One of the hallmarks of Alzheimer’s disease, and other dementia-related illness, is profound anxiety. In the context of clients who are challenging a will, or defending such a challenge, we sometimes see this anxiety appear in the decedent’s medical records. Whether a prescription for Alprazolam, lashing out, or other difficulties, the stress of cognitive decline is apparent for the decedent whose will is being contested. Having their memory compromised, sufferers experience stress on many levels, brought on simple day to day tasks to a general, constant state of unease. While we wait for major medical and pharmacological breakthroughs in the battle against dementia and Alzheimer’s Disease, some memory care facilities are getting creative in the way they approach care for their patients.
Caregivers in the Netherlands have been taking a non-traditional approach to dementia treatment with great success. This unorthodox treatment recognizes the overarching importance of relaxation, paired with a connection to childhood memories, sensory aids, soothing music, family dynamics and other powerful tools that aid in calming and nurturing residents. This approach is quite a departure from the more traditional methods of bed rest, medication and physical restraints.
“The more stress is reduced, the better,” Dr. Erik Scherder, a neuropsychologist at the Vrije Universiteit Amsterdam, shared with The New York Times. “If you can lower stress and discomfort, it has a direct physiological effect.”
This is achieved by creating simulated experiences, whether that be a familiar route on a bus or a trip to the beach. For instance, at a care facility in the Netherlands, patients are able to board a simulated bus that takes them on a familiar route through a Dutch, tree-lined street via moving pictures that are displayed on the “windows,” depicting the passing scene.
In the same facility, a beach room has been created to give the effect of a day at the beach, complete with real sand on the floor, heat lamps and the sounds of wind, waves and gulls piped in that mimic what’s heard at the ocean. How cool is that?
Not only are these situations soothing for patients, but it also affords them a connection with fellow residents. The simulations provide a gathering point but also the opportunity to reminisce about shared experience — a vacation to the shore with family and the daily commute to work. It also provides patients the opportunity to take a mini-vacation and “get away” from what can sometimes be an oppressive care facility.
For patients that are in more advanced stages of dementia and suffering from acute anxiety, the Dutch have found that projecting peaceful images onto the ceiling, such as ducks floating on a pond, have a calming and restorative effect. In the past, a patient suffering an extreme anxiety spell would have been prescribed a sedating medication to end the cycle of distress.
Another method of calming patients and increasing their overall happiness and quality of life includes recreating living areas reminiscent of their childhood, complete with period details, such as a kitchen that mimics one from their youth or a living room they may have enjoyed during their child-rearing years. At another care facility in the Netherlands they have re-created an actual bar, complete with alcohol, in one of the common areas.
According to an article in The New York Times, all of these efforts are the result of a shift that started to occur in the 1990s. The Dutch began approaching the treatment of memory care differently and shifted away from a strict, medicalized approach. Instead of treating residents like patients in a hospital, they were treated more like clients with pioneering “snoezel” rooms. These rooms, developed in part by Isle Achterber, a former occupational therapist, featured light, aroma, massage and sound therapy, enabled the patients to relax and access emotions that are often shunned in a more traditional hospital setting.
These rooms were just the beginning of the types of facilities and level of care described above and prevalent throughout the Netherlands. In the United States, we are just now starting to see a “snoezel” approach to care. It would be wise for doctors and care facilities to take note of the Netherlands other simulations and successful methods and put those into practice here.
Caregivers and scientists in the Netherlands believe that these efforts do help dementia patients cope better, though there is not any scientific, solid evidence that this approach is effective. However, care centers that use these practices have noticed a decline in medications and in the need for restraints. Which is all to say that sometimes you can’t scientifically measure well-being, but that doesn’t mean it’s not effective.