The effect of snoezelen (Multi-Sensory Behavior Therapy- MSBT) to increase independence in activities of daily living and reduce agitation and apathy of patients with dementia on a short term geriatric psychiatric unit

Abstract

Background: Prevention of ADL decline is crucial. Functional decline in ADL’s can cause personal distress, increase the potential for excess disability and increase financial cost and caregiver/staff utilization of time. MSBT was combined with standard inpatient geriatric psychiatric care. Objective: To improve independence in ADLs, reduce agitation and apathy. Methods: A randomized, between group design of 24 participants diagnosed with moderate to severe dementia, 12 in each group from the geriatric psychiatric unit at Beth Israel Medical Center was utilized. Participants were randomized to receive MSBT in combination with standard psychiatric care or to a structured activity such as manipulating play doo or beads, in combination with standard psychiatric care. The protocol consisted of 6 sessions, 25 to 30 minutes, and took place over the course of 2 weeks. Conclusions: Results indicated the elders treated with MSBT combined with psychiatric care and inpatient hospitalization had greater levels of independence in ADLs than the control group, when assessed using blind nurse-rated scale global measure of independence in activities of daily living (p<0.05). In line with improved ADL functioning, elders who received MSBT combined with standard inpatient psychiatric care had significantly diminished levels of agitation and apathy (p<0.05). This combined intervention (MSBT and standard inpatient psychiatric care) may prevent a downward spiral in elder functioning by slowing or diminishing BPSD, excess disability and the negative sequelle concomitant with poor ADL self-care.