A Note From:
IOA Associate Director for Research Jennifer Craft Morgan

Showcasing Aging Research in North Carolina: Graduate Students in Gerontology at Appalachian State University Gain Insights from Abroad

Dr. Ed Rosenberg and Lynsey Capone, MA (a very recent graduate of ASU’s Gerontology program!) have recently conducted research to investigate approaches developed in the Netherlands aimed at improving the quality of life individuals with severe dementia. It is estimated that four million older Americans are currently living with some form and stage of dementia, a progressive and irreversible set of diseases that affects the physical, cognitive, behavioral, and emotional domains of its sufferers (Hooyman & Kiyak, 2005). Since the prevalence of dementia is projected to rise due to rising longevity and medical success in preventing/prolonging other causes of death, innovative and successful methods and therapies to help those with dementia are of increasing importance.

Snoezelen, or multi-sensory stimulation (MSS), has been shown to be an effective approach to dealing with severely demented people (http://www.worldwidesnoezelen.com; van Weert et al, 2004). Snoezelen stimuli excite the primary senses of sight, hearing, touch taste, and smell through the use of lighting, tactile surfaces, music and aromas. The intents are to place fewer demands on individuals’ intellectual abilities and to maintain and increase well-being (van Weert et al, 2004). Photographs at the end of this article illustrate some of the principles of Snoezelen.

The term Snoezelen derives from the Dutch words snuffelen (to seek out or explore) and doezelen (to relax) (Hogg et al, 2001;van Weert et al, 2004; Staal et al, 2005; Kaplan et al, 2006). Dutch scientists Ad Verheul and Jan Hulsegge developed this concept in the mid-1970s to better satisfy the perceptual needs of people with severe learning and sensory disabilities. At a summer fair they set up a sensory tent filled with effects like a fan blowing scraps of paper, ink mixed with water and projected onto a screen, musical instruments, tactile objects, perfumes, soaps, and foods. This pilot test was a great success and led to further refinement of the concept and its implementation.

With a variety of distinct purposes, Snoezelen can be used to stimulate, relax, calm, or energize. It can provide a multi-sensory experience or a single sensory focus, adapting the sensory stimulation to the client’s specific needs. Initially, in long-term care facilities, Snoezelen was relegated to a dedicated room with an assortment of equipment offering stimulation for all the senses (http://www.worldwidesnoezelen.com; Hogg et al, 2001; van Weert et al, 2004; Staal et al, 2005; Kaplan et al, 2006). A projector might show a sunset or bubbling brook or other familiar sights that connect people with calming experiences. Soothing sounds could be piped in. Pillows and fabric panels, placed around a room, can induce comfort and relaxation when touched. Pleasing aromas can be generated.

Research generally reports positive effects on subjects’ mood and behavior. While Baker et al found Snoezelen therapy had no significant effect on dementia subjects’ behavior in a day care setting (compared to a “non-Snoezelized” group), there was a decrease in dementia-related symptoms in the same subjects in their homes. In both settings, however, subjects in the Snoezelen group talked more, recalled more memories, and used more normal sentence length. Snoezelen’s effects on concentration have also been studied. Pinkney (1997) reported equal, positive effects of music relaxation therapy and Snoezelen therapy on the behavior of subjects with multiple mental disabilities. Holtkamp and Kragt (1997), comparing a small MSS group to a control group, found significantly lower levels of awareness disorders, repetitive behaviors, apathy and restlessness in the Snoezelen group.

Of course, Snoezelen doesn’t claim to reverse or even arrest the progression of Alzheimer’s or other dementias. But there is empirical support that it can reduce negative behaviors in persons with dementia. Whether familiar with the concept or not, more and more American long-term care facilities are beginning the transition to a client-centered Snoezelized environment. With a little creative brainstorming, Snoezelen can be introduced into the home environment, too, easily and at low cost. Snoezelen, it seems, is a documented, cost-effective means to improve the environment, relationships and lived experience of dementia victims, their formal and informal caregivers, and their loved ones.

Snoezelen therapy promises to be an intriguing way to engage individuals with severe dementia. We congratulate Dr. Rosenberg and Ms. Capone on looking globally to bring promising practices back to North Carolina’s aging research and service communities.

	3D wall boxes
	hallway structure
	bathing room

References:

• Hogg, J, Cavet, J, Lambe, L, & Smeddle, M (2001). The use of ‘Snoezelen’ as multisensory stimulation with people with intellectual disabilities: a review of the research. Research in Developmental Disabilities, 22, 353-372.
• Holtkamp C.C.M., Kragt K., van Dongen M.C.J.M., van Rossum E. & Salentijn C. (1997). Effects of Snoezelen on Elderly Demented People. Tijdschr Gerontol Geriatric. 28, 124–128.
• Hooyman, N, & Kiyak, H (2005). Social Gerontology: A Multidisciplinary Perspective. Boston: Pearson.
• http://www.worldwidesnoezelen.com/
• Kaplan, H, Clopton, M, Kaplan, M, Messbauer, L, & McPherson, K (2006). Snoezelen multi-sensory environments: Task engagement and generalization. Research in Developmental Disabilities. 27, 443-455.
• Pinkney L. (1997). A comparison of the Snoezelen environment and a music relaxation group on the mood and behaviour of patients with senile dementia. British Journal of Occupational Therapy. 60, 209–212.
• Staal, J, Sacks, A, Calia, T, Moore, J, Pinkney, L, & Hanif, H (2005). The effect of snoezelen (Multi-Sensory Behavior Therapy- MSBT) to increase independence in activities of daily living and reduce agitation and apathy of patients with dementia on a short term geriatric psychiatric unit. Alzheimer's and Dementia 1, 61-70.
• Van Weert, J, Kerkstra, A, van Dulmen, A, Bensing, J, Peter, J, & Ribbe, M (2004). The implementation of snoezelen in psychogeriatric care: an evaluation through the eyes of caregivers. International Journal of Nursing Studies. 41, 397-409.

Stay tuned for next month’s IOA newsletter to learn more about projects with great potential for positive impact on the lives of older adults in North Carolina.

Dr. Morgan welcomes your submissions at any time for future editions of Showcasing Aging Research in North Carolina.