Flatman, S.1, Prendergast, J.1, Yannelis, F.1, Evans, C.1, Lees, T.1.
1Rehabilitation, Aged & Palliative Care, SALHN, SA Health
Background: Approximately 80% of people with dementia experience changed behaviours over the course of the disease process, including agitation, anxiety, apathy, aggression and restlessness. Sensory assessment and modulation helps in de-escalation of behaviours before they progress to an unmanageable level and can help patients to feel safe, comforted and decrease their levels of distress. Documentation in a behavioural management plan assists by centralising important information to inform the clinical team on strategies that have assisted in de-escalation of behaviours.
Methods: Sensory assessment and modulation involves assessing someone’s sensory preferences as well as sensory experiences that are upsetting for them. All patients admitted the ward will have a sensory assessment completed with information gathered from their sensory profile, care giver questionnaire and the Allen’s Cognitive Level Screen and collateral from family and or the patient’s previous facility. The assessment guides the development of sensory modulation activities. This might include music, comfort objects, massage, fiddle blankets, weighted blankets, diet preferences, room modifications (decreased lighting or closing blinds to decrease external stimuli) and education of caregivers and nursing staff. Development of a centralised document was created with consultation from all disciplines involved in the care of the patients in this ward. The behavioural management plan outlines the target symptoms that are to be managed, includes the neuropsychiatric inventory score, collateral history, communication abilities, sleep cycle, likes and dislikes, triggers, sensory preferences, aversions for participating in therapy and activities, and any safety concerns.
Results: Data is currently being collected in order to evaluate implementation.
Conclusions: Reports from staff suggest the introduction of the Behavioural Management Plan and Sensory Modulation activities has allowed effective de-escalation of behaviours before they become unmanageable.
Fotini is currently acting Senior Occupational Therapist in the Geriatric Evaluation and Management Unit at Noarlunga Hospital. Her primary role since late 2017 has been occupational therapist for the Myles unit at Noarlunga Hospital which specialises in dementia and changed behaviours. Fotini has significant experience in clinical practice in both an inpatient and community based geriatric care settings, including the SALHN Community Geriatric Service. Fotini has extensive experience working with clients with geriatric syndromes including dementia. Her vast experience includes functional and cognitive assessments, complex discharge planning and individualised and meaningful patient care planning and engagement. She has been involved in quality improvement activities such as the development of sensory modulation project in the Myles GEM unit and the GenPlay (intergenerational) program on the Whittaker GEM unit.