How noise affect the person with dementia?

Specialties Geriatric

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One of my assignments topic in the university is how environmental modification can enhance the will being of the person with dementia. In particular, I'm focusing on Noise as a fundamental aspect of sensory stimulation that affect the person with dementia. what iplications nurses need to conisder in order to create more therapeutic care environments. for example, switching off TV an radio for an hour ever moring and afternoon or an hour before bed time. unfortunately, I don't have any working experience in dementia field. can anyone help me to give an example from his/her working experince in dementia care? a rationale for the modification and the action plan.

I hope to get the useful information and ideas from you

thank you

Regards

Ma'in

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Specializes in Acute Care, Rehab, Palliative.

Well my take on it would be that noise "pollution" can have the effect of overstimulating dementia patients. People with dementia sometimes have trouble processing what is going on in their environment and decreasing stimuli can decrease certain behaviours. Turning off the TV or radio in the evenings or any time you want them to wind down would decrease the background "chatter" that can sometimes contributes to agitation in the demented patient.

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Specializes in LTC.

I agree with the previous poster about how noise can be overstimulating for them.

However, soothing music works well for our residents as well.

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I work in LTC w/dementia patients on the 3p-11p shift and I can tell you, in my experience, noise greatly affects most of my dementia patients! And not in a good way.

Change of shift often is met with "noise", the chatter of the oncoming/off going employees, the shuffling around, the overhead pages..I notice a lot of the residents who might have been sitting quietly just as we walk on the floor are very agitated and anxious within 10 minutes of us walking on the floor.

The TV or radio being too loud can also set them off. But in the same token at times, a TV or radio set to a low volume with a soothing type sound works wonders to calm an agitated dementia patient.

At the change of shift as I walk onto the floor, as i pass the radio, I turn it off or turn it down low, I make sure the TV isn't blasting, and I try to keep my voice down. The less background noise the better the resident is.

Later in the shift, I remind my staff to try to keep the tone/volume of their voices down, especially around 'sundowners time". Loud talking, laughing etc tends to perk up the dementia resident who might have been quiet prior to.

Dinner time tends to wind up some of the dementia patients, again, the kitchen staff bringing the trays to the floor, their laughter and chatter, the noise of moving residents to their dining area, etc. I try to have my easily set off residents in an area that isn't ground zero for the noise, they tend to be more relaxed if they aren't in the center of all the noise and movement.

With that said, yes, noise definately affects my patients with dementia. Now I said noise, not sound. Hushed background sounds like a radio set on an easy listening station on a low volume actually will calm most of my residents, talking to them in a calm, soft voice will calm them as opposed to a normal to loud voice. The "bubble" machine (what i call it) that makes soft water sounds will lull a lot of my residents into a peaceful state and sometimes a nap.

Sound can have good and bad effects on a dementia resident.

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thank you all for you great comments, CT Pixie I totally agree with you because in an environment where there is no audit or regular evaluation of noise levels, sensory stimulation can become unbalanced. The consequences for the person with dementia can vary from minor to severe, according to the remaining abilities of the person. This includes the person’s capacity for dealing with the often overwhelming presence of sensory stimuli. from the literature that I have read, people with dementia have a reduced stress threshold to many environmental stimuli. in busy care settings the person will pass their threshold at about 90 minutes. Thus, in some settings, the way in which a person presents and behaves may be influenced by the environment. It must not be assumed that the level of impairment and disability observed is entirely caused by pathological changes in the brain.

The majority of older people would not be used to the levels of noise, the continuous noise and noise associated with

movement going on around them in their own homes. Then background noise from phones and

machines, trolleys and other pieces of equipment, the television and radios all add to the auditory stimulation. The motion of people coming and going also adds another layer to auditory stimulation. Noise disturbs rest, relaxation and

sleep.

However, i think that prolonged periods of sensory under stimulation (such as from being in a bland or plain room, with minimal cues and little engagement with others) can also escalate a person to their stress threshold. Thus looking at the environment and the pacing of activity, care and therapy intervention is vital.

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