The Integrated Sensory Experience 2017
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Introductions • Lorraine Gibson, Executive Director • Tracey Adams-Thibaudeau, Director of Resident Programs • Edward Thach, Activation Aide 3
Discuss and share • What is the most effective Sensory Practice currently being used in your home? Or • What is the most effective Sensory Activity you have heard/seen in action Discuss as a group and share 4
Cortisol and the body 5
Dementia and Anxiety Cortisol is a stress hormone Elevates Blood pressure, Elevates Heart Rate Breathing Deeply helps decrease Blood pressure and heart rate Even with Word Finding in Normal Aging 6
Dementia and Anxiety cont’d Dementia Experience, Anxiety and How Confusion feels What gets everyone’s blood pressure up and heart racing- fight flight fright When things makes no sense…..unknown………anticipation of discomfort or pain……….. What else?
Evaluate how you feel
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Evaluate how you feel
Sensory Research • Positive increase in attention and engagement/ability to stay on task • Lower Blood pressure • Reduction in agitated behaviour • Repetitive motions/calling out 11
Project Background • Pre-evaluation for Dove Lane our secured home area • Falls • Behaviours • Mood • Depression • CISs • Code Whites and Forms • Team engagement with Recreation Aid 12
Sensory Room Evolution • Before
Existing Equipment • Fibre optic Sprays • Bubble Tube • Star Projector • Sensory Projection Wheel
Home Area Layout Limitations: • Residents wandering to ends of halls (limited visibility from Nursing station) • Under-used Sensory Room
Previous Aesthetics
Initial Staff Survey Questionnaire 1. Have you heard of Sensory Therapy before? (Please circle) Yes / No 2. Name the 5 senses: ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ 3. Name two possible benefits of Sensory therapy ___________________________________________________________________ ___________ ___________________________________________________________________ ___________ 4. Which type of responsive behaviours could benefit from Sensory Therapy? _____________________________________________________________ _____________________________________________________________ 5. Who can deliver Sensory Therapy? _____________________________________________________________ 6. Where can Sensory Therapy be offered? _____________________________________________________________ 7. Are you currently aware of the Sensory Preferences of 1 or more of the residents you care for? Yes / No IF YES…Is this information documented (to your knowledge?) Yes / No Your Position: _________________________________________________
Survey Says… Have you heard of Sensory Therapy before? Have heard of Sensory Therapy Have not heard of Sensory Therapy
Room for Improvement Awareness of Sensory Preference documentation Aware of Documentation of Sensory Preferences for 1 or more resident No aware of any documentation pertaining to Sensory Preferences
Summary of “before” state • Our Activation Aide was the only person using the Sensory Room • Our Interdisciplinary staff had a basic understanding of Sensory Therapy, but there was room to grow • Families didn’t use the sensory room • Our Sensory Room was cluttered and some equipment was lacking impact • Our residents were often walking through the halls, was there any way to engage them there?
Project Plan
Description Overview
Project Plan
Current Practice The team assesses residents on admission. The Recreation Aid completes an assessment about their life story and it resides in the computer care plan. The Recreation Aid formulates a recreation plan for the resident. • Determine staff knowledge re: sensory uses/risks and aids available • Determine current use of Sensory Room Determine Sensory needs of Residents • i.e. reduction in wandering/relaxation/stimulation
Current Practice cont’d • Nurses and PSW do a separate assessment and complete a lengthy care plan which is rarely referred to on a daily basis. Nurses and PSW do not always engage with the Recreation Aid regarding activities and ideas that will engage residents and families while decreasing responsive behaviors. • Assess staff current knowledge of Sensory therapy/use of Sensory room/Risks & benefits associated • Assess residents who currently use Sensory room • Breakdown most common behaviors on Dove Lane
Desired State/Outcome • Inter-professional team will collaborate with residents and families in the creation of a sensory map • Inter-professional team will be trained by Flag house to use Sensory Magic • Create sensory nooks in hallway areas with Fire Marshall approval and using sensory map • Create evaluation tool for inter-professional team and families
Home Responsibility • Implementation: • Nurses will use report the pre mid post sensory evaluations at each shift report • Nurses PSWs Recreation Aid will collaborate on updating the sensory map based on the evaluation
Training • Assess current state and training needs • Daily Memo and Minutes to follow progress of phases • Flag house training of all staff • Assess resident’s sensory needs and create maps • Daily update memos to be used at shift report regarding maps and pre mid post evaluation • Weekly evaluation of project timelines with Leads
Team Responsibility • ED and Project Lead responsible for deadlines • Director of Programs and Recreation Aid Lead and DOC are responsible for ensuring communications are sent daily and evaluations are completed weekly • ADOC to ensure communications are read and understood for all shifts • DOC and ADOCs to schedule and ensure all education and in-services and 1:1 to ensure understanding of the concepts, goals, and
Key Milestones Key Milestone Dates: Review of Current State including Current processes for Feb 2017 completed assessment of resident sensory needs, Resident Satisfaction, Family Satisfaction, Falls, Restraints, Responsive behaviors, CIHI data, and Shift Report Review Memo of introduction to pilot March 1 2017 completed Phase 1 Review of each resident’s life stories Completed by March 31 2017 Phase 2 training completed and sensory maps created April 3- 2017 completed Phase 3 Evaluation of Pilot May 31 Review of New State including Resident Satisfaction, Family May 31 Satisfaction, Falls, Restraints, CIHI data, and Shift Report Review Preparation for Presentation at TRO June 1-8
Flaghouse Sensory Magic
A workshop 3 things about our residents: That give their life meaning That make them happy
Inspirations for the day Validation Therapy , a proven method of communication developed by social worker and gerontologist Naomi Feil The Intergenerational Choir Project a collaboration between the Alzheimer Society London and Middlesex, the Sisters of St. Joseph and Medway High School
3 things about them
Sensory Magic
In action
Pre-Evaluation
Post-Evaluation
Staff-Training Interdisciplinary Days/Evenings/Nights Including: • What is Sensory Therapy • What are some positive outcomes for the participant? • Practical Applications for them • Evaluating Effect • How to use equipment
Hallways Improvements
Welcoming Hallway nooks
Engaging Artwork
Data Evaluation • Falls decreased by 15% • Behaviors decreased by 25% • Code Whites decreased by 50% • SIE scores • Shift Report included sensory maps/profiles • Families were satisfied (small survey) • Staff were satisfied and engaged with Recreation Aid (small survey)
Recommendations • Nursing roll out was bigger and more challenging than planned – needed more time • Installation was delayed slightly and training on software a little harder than anticipated
Caring Hands – Connecting Heart with Technology
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