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The Activity Director's Office
The ALTERNATIVE SOLUTIONS PAGE
By Sandra Stimson ADC, CALA, CDP
Executive Director,
Alternative Solutions in Long Term Care
Music: "Peg of My Heart" furnished by Heart and Soul Music "Providing Quality Music for Nursing Homes"
Sensory Rooms and FTAG 248

On a daily basis we receive e-mails from activity professionals around the country asking if they have to
have Sensory Rooms? Is it Federal or State regulation?  The answer we give is that it is not mandated
by the federal government or state regulations that you have sensory rooms.  But what is required is
that you provide " Quality of Life" for all residents.  Remember, that FTAG 248 is not the only federal
guideline for nursing homes that apply to recreation.  There are many others.

Sensory rooms are really for any population.  But generally in long term care it is used for the very low
functioning resident's.  Sensory rooms provide a group activity in an environment that is success
oriented, failure free, purposeful and meaningful.  If you don't have programs to fit the needs of this very
special population than the question would be, "how are you impacting their quality of life on a daily
basis?"

As a consultant to many facilities across the country we do not see enough low functioning programs
offered on a daily basis. Either it's not offered enough or not at all.  We also see many residents in day
rooms unable to participate in the scheduled event, left in their rooms, placed at nurses stations or left
in the hallway.  If you have a sensory room that is well staffed, it offers a place for the resident's to go
that is stress free and stimulating.  The sensory rooms can also be used for your NPO programs.  As
activity professionals you are required to have NPO programs for those individuals who are left in their
rooms when meals are being served.  During meal times the NPO residents can come to the sensory
rooms.  Think how hard it must be to smell the food when you cannot have it!  In the sensory rooms the
stress and anxiety over meal times is alleviated.  

For the residents who are bed bound due to illness, a great program is a Sensory Cart.  The sensory
cart could be brought to the residents room on a daily basis.  You could place fiber optics such as
butterfly's above their bed.  Sensory carts generally have but not limited to CD players, aroma therapy
and fiber optics.  Make sure you place the carts where the resident can see them. Otherwise what
would be the benefit to the patient?

Anyone who is attending the sensory rooms should have care plans.  The Activity Professional should
be documenting how often they attend and what they do while in the sensory rooms.  You should have
simple attainable goals and approaches for each resident. You should have some kind of formal
document that nursing would receive that states; which residents are attending the sensory room, time
and days of the week.

For infection control, the activity professional should be washing each resident's hand as they are
brought into the sensory room.  At the end of the day, all of the sensory equipment should be
disinfected.

We have implemented sensory rooms in many facilities in New Jersey.  What a difference it made!  
One facility that had over 200 residents identified 43 residents who could not participate in scheduled
activities and many of these residents were also on the quality indicator report.  Before the sensory
rooms opened on each floor, these residents could be found sitting idle with no stimulation.  Now all
43 residents attend the sensory room in the morning or afternoon and of course as tolerated. There is
a huge difference in a facility with a sensory room compared to those without one.  

The sensory rooms also improves customer satisfaction among family members who feel their family
member has no activity options due to their function level.  With a sensory room you can offer a
wonderful activity on a daily basis. When families visit they can also spend time with their loved one in
the sensory room.  When families visit with their children, the room provides a place for children to also
engage in the sensory products.  A sensory room is a fun and interactive place for a child.

Sensory rooms should be equipped with rocking chairs.  High functioning residents should be
encouraged to use the room and the rocking chairs.  The rocking chairs are soothing and all of us who
have ever sat in a rocking chair can agree how calming an activity the rocking chairs are.

The sensory rooms should also have things to do on each table. Tactile items, pat mats, activity mats,
squeeze balls, etc.  Also place flash lights on each table. Some residents enjoy turning on the flash
light and pointing the light at the wall.

Watch the type of music and sensory stimulation you provide.  Smells should not be overpowering.  We
recommend anything that is recommended for stress relief like lavender.  Strong smells such as
lemon should not be used.  The type of music can also impact the mood.  Use music that is soothing
such as angel music. It is recommended that you not use music with nature sounds, as dementia
clients may misunderstand the sounds of chirping birds or crickets. They misunderstand the sounds of
crashing waves as water running and want you to turn it off.  For the best outcomes, use soothing
angel type music and stress relief scents.

Sensory rooms should have policy and procedures and these should be placed in the administrators
facility manual as well as the Activity Departments manual.  These should be reviewed on a yearly
basis.  

If you have been asking your administrator for sensory equipment and feel your not getting anywhere,
you might consider finding a facility in your area with a sensory room and bringing not only your
administrator but your Director of Nursing.  Every facility has resident's who become agitated due the
stress of the unit, lights, noise, crowded conditions and temperature.  Appeal to the Director of Nursing
how much calmer the floor would be not only for a specific resident but for other residents who are
upset by verbal outbursts if you had a sensory room.  Also, if you have a sensory room, nursing would
not have to watch a confused resident which would free up more of their time for nursing duties.  That
example is sure to make a difference with a DON.    

And if that does not work, try the "survey approach."  Surveyors like to see sensory rooms because it
means you have great programs for the low functioning residents and having a sensory room might
possibly mean the difference between passing survey and not passing survey.  Because again, you
are required to have programs to fit all residents needs living in your facility.  Sensory rooms can
definitely help you with appropriate programming and survey outcomes.

So in answer to the question, is it required. No, Can you do without one with the changes to come next
year and the answer is also No.  Take the time to visit a facility with a sensory room and you will know
how important a sensory room is to quality of life for the low functioning resident.  And if your
administrator still won't allot the money, than begin fund raising because in the end, you will be proud
you raised the money.    

Alternative Solutions in Long Term Care www.activitytherapy.com carries a full line of sensory items,
sensory room care plans, Sensory Room In-services and Sensory Room policy and procedures.        

Happy Activity Professionals Week!
____________________________

Alternative Solutions in Long Term Care
Lisa Reidinger LCSW, CTRS, CSW, CDP
Executive Director

Sandra Stimson CALA, ADC, CDP
Executive Director
ABOUT SANDRA

Sandra Stimson has experience as a
corporate consultant, Corporate
Trainer and National Speaker. Her
experience is in long term care, as
Activity Director, Director of
Alzheimer's Units and Assistant
Administrator of a 550 bed long term
care county home.  She is
Co-founder of Pet Express Pet
Therapy Club, is a Life Replay
Specialist.  Sandra implements
dementia units nationwide.  Sandra
has written several books, Volunteer
Management Essentials for Long
Term Care and Pet Express Pet
Therapy Program. Sandra has been a
facilitator for Alzheimer's support
groups and is the Awards Chair for the
NJ Association of Activity
Professionals.  Sandra is the
Executive Director of
National
Council of Certified Dementia
Practitioners
http://www.nccdp.org  

Alternative Solutions in Long Term
Care offers resources for health care
professionals in many areas of
dementia care, care plans,
Snoezelen products, dementia
activity calendars, adult day care
calendars, sensory calendars,
reminisce videos for dementia,
activity books, and dates to
remember, party supplies,
resources and links.
THE ACTIVITY DIRECTOR'S OFFICE
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in Long Term Care Settings
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