Snoezelen in Dementia care.

  1. I have been using Snoezelen in one of my Dementia units for 3 years now and this has proved to be a very useful Therapy in that it provides a degree of stimulation to those that need it and a restful environment for others. We have also reduced significantly the prescribing of sedative/hypnotic medication. My question is this:
    I can find lots of research evidence re the use of Snoezelen in learning Disabilities services but very little in relation to Dementia care. can anyone help
    •  
  2. 17 Comments

  3. by   Talino
  4. by   mageean
    Thanks Talino this is very useful for a comparative study.
  5. by   adrienurse
    Maybe I can help. Precisely what did you want to ask about? Of you don't have access, I can do a CINAHL search for you.
  6. by   mageean
    I am particularly interested in reductions (if any) in prescribing practices of sedatives/hypnotics in Long Term care settings following introduction of Snoezelen interventions.

    By the way, I like the new avatar!
  7. by   cargal
    My curiosity is piqued! I love the elderly. What is this therapy, and where do I find information about it?
  8. by   donmurray
    The therapy is about enhancing the environment the patient lives in with extra sensory stimulation. (Not ESP, LOL) www.swwf.com gives an overview, rompa is the UK supplier, I think one US supplier is Flaghead? I just searched on ie for "snoezelen"
  9. by   adrienurse
    Sorry, the North American supplier is Flaghouse.
  10. by   adrienurse
    Items 1-11 of 11
    One page.

    1: Cochrane Database Syst Rev 2002;(4):CD003152 Related Articles, Links

    Snoezelen for dementia (Cochrane Review).

    Chung JC, Lai CK, Chung PM, French HP.

    Dept of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, HONG KONG. rsjchung@polyu.edu.hk

    [I have this on file and can e-mail it to you] - Ad.


    2: Disabil Rehabil 2002 Mar 10;24(4):175-84 Related Articles, Links

    Snoezelen: an overview of research with people with developmental disabilities and dementia.

    Lancioni GE, Cuvo AJ, O'Reilly MF.

    Department of Psychology, University of Leiden, The Netherlands. lancioni@fsw.leidenuniv.nl

    PURPOSE: This paper was to provide an overview of the research studies on snoezelen with people with developmental disabilities and dementia. METHOD: Computerized and manual searches were carried out to identify the aforementioned studies. Within-session, post-session, and longer-term effects of snoezelen were examined. RESULTS AND CONCLUSION: Twenty-one research studies were identified, 14 concerning people with developmental disabilities and seven people with dementia. Of those studies: 14 reported positive within-session effects; four positive post-session effects; and two positive longer-term effects. These findings were discussed in relation to: (1) methodological aspects (weaknesses) of the studies; (2) the cost of arranging a snoezelen programme and possibilities of reducing the range of stimuli available in the programme; and (3) some research issues for advancing the understanding and effectiveness of intervention programmes with people with developmental disabilities and dementia.


    3: J Gerontol Nurs 2002 Mar;28(3):41-9
    Snoezelen: a multisensory environmental intervention.

    Chitsey AM, Haight BK, Jones MM.

    Harrison Family Practice Clinic, Arkansas, USA.

    Snoezelen is a multisensory intervention delivered in a specially designed room with high-tech instruments. It is especially useful for end-stage patients with Alzheimer's disease. Snoezelen provides an enabling atmosphere in a failure-free environment. It has been a popular intervention in Great Britain and is just beginning to appear in the United States.


    4: Int J Nurs Pract 2000 Jun;6(3):118-26 Related Articles, Links
    Leisure or therapeutics? Snoezelen and the care of older persons with dementia.

    Burns I, Cox H, Plant H.

    School of Nursing, Deakin University, Geelong, Victoria, Australia.

    Snoezelen is the registered tradename for a multisensory environment approach initially established for purposes of leisure or therapeutics in the special education arena, but now expanding into a variety of client groups and settings, most notably in the care of older persons. Snoezelen is making its way into Australia at a rapid rate despite a lack of evidence-based research. This paper looks at the Snoezelen phenomenon and searches the literature to review the history and contemporary use of this multisensory environmental work. While most articles indicate positive outcomes Snoezelen is not without its critics, some of whom focus on the lack of rigorous research while others critique the artificiality. As a leisure approach Snoezelen appears to add quality to the culture of the care environment.


    5: Int J Geriatr Psychiatry 2000 Feb;15(2):141-61 Related Articles, Links
    The effects of emotion-oriented approaches in the care for persons suffering from dementia: a review of the literature.

    Finnema E, Droes RM, Ribbe M, Van Tilburg W.

    Institute for Research in Extramural Medicine (EMGO Institute), Faculty of Medicine, Vrije Universiteit, Amsterdam, The Netherlands. ej.finnema@med.rug.nl

    OBJECTIVE: This article presents an overview of the results of intervention studies in various emotion-oriented approaches in the care for people suffering from dementia. Recommendations are made with regard to clinical practice and future research.Data SOURCES: We searched for references (1990-99) in several bibliographical databases, i.e. Medline, PsycLit, Embase, Sociofile and Current Contents. The terms 'dementia' and 'Alzheimer's disease' were linked separately to the search terms: emotion-oriented, validation (therapy), sensory integration/sensory stimulation/snoezelen, simulated presence therapy and reminiscence (therapy)/life-review. Based on references in the articles found, other publications were traced. STUDY SELECTION: We started from the 'emotion-oriented' approaches used in 24-hour care distinguished by the American Psychiatric Association (1997) i.e. validation, sensory stimulation/integration, simulated presence therapy and reminiscence. We selected research articles that describe intervention, design, measuring instruments and results. DATA EXTRACTION: The articles were analyzed with regard to research group, setting, design, effect variables, intervention, measuring instruments, statistical analyses and results. DATA SYNTHESIS: It is shown that mainly positive results (including increased social interaction and decrease of behavior problems) are achieved with these emotion-oriented approaches. Unfortunately many studies have methodological limitations and are done independently, which makes comparison difficult. CONCLUSIONS: Despite the limited cogency of the studies we traced, the results are promising. Emotion-oriented care approaches offer the opportunity to tailor the care to the individual needs of dementing elderly and can be complemented with other psychosocial approaches (e.g. psychomotor therapy and music therapy) when necessary. The challenge for the care sector is to develop guidelines to determine which approach should be applied to whom and when. Scientific research can contribute by examining which emotion-oriented approaches, possibly in combination with each other or with psychosocial therapies, effect an increase in the well-being and improve functioning in which patients. Copyright 2000 John Wiley & Sons, Ltd.



    6: Br J Clin Psychol 1998 Feb;37 ( Pt 1):69-82

    Behavioural effects of long-term multi-sensory stimulation.

    Martin NT, Gaffan EA, Williams T.

    Department of Psychology, University of Reading, UK.

    OBJECTIVES: Regular access to a multi-sensory environment (MSE or Snoezelen room) was compared with a non-complex sensory environment for individuals with learning disabilities. We also tested the prediction that those individuals whose challenging behaviour was maintained by sensory consequences would benefit most from exposure to the MSE. DESIGN: The conditions were compared over 16-week periods using a double crossover design, and were matched for social contact and attention from the enabler. Participants were randomly assigned to orders of treatments. METHODS: Participants were 27 adults with severe/profound learning disabilities who exhibited challenging behaviour. Behaviour was assessed before and after each treatment phase using both direct observation and standardized assessments (the Functional Performance Record and the Problem Behaviour Inventory). The behavioural observations formed the basis of a functional analysis of each individual's challenging behaviour. RESULTS: Some participants became more calm and relaxed while in the MSE, however, the objective measures of behaviour outside the treatment settings revealed no difference between the MSE and control conditions. Challenging behaviour maintained by sensory consequences showed no greater responsivity to the MSE than to the control condition. CONCLUSIONS: The multi-sensory environment had no effects beyond those that could be ascribed to the social interaction between participant and enabler. Anecdotal evidence of favourable responses within the MSE itself could not be confirmed outside the environment.

    7: Verpleegkunde 1997 Nov;12(4):227-36 Related Articles, Links

    [The effect of sensory stimulation in the sensory stimulation room on the well-being of demented elderly. A cross-over trial in residents of the R.C. Care Center Bernardus in Amsterdam]

    [Article in Dutch]

    Kragt K, Holtkamp CC, van Dongen MC, van Rossum E, Salentijn C.

    GCP Hospital Research & Transfergroep Rotterdam en Omstreken.

    A controlled cross-over experiment was carried out to investigate the effect of snoezelen in the snoezelenroom on the well-being of elderly people with dementia. Seventeen elderly residents from the Bernardus Nursing Home in Amsterdam participated. All were in a very advanced stage of dementia requiring a high level of care and nursing. In this study, the presence of behavioural problems was used as a basis for the measurement of well-being. The behaviour was registered by video cameras and analysed by means of certain subscales of a Dutch behavioural observation scale for intramural psychogeriatrics, the Gedragsobservatieschaal voor Intramurale Psychogeriatrie (GIP). The results showed that less behavioural problems were seen with the experimental intervention. This indicates a higher degree of well-being during the snoezelen activity in the snoezelen room than when the residents remained in the living room. The results of this study indicate the need for a large-scale study in which additional outcome parameters are measured.


    8: Tijdschr Gerontol Geriatr 1997 Jun;28(3):124-8

    [Effect of snoezelen on the behaviour of demented elderly]

    [Article in Dutch]

    Holtkamp CC, Kragt K, van Dongen MC, van Rossum E, Salentijn C.

    R.K. Zorgcentrum Bernardus, Amsterdam.

    A randomised cross-over trial was carried out at nursing home Bernardus in Amsterdam to investigate the effect of 'snoezelen' in a specially furnished room on the well-being of demented elderly people. The behaviour during the experimental intervention 'snoezelen' was compared with the behaviour during the control intervention, consisting of standard activities in the livingroom. Sixteen elderly persons participated in the study. They were all in a very advanced stage of dementia, requiring a high level of care and nursing. The occurrence of behavioural problems was registered, using video cameras and assessed with four subscales of the Gedragsobservatieschaal voor de Intramurale Psychogeriatrie (GIP) (behavioural observation scale for intramural psychogeriatrics). During the experimental intervention a relatively low level of behavioural problems was observed. This could indicate that snoezelen increases the wellbeing of demented elderly. The outcome of this study indicates the need of a larger-scale study in which additional outcome parameters should be included.

    9: Nurs Stand 1997 Oct 8;12(3):38-40
    Snoezelen: benefits for nursing older clients.

    Morrissey M, Biela C.

    Christ Church College, Canterbury.

    In this article, the authors examine the possible benefits of Snoezelen for older clients. The authors suggest that nurses can be instrumental in developing and creating innovative therapeutic environments for this vulnerable client group.


    10: Elder Care 1996 Dec-1997 Jan;8(6):20-1
    Snoezelen for confused older people: some concerns.

    Savage P.

    School of Nursing and Midwifery, University of Southampton.


    11: Elder Care 1995 Oct-Nov;7(5):11, 13 Related Articles, Links

    Brightening the lives of elderly residents through Snoezelen.

    McKenzie C.
  11. by   adrienurse
    PubMed Services
    Journals Database
    Show:
    Items 1-10 of 10
    One page.

    1: BMJ 2002 Dec 7;325(7376):1312-3
    Sensory stimulation in dementia.

    Burns A, Byrne J, Ballard C, Holmes C.

    Publication Types:

    * Editorial

    2: Am J Alzheimers Dis Other Demen 2001 Jan-Feb;16(1):43-50
    Products for Alzheimer's self-stimulatory wanderers.

    Lucero M, Pearson R, Hutchinson S, Leger-Krall S, Rinalducci E.

    Geriatric Resources, Inc., Las Cruces, New Mexico.

    The objective of this study was to develop a variety of sensory stimulation products for the behavioral intervention of patients with Alzheimer's type dementia. Many caregivers have relied on physical and chemical restraints as the primary method of patient intervention due to the lack of appropriate dementia management products. This significantly lowers the sufferer's quality of care and life. As the age group most susceptible to Alzheimer's disease (65 and older) is the fastest growing segment of our society, an appropriate care solution must be sought. The specific aim of this study was to develop products that are sensory satisfying for the Alzheimer's patient that exhibits self-stimulatory wandering behavior. Sensory satisfying objects for product development would be determined through structured observations of self-stimulatory wanderers in an institutionalized setting. Variations of product design and mounting would be pursued in order to develop products that are not only safe and effective for patient use, but are easy for the caregiver to implement and maintain. Such products would have widespread commercial application in both the institutional and private care settings such as nursing homes, adult day care facilities, Alzheimer's care facilities, convalescent homes, mental health institutions, and assisted-living facilities.


    3: Br J Nurs 1998 Nov 12-25;7(20):1247-50
    Interventions for confusion and dementia. 4: Alternative approaches.

    Woodrow P.

    Middlesex University, Centre for Old Age Studies (COAST), Whittington Education Centre, London.

    While reality orientation and reminiscence are useful therapies, recent years have been a growing awareness of other approaches to caring for people with dementia. This article discusses some of the less established, but potentially valuable, approaches--validation therapy, resolution therapy and multisensory environments. Validation therapy seeks to help care givers understand the thoughts and feelings of care receivers. In contrast to the confrontational approach of reality orientation, it encourages empathy between giver and receiver. Resolution therapy develops aspects of validation therapy, adopting a less structured, more psychodynamic and individualistic approach. Multisensory environments use sensory stimulation to achieve pleasure for the individual. All three approaches have a limited knowledge base, but share a humanistic philosophy that enables them to contribute to a person's quality of life.

    4: Verpleegkunde 1997 Nov;12(4):227-36 Related Articles, Links

    [The effect of sensory stimulation in the sensory stimulation room on the well-being of demented elderly. A cross-over trial in residents of the R.C. Care Center Bernardus in Amsterdam]

    [Article in Dutch]

    Kragt K, Holtkamp CC, van Dongen MC, van Rossum E, Salentijn C.

    GCP Hospital Research & Transfergroep Rotterdam en Omstreken.

    A controlled cross-over experiment was carried out to investigate the effect of snoezelen in the snoezelenroom on the well-being of elderly people with dementia. Seventeen elderly residents from the Bernardus Nursing Home in Amsterdam participated. All were in a very advanced stage of dementia requiring a high level of care and nursing. In this study, the presence of behavioural problems was used as a basis for the measurement of well-being. The behaviour was registered by video cameras and analysed by means of certain subscales of a Dutch behavioural observation scale for intramural psychogeriatrics, the Gedragsobservatieschaal voor Intramurale Psychogeriatrie (GIP). The results showed that less behavioural problems were seen with the experimental intervention. This indicates a higher degree of well-being during the snoezelen activity in the snoezelen room than when the residents remained in the living room. The results of this study indicate the need for a large-scale study in which additional outcome parameters are measured.

    Publication Types:

    * Clinical Trial
    * Randomized Controlled Trial


    5: Perspect Psychiatr Care 1994 Jul-Sep;30(3):13-6
    A group for "wandering" institutionalized clients with primary degenerative dementia.

    Arno S, Frank DI.

    The authors implemented a group in a state psychiatric institution for women with primary degeneration dementia. The group provided scheduled opportunity in a nonrestrictive environment for structured movement and sensory stimulation. Over a period of nine sessions, small but significant changes were noted in the members' behavior. This type of therapy can benefit such limited clients by enhancing the quality of their life in the institution.


    6: Biomed Pharmacother 1994;48(7):275-81

    Alzheimer's disease: rhythm, timing and music as therapy.

    Aldridge D.

    Medizinische Fakultat, Universitat Witten Herdecke, Germany.

    Active music-making provides a form of therapy for the Alzheimer's patient which may stimulate cognitive activities such that areas subject to progressive failure are maintained. Anecdotal evidence suggests that quality of life of Alzheimer's patients is significantly improved with music therapy, accompanied by the overall social benefits of acceptance and sense of belonging gained by communicating with others. Music therapy, when based on clear treatment objectives can reduce the individual prescription of tranquilizing medication, reduce the use of hypnotics and help overall goals of rehabilitation. Mood improvement and self-expression, the stimulation of speech and organisation of mental processes; and sensory stimulation and motor integration are promoted. Given that the rate of deterioration in Alzheimer's disease is not predictable, a series of single case experimental designs would generate valuable empirical data concerning treatment outcome and promote basic research into the timing functions required for the co-ordination of cognition, physiology, motor ability and the integrity of behaviour.


    7: Nurs Clin North Am 1988 Mar;23(1):57-68
    Management of patients with Alzheimer's disease in long-term care facilities.

    Maas M.

    University of Iowa College of Nursing, Iowa City.

    The care of residents with AD in long-term care facilities presents a number of challenges to nursing staff. The institutionalized person with AD displays a number of behaviors that are difficult to manage on traditional, integrated nursing units. In these units, behaviors such as wandering and falling are often managed by chemical and physical restraints. Multiple, complex stimuli, common on integrated units, contribute to the confusion and disorientation experienced by residents with AD. An alternative setting, the special-care unit designed specifically to meet the needs of residents with AD, has been described. Special-care units modify the environment of the traditional nursing unit to promote the safety of demented residents. The units are an attempt to reduce or control the amount of sensory stimulation in order to prevent catastrophic behaviors in the residents and maximize patient functioning. Staff on special-care units are selected specifically for their commitment to the unique care demands required by residents with AD. Ordinarily, staff in long-term care settings need specialized education to provide this care. A research project designed to evaluate the effectiveness of a special-care unit was also described. This research is valuable to residents with AD, their families, managers, and policy makers of long-term care institutions concerned with the effective use of resources. Considerable costs are involved in the construction and staffing of special-care units. However, the potential costs and threats to quality of care associated with care of residents with AD on traditional units make it imperative to evaluate the effectiveness of special-care units. With the increasing number of persons expected to develop AD, nurses, managers of long-term care facilities, and policy makers are faced with the difficult prospect of determining the most effective means of caring for these residents. Because there have been no definitive, comprehensive studies of special care units, there is an absence of empiric support for the many proposed advantages. Few studies have used systematic measurement techniques or measures with established reliability and validity. Given the growing number of elderly persons in the United States and the expected growth in the number of nursing home residents with AD, it is important to establish the value of special treatment units for residents with AD.


    8: Am J Occup Ther 1984 Aug;38(8):505-9
    The effectiveness of sensory stimulation for geropsychiatric inpatients.

    Paire JA, Karney RJ.

    The objectives of this study were (a) to explore the effectiveness of sensory stimulation therapy under controlled conditions, and (b) to ascertain the short-term effectiveness after treatment ceased. Thirty geropsychiatric patients were divided into three treatment condition groups: sensory stimulation, staff attention, and standard hospital treatment. Twenty-seven subjects completed the 12 weeks of treatment and 6 weeks of follow-up. Assessments were made prior to treatment, upon completion of treatment, and six weeks after treatment was completed. The results showed that those subjects who completed the sensory stimulation treatment significantly improved and maintained their improvement in the areas of personal hygiene and interest in group activities relative to the subjects in the other two treatment approaches studied. Discussion focuses on the implications of sensory stimulation for the treatment of elderly psychiatric patients.

    Publication Types:

    * Clinical Trial
    * Randomized Controlled Trial

    9: Isr Ann Psychiatr Relat Discip 1978 Dec;16(4):315-26 Related Articles, Links

    Sensory stimulation of elderly patients: preliminary report on the treatment of patients with chronic brain syndrome in an old age home.

    Ernst P, Badash D, Beran B, Kosovsky R, Lerner K, Kleinhauz M.


    10: Med J Aust 1967 Jun 3;1(22):1113-9
    Sensory stimulation and the treatment of senile dementia.

    Bower HM.
  12. by   donmurray
    Alzheimer Cafe's would seem to be the hot thing at the moment.
  13. by   adrienurse
    "Alzheimer Cafe's would seem to be the hot thing at the moment."

    I don't know what that is. Is it a new therapy or an internet group?
  14. by   mageean
    Thanks Adrienurse and other guys, this is very helpful. I can see you have been busy.

close