive if overwhelmed

Multisensory environments (MSE)

-Can also be known as snoezelen, SI (sensory integration), MSE

-incorporates the use of tactile, visual, auditory, olfactory, and gustatory pathways along with movement to help individuals interpret the environment

-goal is to stimulate the primary senses without the need for sensory activity in an atmosphere of trust and relaxation, failure-free approach

Research on MSE

-decrease negative behaviors, anxiety, and pain

-increase pos behaviors (engagement, convo)

-increase spontaneity, intelligible speech, and recall

-increase attention and concentration

-decrease wandering, boredom, and lethargy

-be as effective or more effective than alternatives (medications, relaxation, reminiscence, activities, etc)

-Can improve client caregiver relationships

Research also supports

-session length 30-45 min 3x/week

-Staff behaviors are often causes of resident behaviors

-impact of one-to-one sensory experience

-pos impact on staff, shift from task-oriented to resident-oriented care

-pos impact on fam, caregivers, other healthcare professionals, administration

Steps for gathering MSE

1 Gather sensory items (for MSE or mobile carts)

-hearing

-vision

-tase

-touch

-smell

-vestibular and propeceptive systems

2 Educate/collaborate on how OT can use this

-sensory inventory to discuss processing

-experience room & sensory things

-Make it fun!

3 one-on-one sensory sessions

-no goals to achieve

-Don’t forget the role you could play in behaviors

-possibly demonstrate what to do with activities

-safety and basic needs met

Accessing and documenting MSE

-complete sensory inventory on candidate and tailor to experiences

-get information from fam/caregivers

-What sensations do they prefer that are they over and under-responsive

-never take the client into the room if preferences are not assessed first

Think of sensory-based treatments as a modality!