Do you know "basic-stimulation"?

talaxandra · Sep 14, 2004

Hi Dirk

the talking to the brain dead thread is mine - thanks for dropping in on it :) I'm not aware of a technique called basic-stimulation. What does it involve?

T

gwenith, BSN, RN · Sep 14, 2004

Are you talking early coma recovery techniques???

Dirk · Sep 14, 2004

Hello !

I just make a try - and please don´t laugh about my english.

Now I get into special nursing-english, that I don´t know ...

Basic stimulation is a concept for the advancement and care of disabled (special with neurologic disorder (hope that is right))

BS was found (or developed) by a social pedagogic - Andreas Froehlich. He made this experinces with mentally and physically retarded childeren. A nurse worked with this concept, and tried with adult patients.

The following text is written by Peter Nydahl - a great pusher of this concept (and a real great friend)

The term basic stimulation means the offer to patients of pleasant, clearly perceptible information (stimulation) about themselves or their environment, using familiar and elementary (basic) experiences.
Aim of basic stimulationis the stimulation and accompaniment of individual learning processes.
Target group All persons with restricted or impaired perception, movement or communication. For example: Unconscious, artificially respirated, disorientated, and somnolent patients. Patients with cranio-cerebral trauma, brain damage following hypoxia, Alzheimer's disease, hemiplegia, and apallic syndrome. Dying, elderly, motorically disabled, and retarded patients, as well as premature infants.
Human understanding: Human beings live autonomically through and in interrelation with the environment. The greater the impairment of autonomy and ability to interrelate, the greater the dependence upon the environment. We understand the patients as equal partners, holistic beings with individual stories. The capability of experiencing is always present, the need for expression and communication in the actual life situation elementary. The patients are human beings with communicative and social competencies, with their own goals and strategies of accomplishment.
Background: Perception is individual, it is alterable and our experiences depend on it. We believe that the experience of oneself and the environment is changed following a serious disease, a phase of sedation or brain damage. Immobility, reduced communication and a strange and boring environment often cause a loss of motivation, disturbances of orientation, psycho-emotional withdrawal and so on. General care seems meaningless to these patients and is paired with a reduced rehabilitative potential. They require special conditions for learning and rehabilitation, their care necessitates special pedagogical qualities.
Basic stimulating care means a mutual learning process. The nurse offers activities to the patient and watches for reactions. These are integrated into and guide the further activity of the nurse.
This requires that the nurse accepts the patient in his reduced abilities, as well as flexibility and a large repertory of possible strategies and responses to the expressions of the patient. These then form the communication. The patient is so able to determine his own care. He feels respected and understood, he learns to realise and trust his own effectiveness and selfdetermination.
These nursing activities are offers to the patient. They are orientated on the learning potential, awareness and biography of the patient. They are simple, understandable and interesting for the patient. The offers invite him to join in the activity. This learning process often means to perceive and update the own bodily and psychic identity, experience and change the environment, understand meanings, develop an own rhythm and to take control of or even leave- life.
Basic stimulating care is featured by
Preserve life (Breathing, Feeding, Moving) and experience developement
Feel oneself
Give safeness and establish trust
Build up relationship and form encounters
Experience environment
Meaning and sense
Develope rhythm
Form life
Autonomy and responsibility

Can you imagine, what I mean ?

Do you want an example of practical use ???

For me, basic stimulation is a great philosophy of take care for other people (hope I have written everything right)

Dirk

gwenith, BSN, RN · Sep 14, 2004

Dirk you are doing wonderfully. At the moment I am heading off to bed (it's 1 am here but I promise I will read this tomorrow and give some feedback. Night!!!

talaxandra · Sep 15, 2004

Dirk, what you describe sounds to me like good general nursing care, so I think I must be missing something. Could you post an example?

PS Don't worry on the language front, you're doing fine :)

Dirk · Sep 15, 2004

Yes - you are right - except some differents.

I made the experince, that we some things do, because they have to be done, and the way we do, is the way we ever have done.

I will write you more a little later, if I will be at home (now I`m at work).

For now I copy a text, written by Peter Nydahl. This text describes with a few words, an example of BS :

A 56 year old woman with a severe encephalitis, decreased muscle tonus, just able to open her eyes a little, was asked to open her mouth for a mouth rinse. By the first contact she closed her mouth and pressed her lips together. The situation was reflected: The woman did not seem to understand the meaning and the nurse started the activity in a different manner. She looked through the patient's toilet articles and found a mouth wash. She showed this to the patient and let her fix it with her eyes. The nurse put some of the mouth wash in a glass in front of the patient and guided her hand slowly to the glass. The nurse raised the patient's arm a little, as a question. She felt a higher tonus in the arm and moved the arm upwards to her lips and asked her again to rinse her mouth. The patient opened and rinsed her mouth. The arm was raised again, the patient accepted and so the activity was repeated three times.

Here you have a link, for another text :

http://www.basale-stimulation.de/DE02.HTM

Greetings

Dirk

talaxandra · Sep 16, 2004

So is Basic Stimulation the theory that, when working with altered (as in confused, disoriented etc) patients, we may need to use a variety of methods to convey information? In other words, they may not be able to interpret a verbal massage, such as "open your mouth for a mouth rinse"?

I'm sorry to be geting a stronger grasp on it than this, and perhaps it's because I'm unwell at the moment, but the example you gave above still seems like an example of expert general nursing care.

I work with stroke patients, many of who have receptive and/or expressive issues,and we routinely use alternative methods of basic communication. Yet I get the feeling that the theory you mention is more than this. I'm really interested in knowing more, Dirk - please continue to post :)

Dirk · Sep 16, 2004

please continue to post :)

Hello !

Yes I will try - but you have to be patient with me, because I have to translate my knowledge - and it is very difficult for me.

I only know school-english - but nursing-englisch is a little different.

If it is OK, I will try to give little eamples.

Especially for stroke patients this concept is very useful.

The time, before I started at the ICU I worked in a neurology unit, where the most patients where stroke-patients.

I try to wriete the first little example today.

Take care

Dirk

Dirk · Sep 16, 2004

First I have to apologize for my english.

I try to describe things, if I don´t know the right english word. Please help me to learn - if you use special words, let me know ! - Thank you !

The constantly existing possibility for the independent movement makes it for us possible, always to notice our body as entireness. By the movement and the associated changes receive we differentiated information about our physical condition and environmental condition.

In a condition, in which we cannot move any longer, reduces this information flow. The perception of the body, the body picture and the environment becomes ever more indistinct.

(body picture : how we know our body ... how long are my legs, in which way I walk....)

Measurement feelings can occur, those finally in orientation disturbances or even heavy identitycrises flow.

Here I have copied a drawing out of the book " Basale Stimulation - Neue Wege in der Pflege Schwerstkranker" written by Peter Nydahl.

The advice was, to draw, how the body feels like.

Left you see a drawing before, in the middle after lying on a soft ground for 30 minutes without moving, and right the same on a hard ground.

If you could read this - I will continue later ...

Greetings

Dirk

talaxandra · Sep 29, 2004

It sounds as though you're talking about altered proprioception (the ability to tell where parts of your body are in space without looking), which happens in some kinds of stroke and other acquired brain injury. Is this correct?

Dirk · Oct 1, 2004

hmm .. just a little more ...

Not only some patients after a stroke feel like this.

Try following :

You have to be with another (perhaps your friend or collegue)

Take place on a chair

sit on your hands, and stay sitting.

This is like staying in bed - without moving.

After some minutes, you loose your hands !

Now close your eyes, and hold your hands in front of you.

Let your friend or collegue give one of your hands a form by holding and pressing.

Now try to describe both of your hands - you will see, that you will have such a feeling without having a stroke.

If you stay lying in your bed, without moving, you will loose your body-feeling.

I hope, I told it the right way (and you can understand, what I mean)

Greetings

Dirk