Sensory stimulation is the method in which a person’s level of consciousness can be altered.
We have 7 different senses as human beings. The senses are:
Visual - Vision
Olfactory - Smell
Gustatory - Taste
Auditory - Hearing
Tactile - Touch
Vestibular - Movement
Proprioception - Where our bodies are in space
In order for our brains to develop during infancy, we need exposure to all these different senses. The same is true when we have a nervous system debilitating disease like dementia. When we are young, we use the senses to orientate ourselves to our environment, time of day, weather, whether or not food is edible etc. When we get older, the same is true, but two things that become more important are our quality of life and prevention of deterioration.
In order to facilitate this, correct sensory stimulation is important.
The value of sensory stimulation
It increases consciousness of self and environment
Activates motor responses and reflexes
Decreases sensory deprivation
Improves range of motion
Supports normal muscle tone
Increases attention span and focus
Improves controlled movements
The optimal environment for sensory stimulation
The environment must be as quiet as possible with natural light. No sudden interruptions or loud noises.
How does sensory stimulation work in the elderly
We have to know the person well in order for sensory stimulation to have its optimal effect. If an unknown song for instance is presented, there will be no significant triggers for the specific person, but if he/she hears a lullaby that his/her mom used to sing the impact of the auditory stimulation is so much bigger.
The idea of sensory stimulation in the elderly is to provide them with a better quality of life in general as well as helping them to be better orientated to person, place and time.
Specific stimulation in a system can either be inhibitory or activating. For instance, the taste of something sour is activating, where the taste of something sweet is generally inhibitory. Again it is important to know the person well, because if he/she did not enjoy sweet things, the taste of sugar might be activating for them.
Different sensory stimuli and the influence
Present to patient in a dark room
Change in environment, moving outside
Following a flashlight in the dark
Sitting in a dimly lit room
Present to the patient anywhere in the house without possibility of sudden interruptions
Listening to the radio by using earphones
Different animal sounds
Soft calming sounds
Present the stimuli with a dropper while the patient is seated or place small amounts in the mouth.
Present to patient in a temperature controlled environment to reduce the need for excessive clothing
Using a baby brush to brush arms and legs against the hairline
Light touch up and down exposed body parts
Quick fleeting touch
Use different textures to rub
Rubbing down extremities with a firm grasp
Olfactory system (Smell)
Present to patient before mealtimes and be on the lookout for autonomic nervous system signs like sweating, tachycardia or gagging. Present on an earbud. Hold it close to the nose, but take care not to touch the nose.
All smells known to the patient
The system is located in the inner ear and based on the speed and angle of head rotation. Ensure that the environment is safe when movements are being performed. This might be the most challenging stimuli to give, but it is very important. Swivel chairs are great tools as acceleration and rotation can be achieved using them.
Stop and start movement
Head in the upside down position
This system registers where the body is in space by informing the brain of where the joints are at a given time. This system registers tension in the muscles and ligaments as well as movement in the joints. When this system is stimulated it may reduce the risk of falling.
Fast movement of the joints
Do these rhythmically and smoothly
It is always helpful to start early when working with a patient who has cognitive decline. We want to establish new routines and make them aware of certain things while they still have the cognitive capacity for it. Introducing new coping mechanisms when it is too late, often leads to the caregiver and patient becoming frustrated.
It is important to have a big calendar up in the patients room where he/she then has to mark down every day in order to orientate themselves to the year, month and date. It is useful to have 2 different coloured pens to alternate in case the patient forgets that he/she has already marked the date.
Big digital clocks in every room are important as the brain struggles to read the time on analogue clocks later in life. It is also important to have a note next to every clock that informs the patient of important hours in the day, like breakfast or lunch time.
A steady routine is of utmost importance. As far as possible, this routine should stay the same from day to day and where not possible it should stay the same from week to week. The patient must be made aware of the routine and a laminated copy can be kept next to the bed, in the bathroom and in the lounge to help with orientation.
Clothes in the cupboard must be placed together according to what will be worn per day. Therefore a pile of shirts and a different pile for underwear should be avoided. The clothes should be put together by days.
A tick list in the bathroom is also handy. There should be a list of things that has to be done, like brush teeth, wash face, put cream on, comb hair etc.
On every door leading out of a place with possible dangerous aspect a sign needs to be put up which reads for example… “oven off?”, “tap closed?” etc.
Lastly if differently coloured arrows can be placed on the floor leading to specific places, for example the bathroom, kitchen, room and dining room it will better orientate a person to where they will need to go and how to get there.