I have often sang the praises of Teepa Snow on this blog, and I want to spend time this weekend staying close to Maureen and thinking about her presentaion from the perspective of this article:
Dementia and Sensory Cues: Reading the 5 Senses to Understand People with Dementia
A Clinical Pearl by Teepa Snow, MS, OTR/L, FAOTA
Over the last ten years, I have done a lot of research, direct care, and education in dementia. I have learned a great deal about how people living with dementia navigate their world when challenged by the effects of a changing brain. The sensory system – what we see, hear, feel, smell, and taste – continuously takes in, processes, and uses data to help us understand and interact with the world. The challenges you might be experiencing with dementia patients are often a breakdown in the sensory system. So how can we help? Below, you will find a few lessons I’ve learned about observing the “cues” available to us that can improve our work as professional Care Partners.
Notice and Acknowledge
The first and most important step is to notice and acknowledge. If you take the time to observe, you can often discover the abilities a person living with dementia is actually working with at any given moment. If we understand more fully what someone can do, we can choose to support and care for them in a way that meets their needs. This begins with observations, not assumptions about what is happening.
Look for Sensory Cues
All human beings give clues and information about their ability through their interaction with others and the environment. Take an inventory for yourself by honestly observing and respecting how your patients are relating to the world through the five senses.
Visual cues
Observe: What is a person focused on? What do they see that might be different from what you are able to see?
“Visual cues” are a great tool. Vision is the preferred way for human beings to receive information. We like to see. Over time, dementia affects the brain’s occipital lobe impacting a person’s visual field and depth perception. As a result, a person literally may not know you are sitting next to them. They can’t see you, even though you can see them. If you are aware of this, you can move yourself into a person’s visual field before attempting to communicate or care for them.
Auditory cues
Observe: What do they respond to when you speak? Do they respond at all? A lack of response can also be a “cue” about ability in a particular moment.
Do they hear you? Did they actually process what you said? Are they giving you a response that suggests they understood? What is happening in their body that might tell you? Set your client and yourself up for success and look for a “cue” from them to confirm that what you think transpired actually did.
Consider other “cues” that may be helpful. What needs might someone be attempting to meet in their behavior? What are they saying or communicating with their actions?
Dementia affects all 5 senses
It’s important to understand and be aware that over time all 5 senses will change for a person living with dementia: visual abilities, auditory processing and comprehension ability (and please don’t confuse this with the hearing of sound as these are two different things), feeling ability (including touch sensation and the ability associated with motor skills), and the ability to smell and taste.
Everything changes experientially for a person living with dementia and this impacts their behavior, communication, and relationship with others. If we truly understand and are willing to observe their abilities and stretch ourselves by looking at what’s happening through the lens of curiosity, we can further understand and choose to support and care for others in ways that make more sense. These changes in perspective will improve relationships, set realistic goals for Care Partner interactions, and give the person living with dementia a greater sense of personal dignity and worth about their life.
I realise I am very fortunate that we have Admiral Nurses in this area. When I discussed changes in Maureen’s presentation with our social worker last week she advised me to seek more support from Mel my Admiral Nurse. We have chatted this morning on the phone and I know that Mel will guide Maureen’s referral to the Memory Service to the Home Treatment Team.
