The Memory Unit OT

Sensory Intervention is one of my favorite discussion topics when it comes to long term care, so let’s jump right in!

First off, what do we mean by “sensory seeking”?

In the body, we have proprioceptive sensory nerves that respond to pressure and touch to let the brain know where the body is in space. These particular receptor nerves are in the joints and muscles and on the skin. People who are sensory seeking are not getting enough or adequate information from these proprioceptive nerves. Because they’re not fully aware of where their bodies are in space, the rest of the sensory system becomes reactive. This can look like increased fidgeting, scratching, pulling at clothing, chewing on objects or fingers, becoming agitated or irritated, pacing to the point of exhaustion, and an overall appearance of ‘clumsiness’.

As occupational therapists, we can use interventions that will increase proprioceptive input thereby improving the communication between the body and the brain, thus treating the above reactive symptoms.

Offer Deep Pressure Input via Crunchy Snacks or Thick Drinks

Some of these proprioceptive nerve receptors are located in the mouth and jaw. As long as you’ve got the okay from the SLP and dietician, you can offer crunchy snacks like Oreo cookies, crackers, raw veggies like carrots, chips, or granola. You can also make a thick smoothies or milk shake and offer it to the Resident in a cup with a straw. The oral muscle work required to pull a thick drink up through a straw will engage the proprioceptors in the mouth to increase adequate deep pressure input.

Offer Deep Pressure Input via Soft Weighted Blankets

There is a significant amount of research around the use of weighted blankets among children to improve proprioceptive input, and the research is emerging in it’s use among older adults. Weighted blankets have been found to reduce anxiety, improve sleep, and decrease feelings of distress among Residents living in long term care facilities. Over the years, they’ve become far more accessible and machine washable which makes them a great option for The Memory Unit.

Offer Deep Pressure Input via Standing Tasks

Something that I wish more care facilities promoted was movement and ambulation. How many times do we hear, “Please sit down” when someone living with dementia stands up from a wheelchair in a long term care setting? In some instances, taking a little walk or spending time in standing can actually improve some of the “behaviors” staff see on The Memory Unit. And hey, if a Resident’s disease is so progressed that he/she is no longer able to stand, try placing a stool underneath his/her feet to allow him/her to press the feet down and get the same sort of proprioceptive input.

Offer Vestibular Input via Movement

Proprioceptive and Vestibular input go hand in hand. The simple task of walking provides us with the proprioceptive and vestibular input we need to regulate our sensory systems and maintain homeostasis. If you’re working with a Resident who can no longer walk, use wheelchair mobility instead. Working to propel the chair as fast as they can will give Residents proprioceptive input through the upper extremities while simultaneously offering vestibular input. And if this isn’t an option, push the chair for the Resident. Maintain an even and steady pace, reading and interpreting body language to find a pace and rate that works best for the specific Resident.

Offer Deep Pressure Input via Joint Compressions

Because proprioceptive receptors are located within joint spaces, applying pressure to the joint itself can be a quick and easy way to increase body grounding. Of course, when working with older adults we have to consider comorbidities like arthritis that could make an intervention like joint compressions contraindicated. Essentially, we provide joint compressions by gently pressing two bones around a joint together, pressing the joint against itself and briefly decreasing the joint space.

As always, use your best clinical judgement, consider all present factors, collaborate with the interdisciplinary team, and strive to provide Resident-centered care.

You’ve got this!

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