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A
Room Comes Alive With Color and Sounds
By
Gwen Kinkead, the New York Times December
23, 2003
Dr. Jason Staal and his Snoezelen room at
Beth Israel. He has studied using lights and music as treatment. In the dim room at Noble Horizons, a long-term-care center in Salisbury, Conn., glow-in-the-dark stars shone faintly. Colored bubbles rose in a tall lighted column before a mirror. Fiber-optic strands winked orange, yellow and ice white. In recliners, three elderly people sat comfortably, holding teddy bears. Music played softly as scenes of an autumn woods — a country fence, a deer — were projected on a wall. This is the Snoezelen (SNOO-zuh-len) room for residents with severe dementia. Donna Hoskins, associate director of nursing, says its effects are intended to stimulate the primary senses with music, soft tactile objects, lighting and fragrances. The stimulation, nurses find, blunts the anxieties of even the most regressive residents and helps them relax. "This is our biggest wanderer right here," Ms. Hoskins said of a man who was asleep. "The lady over by Bonnie is never still. "Here, because it's so peaceful, they become peaceful. And while they're relaxing, they become more alert and aware of their surroundings, because there's lots of interesting things to look at. It cuts out all the extraneous stimulation of a nursing unit, which has a lot of noise — people talking, bright lights. And it's fun. Even the staff relaxes here." An import from Europe, Snoezelen, or multisensory stimulation for the elderly and for disabled children and adults, is being discovered in the United States. About 500 to 600 Snoezelen rooms have opened here. Sunrise Senior Living, a chain of 200 assisted-living communities, has multisensory rooms in most centers. The rooms do not provide a cure. They may not even be therapy. Scientists have not examined their effects on sensory-deprived brains. Rather, the rooms are set up to promote well-being without medication. For that reason, experts who expect a wave of Alzheimer's cases are looking at them anew. "It's like lots of things that don't have a lot of evidence base behind them," Dr. Peter Whitehouse, a neurologist at Case Western Reserve University in Cleveland, said. "You will find some skeptics and some enthusiasts." Snoezelen originated in the 1970's in the Netherlands, its name a contraction of Dutch for "sniffing" and "dozing," to convey the goal of lazy relaxation. In the Netherlands, Snoezelen is standard in caring for the disabled and elderly. Most long-term institutions have Snoezelen rooms for residents' weekly sessions, said Dr. Henk Nies, director of the care division of the Netherlands Institute for Care and Welfare in Utrecht. Britain has 1,000 rooms, according to Rompa, the company that owns the Snoezelen trademark and sells the signature bubble tubes, projectors and fiber optics to Australia, Germany, Israel, Malaysia and Switzerland, among other countries. The health care industry in the United States has been less enthusiastic about multisensory stimulation, in part because studies that show that it reduces anxiety and improves sociability have been criticized for their methodology and small sample size. Dr. Barbara Haight, a former professor at the Medical University of South Carolina College of Nursing who was the lead author of a recent review of Snoezelen in The Journal of Gerontological Nursing, first saw Snoezelen in the Netherlands and was astonished at the sight of elderly people with serious dementia having tea and conversation around a table. She asked whether their calm was caused by medication and was told that it was because they received Snoezelen several times a week. "There have to be key studies to show that it is effective, and then insurance here will pay for it," Dr. Haight said. At the Beth Israel Medical Center in Manhattan, Dr. Jason Staal, a behavioral psychologist, has conducted small studies on cardiac and dementia patients, as well as psychiatric nurses. For children and adults with anxiety disorders that he called "treatment resistant to everything," Dr. Staal provides Snoezelen for several weeks to ease fears and enable the patients to accept psychiatric therapy. Edith Nourse Rogers Memorial Veterans Hospital in Bedford, Mass., uses Snoezelen projectors to soothe dying Alzheimer's patients. Children's Mercy Hospital in Kansas City, Mo., uses them in neonatal and pediatric intensive care wards. An executive at Sunrise Senior Living, Sherill Garvey, said, "It's a very powerful way of calming, comforting and soothing." Carol Edelstein, vice president for program development at Sunrise, added, "The stories we get are of people coming alive almost when they have been very reclusive, anxious and withdrawn." Susan Berry, principal of Escambia WestGate, a school for handicapped children in Pensacola, Fla., has raised several million dollars for a Snoezelen complex with differently themed rooms — rain forest, polar, magic and space. "They give up," Ms. Berry said of the children. "But Snoezelen is fun and relaxing. It can be used as a reward, as leisure and as motivation for kids who say, `Why bother?' " Even though Snoezelen was created for mentally handicapped children, its effects on them are sometimes unclear. At Matheny School and Hospital for children with multiple handicaps in Peapack, N.J., Gail Serwick, a therapist, lifted Kathryn Van Orden, 8, from a wheelchair onto her lap recently in the new Snoezelen room, with its interactive bubble tubes, fiber optics, a waterbed and a ceiling padded to resemble clouds. Briefly, Kathryn looked up, apparently at the bubble tube. "We are working on Kathryn's neck muscles," Ms. Serwick said. "I'm looking for her to keep her head up for three to five seconds at once and attend her environment." Kathryn did lift her head several times, but because she does not speak, it was unclear whether the bubbles attracted her attention. "Do disabled children benefit? asked Joe Kewin, the chief executive of a health care organiztion in Northumberland who introduced Snoezelen to Britain. "This is down to personal feelings. If benefit means smiling, engaging and relaxing, then I believe it is beneficial."
Copyright
© 2002 Global Action on Aging |
