This installment of my blog is going to introduce you to sensory rooms in skilled nursing facilities and my experiences utilizing one. A former Creighton student / now therapist at my site (and one of my lovely mentors 🙂 ) designed and drafted the plans for our facility’s sensory room and was able to convince the board to fund the room as a part of her professional rotation (how impressive is that?!). Now that she has been hired on as a therapist, she has not had a lot of time to work on program development with the room (and this is where I come into the picture).
I have been using the room with patients using skilled observation to determine which aspects of the sensory room are most therapeutic for people on an individual basis. I have noticed that many residents are hesitant to touch the items in the room and are not very ‘active’ in their participation, but rather, taking on a more passive role. Most of the residents I have brought into the room are passive in their experiencing of the room and tend to relax and watch the colors of the bubble tube and fiber optic light ropes change in addition to enjoying the projected images of fish or birds while listening to music. Some residents enjoy flipping the power cube around as it controls the colors of the bubble tube, but this is typically as active as they get.
In order to determine the best way to go about formally evaluating patients upon taking them onto caseload for sensory integration, my mentor and I have referred to assessments like the Pool Activity Level (PAL) instrument and the Allen Cognitive Lacing Screen (ACLS). We collaborated and developed an evaluation where we will first write about a resident’s social history, their likes and dislikes, former and current hobbies, among other important details. The next section of the document focuses on the resident’s current level of participation/need for assistance with basic activities of daily living (BADLs) like self-feeding, dressing, grooming, bathing, and toileting. We will then administer the ACLS to determine residents’ current Allen Cognitive Level in order to determine which aspects of the sensory room may best suit them in addition to providing caregivers with education on patient’s ability to participate in BADLs and encouraging caregivers to give patients the time necessary to complete these within their best ability to function. In addition to reviewing evaluation materials, I called around to various facilities with sensory programs already in place in order to see what has been tried and true with regard to the screening and evaluation process as well as how to bill for services. Of all the places I contacted, I was able to speak on the phone with two and I learned a lot from a facility in Lincoln, NE, that has a sensory room that has been utilized for several years. Their advice to me was to use the therapeutic activities CPT code for billing purposes as the sensory integration CPT code does not often get reimbursed. When documenting, ensuring that you’re writing the purpose of using the room (i.e. for calming or stimulation), what you did in the room and the outcome are all important in ensuring our documentation is ‘billable.’
Now that we have gone over some of the details of program development, I’m going to back up a bit and tell you about the efficacy of sensory rooms and the research backing their use. For years, therapists have been exploring the use of sensory rooms in decreasing some of the ‘negative’ behaviors associated with dementia including aggression, wandering, lethargy and apathy. Oftentimes when patients exhibit these behaviors, they are given anxiolytic agents and antipsychotic medications. Serious problems and side effects including increased confusion, falls, sedation, anticholinergic and cardiac side effects and even death are associated with the use of these medications (Mitchell et al., 2014). As holistic healthcare professionals, occupational therapists are interested in using non-pharmacological means to help decrease the negative effects of dementia. Sensory rooms are one of the avenues that can be taken in alleviating these symptoms. As individuals advance through the stages of dementia or Alzheimer’s disease, they often lose the ability to participate in previously enjoyed activities. Occupational therapists recognize that these individuals can still enjoy some of the sensory aspects of activities. Focusing on using the senses to bring about stimulation or relaxation can add to the quality of life of individuals with dementia and could help to reduce ‘problem’ behaviors like wandering, going into other individuals’ rooms and being physically aggressive (Collier, McPherson, Ellis-Hill, Staal & Bucks, 2010). More research needs to be done, but the current research suggests that sensory rooms can have positive effects on individuals with dementia.
Have a blessed week ♥,
Collier, L., McPherson, K., Ellis-Hill, C., Staal, J., & Bucks, R. (2010). Multisensory stimulation to improve functional performance in moderate to severe dementia—interim results. American journal of Alzheimer’s disease and other dementias, 25(8), 698-703.
Mitchell, A. M., Chiappetta, L., Boucek, L., Cain, M., Patterson, G., Owens, K., & Stark, K. H. (2014). Nonpharmacological therapeutic techniques to decrease agitation in geriatric psychiatric patients with dementia. Journal of gerontological nursing, 41(2), 53-59.