Dementia Care

20 / 40

20 Australian Journal of Dementia Care December 2016/January 2017 Vol 5 No 6
Available at:
design_in_dementia_care/doc/How%20to%20m
ake%2Qa%2 0Sensory%20Room%20for%20
people%20With%20dementia.pdf
Johnson R, Elliott A (2006) Using multi-sensory
prompts as a means of communication: working
with individuals who have Down’s syndrome and
dementia. Downs Syndrome Association Journal
11221-11222.
Johnson R, Elliott A (2008) Sensory prompts and
dementia. Down’s Syndrome Association Journal
118 24-25.
Jones J (2000) A total communication approach
towards meeting the needs of people with
learning disabilities. Tizard Learning Disability
Review 5(1) 20-26.
Kindell J, Burrow S, Wilkinson R, Keady JD
(2014) Life story resources in dementia care: a
review. Quality in Ageing and Older Adults 15(3)
151-161.
Lacey P (2006) Inclusive Literacy. PMLD Link 18
(3, 18) 11-13.
Longhorn F (2011) A short history of shout, glow,
jump, taste, smell, touch and wobble. PMLD Link
23 (1, 88) 32-33.
Mansell J (2010) Raising our sights: services for
adults with profound intellectual and multiple
disabilities. London: Department of Health.
Mencap (2014) About profound and multiple
learning disabilities: factsheet. London: Mencap.
McKeown J, Clarke A, Rapper J (2006) Lifestory
work in health and social care: systematic
literature review. Journal of Advanced Nursing 55
237-247.
McKeown J, Ryan T, Ingleton C, Clarke A (2015)
You have to be mindful of whose story it is: the
challenges of undertaking life story work with
people with dementia and their family carers.
Dementia 14(2) 238-256.
Pagliano P (2008) MSE definition. Presentation at
6th international Snoezelen symposium,
Neuwied, Germany.
PAMIS (2002) Real lives: real stories. Summary of
results leaflet. University of Dundee.
Park K (2004) Interactive storytelling: from the
Book of Genesis. British Journal of Special
Education 31(1) 16-23.
Penne A et al (2012) Staff interactive style during
multisensory storytelling with persons with
profound intellectual and multiple disabilities.
Journal of Intellectual Disability Research 56(2)
167-178.
Raphael C, Clark M (2011) Christian. PMLD Link
23 (1, 88) 18-21.
Royal College of Speech and Language
Therapists (2013) Position paper: speech and
language therapy provision for people with
dementia. London: RCSLT
Schweitzer P, Bruce E (2008) Remembering
yesterday, caring today: reminiscence in
dementia care: a guide to good practice.
London: Jessica Kingsley Publishers.
Taylor J (2006) Using multi-sensory stories to
develop literacy skills and to teach sensitive
topics. PMLD Link 18(3, 18) 14-16.
Young H, Lambe L (2011) Multi-sensory story
telling for people with profound and multiple
learning disabilities. PMLD Link 23 (1, 88) 29-31.
Whatever approach is taken to sensory storytelling, two
considerations are essential: stimulus selection and sensitivity.
Stimulus selection
The choice of stimuli is centrally important; careful, person-specific
and dementia-specific selection is key. This choice is not
necessarily focused on the progression of sensory development as
it might be in supporting individuals with PMLD (although this is a
potential outcome which might be explored in research). Rather, it
is focused on recall and pre-existing associations, on finding stimuli
which are strong memory triggers and which are not distressing or
confusing (nor likely to become so as dementia progresses).
Identifying strong memory triggers can be difficult, particularly if the
person has limited verbal ability to relate their memories, but thinking
creatively tends to get results.
Breaking tasks down is a good starting point – if the person liked
baking, explore the sensory elements of each stage of baking
(stirring or kneading actions, feel of flour, smell of vanilla essence,
taste of icing) and observe their responses.
This type of process revealed, for example, that using a bicycle
pump was a great kinaesthetic experience for prompting Shah* to
talk about the cycling races he won as a young adult.
An assessment or activity to establish the person’s sensory
preferences is a wise step, so that the experience is an enjoyable
and meaningful one:
• Is the person calmer with firm or light touch?
• Do loud sounds frighten them?
• Do they love sweet tastes?
Occupational therapy assessments are often excellent sources of
guidance for selecting personalised sensory stimuli; alternatively,
tools may be found in Fowler (2007) and Grace (2014).
Personalising stimuli is of course more challenging in group
storytelling, but tweaking the experiences to fit each group member
is not insurmountable.
Consideration of general sensory features of dementia is equally
important. Progressive neuronal changes affect the way sensory
stimuli are processed and experienced (Baker et al 2003). For
example, mirrors and abstract projected images may be confusing
(Hope & Waterman 2004). Smells, on the other hand, are likely to
be successful stimuli because they are the only form of sensory
information to remain indefinitely once encoded (Johnson & Elliot
2006).
Readers are directed to Jakob & Collier (2014) for further
information.
Sensitivity
Sensitivity is essential in all aspects of sensory story work. As in
all life story or reminiscence work, there is potential for traumatic
memories to arise and the practitioner should be prepared for this.
There is also a need to consider how the rather reductive act of
condensing someone’s life memories into eight to 10 sentences
might be experienced.
Having an example of a sensory story helps to introduce the
concept. Great sensitivity is required in discussing likely
deterioration in verbal communication and increasing need for
more multi-sensory, non-verbal supports. Talking about those
abilities that might be maintained through sensory stories (for
example, continued potential for sharing memories and
connecting with family and friends) is a more positive approach.
Finally, storytelling can be viewed as ‘for children’ and it can help
to focus on sharing stories rather than being told a story.
A ‘story tree’ can visually record stories that arise during group
storytelling sessions and become a talking point for visitors and
care-givers.
Sensory stories may not be appropriate for everyone and they are not
posited here as a replacement for any existing approach. Rather, they
are an addition to the toolbox of approaches that can be used to
support people with dementia, chosen where it is clinically indicated
and fits with the person’s own goals.
Sensory storytelling: points for practice