Stimulation of Senses in Dementia Patients

As dementia progresses, patients become less and less interactive with their environment and the people around them. It becomes increasingly difficult to converse and you may wonder “Can my being here make a difference?” The answer is “yes” — you can make a difference and improve quality of life.

One way to do it is by interacting by way of the senses. Even if the patient doesn’t recognize you or even realize you are there, you can feel as though you are providing a meaningful interaction that can be soothing and bring pleasure.

You may want to think about your own feelings. What do I want to accomplish in my interactions? Am I frustrated?  Can I control my feelings? Why do I get upset when I know he can’t help himself?

Planning Ahead

Meaningful interaction begins with preparation. Interacting with a person with dementia can be frustrating and unrewarding when you feel as though there is nothing you can do.  A little planning can make your time together more rewarding.

Gather together some supplies so that you are prepared for whatever the situation.  A few ideas are:

• • Knitting, a crossword or a book to read if the patient is sleeping
  • A picture book with large colorful images
  • Animal photos
  • Music you know the patient likes
  • A newspaper column, such as Dear Abby or the sports page to read aloud
  • A photo album
  • A special and familiar memento
  • A letter from a mutual friend to share
  • A nail file and polish for a manicure
  • The patient’s favorite perfume or aftershave
  • A favorite food, such as a milkshake
  • Lotion for a hand or foot massage
  • A squishy ball to handle
  • Crayons and paper for drawing
  • A pet

The sky is the limit. Use your imagination and everything you know about the patient to come up with ideas of things to share. The patient may like hearing the latest news about others in the family, neighbors, or people from his church.

Begin with Basics

Interactions with the patient will be more successful if he or she is clean and dry, is not hungry, and is comfortable. Do your best to make sure these things are taken care of first. It is difficult to enjoy pleasant sensations if you feel cold, hunger, wet, or pain.

Pain can sometimes appear as negative behavior. People with dementia may withdraw, strike out, or display other “bad” behaviors when in pain. If you have seen behavior changes that you suspect may be due to discomfort, you may want to look into a trial of pain medicine.

Touch

We all need to be touched, but seniors are often deprived of this essential element to well-being.

Touch can be “instrumental;” that means required to carry out activities such as bathing or dressing. But research shows that often people with dementia can tell the difference between “instrumental” and “expressive” touch. Expressive touch is when we hold hands, put an arm around the person, or give a back rub or hug. This conveys acceptance, nurturing, and caring.

Expressive touch helps the elderly feel less isolated, dependent, and depressed. One researcher found that it also made the caregiver feel better. It is no coincidence that the ultimate form of punishment is solitary confinement — no touching.

Caring touch can trigger the brain to release endorphins and serotonin—natural chemicals that suppress pain and depression. This is one reason massage can lower the perception of pain.

• • Massaging a loved one’s hands or back can help while waiting for pain medicine to work.
  • Brushing the patient’s hair and applying lotion have the same affect.

Hearing

We believe that hearing remains intact until the very end of life. This gives us an opportunity for providing comfort.

• • Soft music can be very soothing to an agitated person who has dementia.
  • If they have been religious, the person may appreciate hearing hymns and spiritual music. You can play CDs of favorites.
  • You can even sing or hum a familiar tune—maybe one from car trips many years ago.
  • Wind up a music box or play an instrument.
  • An artificial waterfall or other sounds of nature from a sound-generating machine can also be soothing.

Communication

Just chatting can be very reassuring. “I spoke with Michael today, back in Virginia. He says he and Alice are going to take a trip to Vermont. They are going as soon as the snow melts. It’s February now, so it may be a couple of months.”

Maintain the resident’s dignity in small ways: use terms like “disposable briefs” instead of “diapers.”

Remember to speak slowly and clearly. People with dementia take longer to process what you have said.

Sense of Smell

This sense is so basic that when we smell a certain scent, it can bring back memories from decades ago.

• • Aromatherapy takes advantage of this by providing pleasant smells that might bring back sweet recollections or feelings.
  • Offer a rose, a lavender sachet, or a scented candle that smells like pumpkin or apple pie.
  • A favorite perfume or aftershave can brighten spirits.
  • Try putting scented oil in bath water.

Taste

• • Provide a favorite food or drink. The person may love milkshakes or pudding and they don’t usually get them.
  • Cleaning the mouth with minty toothpaste or mouthwash on a piece of gauze may be refreshing. (Be sure that the patient is not likely to bite down on your fingers if you do this.)

We have to be very careful about anything in the mouth at the end of life. With dementia, all the muscles get weaker—including the muscles for swallowing. If the patient coughs or sputters a lot during meals, he or she may be getting food or fluids in the airway. This can cause pneumonia.

Sensations & Textures

• • A person with dementia may have little chance to experience unusual textures, such as soft fur or a smooth, cool stone. A pet or even a stuffed animal may provide comfort.
  • Wrapping someone’s hands or feet in a warm, wet towel might feel very soothing and relaxing — the spa treatment! To make the heat last longer wrap the towel in a plastic bag.
  • Find a way to warm a flannel blanket to wrap the resident in; the clothes dryer makes a good blanket warmer.
  • Smooth the sheets or put cool, clean sheets on. Change the pillow case or turn over the pillow.
  • Open a window to feel a breeze.

Imagination

Use your imagination.  Think about what kinds of things would bring you comfort. What would feel good to you?  For each interaction plan a simple, creative way to bring pleasure, serenity, or comfort. Quality of life will improve for both you and the patient!