Why sensory integration items and play is important for individuals with dementia

Just about everyone has sensory needs. Whether it’s an attraction to smell, material, tactile stimulation, or a predisposition to like fluffy things, all humans crave some kind of sensory input. Individuals with dementia are no different, and some of them may have more sensory needs later in life than they had previously.

In addition, dementia can affect the way in which an individual interacts with their environment.  Many are scared of shadows or dark areas and have difficulty with visually cluttered or heavily patterned environments.

Sensory integration in the environment of dementia patients can prove to be a more holistic approach to quality of life care.

There are a plethora of ideas and practices a caregiver can do to help their patients with dementia thrive at their present levels.

Allen Cognitive Levels

Allen Cognitive Levels are used in dementia care to describe the abilities and functioning levels of patients. Occupational therapists, doctors, and the likes can use these levels to help individuals modify their routines and environments to help them best integrate into their environment.

The Allen cognitive levels are important to understand because they can help a caregiver determine what products and routines might work best based on the patient’s abilities. They go as follows:

1. Infantile stages
   1. Reflexes
      
   2. Withdrawal from obnoxious input
      
   3. Need postural support, positioning, wheelchair
      
2. Gross body motors
   1. Ability to overcome gravity, walk, sit at the edge of the bed
      
   2. Requires maximum assistance
      
   3. Aimless, directed walking
      
3. Manual actions
   1. Requires moderate assistance
      
   2. The therapist may need to re-focus the individual for repetitive tasks
      
   3. Difficulty sequencing
      
   4. Difficulty in motor planning
      
4. Familiar activities
   1. Requires moderate assistance
      
   2. Goal-directed
      
   3. No new independent learning
      
   4. Will not correct mistakes
      
5. Learning new activities
   1. Learning new things from problem-solving
      
6. Planning new activities
   1. Problem-solving skills
      
   2. Executive functioning abilities

Understanding the Allen cognitive levels of an individual can help with specialized care, especially sensory-based solutions. Since the abilities of an individual at each level varies, the sensory needs also may vary.

Considerations

For individuals with dementia, Allen cognitive levels are not always linear. Some individuals who were at a 4 one day can very quickly move to a 2 with little warning. Planning care interventions for individuals with dementia at their present cognitive level with considerations for their future level is virtually necessary.

Sensory-based preferences vary from individual to individual, as well. While one person may love vibration or vibrotactile sensory items, another may prefer something more olfactory-based.

In addition, individuals who have dementia may also prefer more age-appropriate sensory solutions. There are a plethora of products for kiddos with sensory issues, and there are a plethora of products for adults with sensory issues, too.

Level-based intervention care and recommendations

Occupational therapists, who work with the aging population have to constantly ask themselves: what will work for now? What will work a year from now? Forward-thinking into care can be hugely beneficial in transitioning the individual into the next level.

Together, our staff occupational therapists brainstormed a lot of ideas that may be able to help individuals with dementia at their present levels.

Levels 1 &2: Infantile stages and gross body motors

• Olfactory stimulation
  • Familiar scents to elicit responses (familiar lotions, aftershave, perfumes, etc.)
    
  • Scents like lavender to decrease agitation
    
• Tactile stimulation
  • Vibration mitts
    
  • Sensory walking path (indoors or outdoors)
    
  • Modify the home environment visually
    • Different, calming wall colors, less busy wallpaper
      
    • Minimizing how visually busy home environment is
      
  • Visual stimulation
    • Fiber optic lights
      
  • Auditory stimulation
    • Relaxation tapes, guided meditation, vibration noises, wind chimes, favorite songs
      

Level 3: manual actions

• Replacing daily tasks with automation
  • Age-appropriate care
    • Example: individuals who are presently in the geriatric population and are a level 3 often have difficulty brushing their teeth. A seemingly obvious answer is that electric toothbrushes work well to get people to brush their teeth. That’s not such a good idea, because individuals who are in the geriatric population didn’t grow up with that, so they won’t know well how to use it. Try using a double-sided toothbrush instead.
      

Level 4: familiar activities

• Labeling containers of clothing or dishes
  
• Cameras, locks on doors, elopement prevention plans
  
• Tactile stimulation
  • Fidgets
    
  • Personalized sensory blankets
    
  • Weighted blanket
    
• Vestibular motion
  • Gliders
    
  • Rocking chairs
    
  • Stretching
    
  • Reaching
    

Going forward

Please keep in mind that what might work for some might not work for all. Individuals may have a personal preference based on their sensory needs, Allen cognitive level, and age. What might work for some might not work for all.