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Wardipedia – 14. Multi-sensory

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The sense of calm

Introduction

There’s no lack of sensory stimulation on wards! But often the continuous presence of noise in particular, along with all the other stressors of ward life, makes it important to provide actively therapeutic and calming sensory experiences for patients.

Sensory activities are particularly valuable when patients are in a highly agitated or distressed state, as it is in these times when cognitive processes are seriously impaired and bodily sensations are the most accessible channels for returning to equilibrium. As well as sensory experiences being fabulous for helping diffuse agitation, they’re great for smokers struggling to cope with restricted (or in some cases non-existent) ciggy opportunities. And techniques learnt in hospital can become valuable elements in people’s coping repertoires once they’re back home.

Many of the ideas in this feature come from three specific groups –

  1. people with ‘profound and multiple learning disabilities’ (i.e. who have severe learning disabilities and additional physical and/or sensory impairments),
  2. elderly people with dementia (who often have a similar set of multiple disabilities to individuals with PMLD)
  3. and people who self-harm. Although most are presented individually here, combining multi-sensory experiences can be very powerful.

For example, research shows that that aromatherapy especially if combined with massage is effective in helping reduce agitation in people with dementia.

The ideas below are somewhat randomly categorised, as most of them encompass more than one sense. Some activities are inherently multi-sensory and it’s of course possible to combine others eg listening to music while painting. Indeed multi-sensory experiences are particularly valuable as they stimulate more parts of the brain as well as body. And for patients who self-harm, because this behaviour is so powerfully multi-sensory, alternatives which harness more than one sense are more likely to be effective.

 

Ward Examples

  • Small toiletries’ bags are offered to patients on admission. Feels very hospitable and saves giving big bars of soap, and shampoo, so also saves money.
  • Total well-being sessions’.
  • Nurses run a TIPIY group (Taking Pride and Interest in Yourself).
  • Make-over sessions, with female patients enjoying each others’ attention and physical contact as well as their new look nails, hair etc. Foot spas for men are very popular.
  • A well equipped Hair Salon, where patients and staff can do each other’s hair etc.
  • Ladies ‘pampering room’ providing hairdressing, manicuring, hand massage, etc.
  • A make-over session included clothes donated by Paul Smith, Vivienne Westwood and other designers!!
  • Volunteer beautician for the female ward and a volunteer yoga instructor for group sessions.
  • A Red Cross beauty therapist comes in for hand massages, make-up advice, etc and also to advise on techniques for dealing with self-harming scars and burns.
  • Massage therapy and pampering sessions
  • Aromatherapy room! Treatment bench, relaxing pictures and astutely, the framed diploma of the nurse who is a qualified aromatherapist.
  • The hospital has carefully built relationships with the women’s centre across the road. Patients can enjoy reflexology and aromatherapy there, as well as supportive contact with other women.
  • A nursing assistant is trained in beauty treatments including Indian head massage.
  • ‘Wake and shake’ start to the day with the sports therapist and/or physio.
  • Relaxation room includes lava lamp and colour changing globe.
  • Relaxation – learning techniques in afternoon then relaxation session at 10pm, half hour before bed.
  • Sensory groups for elderly patients e.g. food tasting i.e. cheeses; different fruits; smells boxes (recognising different familiar smells e.g. mown grass, Vick’s).
  • Tea dances with carers invited and non alcoholic fruit punch and assorted nibbles. Themed groups e.g. showing a musical film and having fresh popcorn and ice creams or food relevant to the film i.e. Mamma Mia and Greek food
  • Providing smoothies and non-alcoholic cocktails for ward parties
  • Older People’s wards have a record player and LPs of music enjoyed by their patient group. They regularly hold informal tea-dance afternoons for patients and their family where war-time songs are played and everyone enjoys tea and cakes.
  • We have a multi-sensory room, with a variety of sensory integration equipment, which can be prescribed by OT staff.

Patient Examples

  • My husband washes all my clothes at home and brings them in to the ward. This makes my clothes smell like home and gives me some comfort.
  • I would take long baths on the ward with plenty of bubble bath.
  • I love chocolate and would let the chocolate melt slowly in my mouth, a little treat but not too much of course!
  • Having a warm bath using my favourite bubble bath was not only relaxing but bliss.
  • A very kind lady from the Red Cross gave me a hand massage, which was enjoyable and relaxing.
  • I used to love having a bath with all my favourite products and a cup of tea and painting my toenails. It was perfect me time.
  • I couldn’t use my normal coping mechanisms on the ward but have learnt lots of new healthy ones.
  • Sometimes I like to be very busy so I don’t have to think, I normally play on the Wii I or join the art group. Other times I have a hot bath with my favourite lotions and it reminds me of home.
  • Sensory room is a brilliant idea. I’ve worked at a Special School and I love taking the pupils into their sensory room as it’s so calming for me! It has soothing music and beautiful lights and bean bags – brilliant for relaxation.

Multi-sensory stimulation

  • Regulated, deep, calm breathing is probably the most fundamental and important technique of all, but can be impossible to achieve when highly wound-up or distressed.
  • Visualisation – soothing images and scenarios of safe spaces. The classic is imagining being on a sunny beach, and working through each of the sensations – the heat of the sun on the skin, the feel of the sand, the sight of waves lapping, the sound of seagulls, the smell of fish and chips etc. But the choice is very individual – for some people, imagining being in a deserted forest is calming, for others it’s totally terrifying.
  • Hot water bottles, microwavable warmers etc
  • Mini indoor fountain
  • Sound machine
  • Lavalamps
  • Weighted blankets and lap pads available from http://bit.ly/weightedblankets
  • Heavy duvets – eg wool ones
  • Books and magazines eg:
  • Photography
  • Gardening
  • Landscapes, travel
  • Art
  • Film, music
  • Poetry
  • Food
  • Arts and crafts’ materials eg paints, pens, papers, sewing, knitting, scrapbooking, balsawood, beads, pottery, ceramics, models, mosaics, origami
  • Drawing, doodling, scribbling
  • Indoor gardening – eg herb gardens, mini-Zen garden
  • Really noticing everything around you, as if you were going to draw it. Describing features like colour, the effect of light and dark, textures, shapes, contrast, people’s interesting physical characteristics etc
  • A less taxing version of this is simply counting the colours you can see or listing five things you can see, hear, smell, touch.
  • Henna tattoos
  • Jigsaw puzzles
  • Balloon modelling
  • Blowing soap bubbles
  • Music
    • Having a choice of different types of music – classical, chart, dance, jazz, opera
    • Listening to really loud music (with headphones…)
    • Listening to music at a really low volume so you have to fully concentrate to hear it
    • Singing, rapping
    • Musical instruments, including drum machine, electronic drum sticks, keyboard, electric guitar and vocal recording equipment, kazoo, harmonica
  • Relaxation tapes and DVDs
  • Stroking animals – for many people, there is nothing more soothing than this
  • Squeezing stress balls, other squidgy products
  • A hot bath with bath oil or bubbles
  • Body lotion, scented or unperfumed
  • Foot spas
  • Hand or foot massage
  • Indian head massage
  • Finger-painting
  • Washing up
  • Aromatherapy essential oils and diffusers
  • Ambient scent products, from the vast choice in supermarkets or more specialised ones like Scentcube
  • Scented bath oils
  • Different foods eg chocolate, coffee, herbs, lemon
  • Flowers
  • Cooking
  • Animals!
  • Anything that the individual finds calming and pleasurable to eat or drink
  • Strongly flavoured sweets – mint, sour, aniseed etc.
  • Cup of tea or coffee – can be ramped up by indecent amounts of sugar or made more distinctive by unusual flavours. (Who wouldn’t feel better after a lovely cup of chocolate chip cookie flavoured coffee?)
  • Exercise eg:
  • Gardening
  • Walking
  • Jogging
  • Dancing
  • Weightlifting
  • Cycling
  • Football
  • Croquet, cricket, rounders, softball
  • Badminton
  • Table tennis
  • Exercise equipment eg bikes, rowing machines
  • Space hopper races!
  • Trampoline
  • Indoor games eg
  • Wii-fit
  • Air hockey
  • Pool
  • Table football
  • Flattening drinks’ cans – a cathartic as well as green activity
  • Ripping up old newspapers, cardboard, junk mail, pointless (non-confidential)official reports
  • Chewing gum, bagels – especially helpful for smokers and people who bite their nails
  • Using a rocking chair
  • Juggling

 

Sensory ideas

  • Air hockey
  • Aquarium
  • Aromatherapy essential oils and diffusers
  • Art – looking at and discussing artwork
  • Arts and crafts’ materials
  • Audio-books
  • Badminton
  • Balloon modelling
  • Bath with lovely oil or bubbles
  • Blowing soap bubbles
  • Body lotion, scented or unperfumed
  • Books and magazines
  • Breathing exercises
  • Candles (battery powered)
  • Chewing eg gum or bagels
  • Cooking
  • Cycling
  • Dancing
  • Drawing, doodling, scribbling
  • Exercise
  • Fiber-optic lights
  • Film
  • Finger-painting
  • Flattening drinks’ cans
  • Flowers
  • Food
  • Foot spas
  • Football
  • Gardening
  • Heavy duvets – eg wool ones
  • Henna tattoos
  • Herbs
  • Hot drink
  • Hot water bottles, microwavable warmers etc
  • Indoor fountain
  • Indoor games
  • Indoor gardening – eg herb gardens, mini-Zen garden
  • Interactive toy animals
  • Jigsaw puzzles
  • Jogging
  • Juggling
  • Lavalamps
  • Listening to music
  • Massage eg hand or foot
  • Photos eg of landscapes, travel
  • Playing musical instruments
  • Poetry
  • Pool
  • Rapping
  • Relaxation tapes and DVDs
  • Reminiscence Kits (eg nostalgic music, food brands, posters and objects)
  • Ripping up old newspapers, cardboard, junk mail, pointless (non-confidential)official reports
  • Rocking chair
  • Scent diffusion products
  • Scented bath oils
  • Scented boxes
  • Sensory Baskets
  • Singing
  • Sound machine
  • Space hopper races!
  • Sports with strong sounds, physical experiences etc
  • Squeezing stress balls, other squidgy products
  • Stroking animals
  • Strongly flavoured sweets – mint, sour, aniseed etc.
  • Table football
  • Table tennis
  • Taking photos
  • Trampoline
  • Transitional or comfort objects eg soft toys, snugly blanket
  • Visualisation – soothing images and scenarios of safe spaces
  • Walking
  • Washing up
  • Weighted blankets and lap pads
  • Weightlifting
  • Wii-fit

 

Categories: Mindfulness, Wardipedia
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