Use of multisensory stimulation in institutionalized older adults with moderate or severe dementia

Abstract

ABSTRACT. The Multisensory Stimulation Program can help manage behavioral and psychological symptoms of dementia. Objective: The objective of this study was to investigate the effects of the Multisensory Stimulation Program on behavioral, mood, and biomedical parameters of older adults with moderate and severe dementia compared to a control group not submitted to this program. Methods: This study is an interventional, parallel, open-label, quasi-experimental clinical trial, which is quantitative and qualitative in nature and is also an exploratory type. The sample was divided for convenience into intervention group (IG) and control group (GC) that did not participate in the Multisensory Stimulation Program. Data analysis included descriptive statistics, nonparametric tests (two-tailed alpha value of 0.1 was applied), and thematic content analysis. Results: The sample consisted of 20 older adults (IG=10 and GC=10), with a mean age of 83 years, an average of 3 years of education, and moderate or severe dementia. Reduction in intervention group behavioral changes (p=0.059) and numerical improvement in intervention group cognition were observed. A decrease in heart rate (p<0.05) and diastolic blood pressure (p<0.05) was observed before and immediately after the session in the intervention group. The caregivers described engaged behavior in intervention group, while they reported apathetic behavior in control group. Session records described verbal and nonverbal communication and sustained attention for more than 3 min regarding the sensory resource explored. Conclusions: The Multisensory Stimulation Program could be a new look at the health care practices performed in the nursing homes that consider the older adults’ sensory preferences and may help with dementia behavior management.

Snoezelen in people with intellectual disability or dementia: A systematic review

“… Observation of positive and challenging behaviours Effect compared to control: ↑ engagement ↑ mood ↓ challenging behaviours 30 Lorusso et al., 2020 United States of America Qualitative study 5/5 1) n = 32 2) 28F, 4 M 3) NA (staff): snoezelen used in veterans with dementia 4) 12 different sites Explore staff perceptions of the effectiveness of MSEs NA 21 individual interviews and one group interview with 11 participants Perceived benefits: ↑ positive distraction, engagement, relaxation ↓ challenging behaviour Perceived benefits for staff: ↑ relaxation Perceived negative effects: increased negative emotions (for example, scared or upset) 31 Lotan et al., 2009 Israel Non-randomized study; multiple-case study Control: washout period with usual care Failed screening criteria 1) n = 10 ( M = 45 yrs; SD 16.45; range 28–74) 2) 4F, 6 M 3) moderate to severe ID, additional diagnoses include Fragile-X syndrome, Angelman syndrome, and hearing impairment. 4) residential Investigate the efficacy of the MSE as an appropriate, accepted therapeutic tool to reduce challenging behaviour 1) provide relaxing atmosphere 2) individually 3) 2x per week 4) 30 min 5) enabling approach; preference assessment during the first session; the participant received the same individually selected environment on repeated visits (ranging from lying on the waterbed for half an hour with no contact, to a full body massage) Challenging behaviour was recorded on an individually adopted chart Effect compared to control: ↓ challenging behaviours 32 Machado and Castro, 2022 Brazil Non-randomized study Control: usual care 1/5 1) n = 20 ( M = 83 yrs) 2) 17F, 3 M 3) moderate or severe DM, additional diagnoses include depression, Parkinson's disease, and stroke 4) nursing home Investigate the effect of a multisensory programme on behavioural, mood, and biomedical parameters 1) provide excitatory or relaxing stimuli 2) individually 3) 2x per week 4) 30 min 5) non-directive approach, preference assessment in first session, possibility during sessions to transfer between various sensory spaces (garden, room, corridor), Cornell Scale for Depression in Dementia; Neuropsychiatric Inventory; Checklist on behaviour, mood, interaction with the environment and caregiver; physiological measures …”