The Memory Unit OT

Several years ago, I was working in the SNF setting, and received a referral for a resident on the memory unit for what the nurses described as ‘increased wandering’. Through my evaluation I discovered that this resident’s sensory system was so dysregulated and her task termination was so poor that she would walk throughout the unit constantly without stopping to rest. Staff would try to engage her in a seated activity or help her into bed, but even if she felt tired her body would still get her up and she would continue to roam the unit. The situation was a concern because she was starting to fall due to the level of physical and cognitive fatigue.

Now keep in mind, this resident’s dementia was quite advanced, so her ability to participate in formal evaluation independently was quite limited. So I did a modified sensory assessment which indicated that she responded very well to deep pressure. I also completed an Occupational Profile by interviewing her closest family members and learned that she came from a large family with many children and grandchildren, and that child care was incredibly meaningful to her.

So I combined the results of these assessments to create an intervention strategy that the nurses could continue to use after discharge from therapy.

I took a weighted ankle cuff from our exercise equipment supply and I wrapped it around the lower torso of the baby doll, essentially where the diaper would be on a human baby. Then I put a cute, soft onsie over the doll and handed it to my resident just like I would hand over a human child.

This resident responded so well to this intervention because it addressed multiple unmet needs: a meaningful leisure activity and an appropriate sensory input that had otherwise been missing from her normal routine.

She would sit and hold the doll, which sometimes would result in her taking a much needed nap.

This is a really great example of how OT services can benefit individuals with dementia of all levels. It’s not always about using complicated techniques. It’s about using your clinical skills of assessment and activity analysis to find simple and effective strategies to maximize the quality of life of your patients and residents.

And side note: after implementing that strategy, that doll lovingly became known as ‘baby lead-bottom’ among the rehab department.