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Functional Analytic Multisensory Environmental Therapy for People with Dementia

DOI: 10.1155/2012/294801

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Abstract:

This paper introduces Functional Analytic Multisensory Environmental Therapy (FAMSET) for use with elders with dementia while using a multisensory environment/snoezelen room. The model introduces behavioral theory and practice to the multisensory environment treatment, addressing assessment, and, within session techniques, integrating behavioral interventions with emotion-oriented care. A modular approach is emphasized to delineate different treatment phases for multisensory environment therapy. The aim of the treatment is to provide a safe and effective framework for reducing the behavioral disturbance of the disease process, increasing elder well-being, and to promote transfer of positive effects to other environments outside of the multisensory treatment room. 1. Introduction The behavioral and psychological symptoms of dementia (BPSD) comprised of aggression, apathy, psychosis, depression, and increases in motor activity [1] causes much suffering for afflicted elders and their families and challenge health care systems which provide treatment. Traditional psychiatric care for BPSD has begun to incorporate aspects of three nonpharmacologic models of care: environmental vulnerability/reduced stress threshold, unmet needs, and behavioral/learning [2]. The focus of this paper can be categorized as integrating two nonpharmacologic models, environmental and behavioral/learning theory, for use with an elder with dementia in a MultiSensory Environment (MSE). An MSE is a designated space or room designed to stimulate the senses, visual, auditory, tactile, and olfactory via equipment which produces contrived reward. Two theoretical conceptualizations exist to date to explain the underlying mechanism of action of the MSE, one behavioral and the other neurological. The behavioral position, which is built upon in this paper, is that the MSE provides the elder with noncontingent sensory reinforcement which evokes states of reward and the relaxation response [3]. The hypothesized mechanism of action contrived rewards produce positive emotion which in turn increases attending to the environment, thus reducing apathy and increasing redirection of behavior and evoking the relaxation response, which is an incompatible physiological response to agitation, especially when combined with psychotropic medications [4]. The rival theory conceptualizes the MSE as an activity-based intervention that changes negative sensory experiences with sensory calming activities, thus returning a person to a more balanced level of sensory functioning, sensoristasis [5, 6]. Recent

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