Multisensory Interventions Research Articles

The effect of educational- supportive program on the anxiety of mothers of infants admitted to the neonatal intensive care unit (NICU)

IntroductionThe admission of preterm infants to the neonatal intensive care unit (NICU) often causes stress and anxiety in their mothers. Nurses must implement nursing interventions for mothers as the most important caregivers of infants. Accordingly, the present study aimed to explore the effect of Educational- Supportive Program (multi-sensory stimulation) on the anxiety of mothers of preterm infants admitted to neonatal intensive care units. MethodsThe present study used a quasi-experimental design with two groups and pretest and posttest and was conducted on 100 mothers of preterm infants admitted to the neonatal intensive care unit. The mothers who met the inclusion criteria were selected as the participants using convenience sampling and were randomly placed into intervention and control groups (50 persons in each group) by drawing lots. The participants in the intervention group performed multi-sensory interventions for the infant for 12 min at a time, once a day for 5 days a week according to the instructions provided by the researcher. The mothers in the control group did not perform any intervention for their infants. The participants in both groups completed the Spielberger State-Trait Anxiety Inventory (STAI) on the first day and one week after admission. ResultsThe results showed that the mean scores of maternal anxiety for the participants in the intervention and control groups before the intervention were 38.98 ± 3.44 and 35.86 ± 7.16, respectively, showing a statistically significant difference (P = 0.007). Besides, the mean scores of maternal anxiety for the participants in the intervention and control groups one week after the intervention were 33.36 ± 3.46 and 36.22 ± 7.46, respectively, showing a statistically significant difference (P < 0.001). ConclusionThe present study showed that the multisensory stimulation intervention had a positive and significant effect on the anxiety of mothers of preterm infants and reduced it. Therefore, this simple and practical relaxing measure can be used by nurses in clinical settings to reduce maternal anxiety.

Early parental vocal contact in neonatal units: rationale and clinical guidelines for implementation.

This paper aims to present clear and evidence-based proposals for the integration of Early Parental Vocal Contact into the clinical practices of neonatal units. In the first part, we present a comprehensive rationale exploring the ontogenesis of voice perception in both term and preterm newborns that establishes a foundational understanding. This knowledge serves as a crucial starting point for developing evidence-based auditory and multisensory interventions aimed at fostering the developmental trajectory of preterm infants. Drawing insights from neuroscience and brain development, our proposals underscore the significance of tailoring auditory environments within neonatal settings. Special attention is given to the unique needs of preterm infants, factoring in their gestational age and maturation levels. In the second part clinical guidelines for implementation are provided and healthcare professionals are supported to assist parents in modulating their vocal interactions, aligning them with the infant's responses. Furthermore, we provide practical suggestions for engaging in discussions with parents about the content, duration, and frequency of vocal interventions. Finally, we delve into the potential roles of caregivers, parents, and health professionals within this enriched parental vocal interactional environment. Our perspective is firmly grounded in an infant and family-centered developmental care philosophy, aiming to enhance the overall well-being and the neurodevelopment of preterm infants in neonatal units.

Uni‐ and multimodal sensory‐supported interventions for very preterm and extremely preterm infants in the neonatal intensive care unit: An overview of systematic reviews and interventional studies

AbstractBackgroundVery and extremely preterm infants (VEPIs) experience sensory deprivation in the neonatal intensive care unit (NICU). While various sensory‐supported interventions might improve immediate physiological response, their impact on long‐term development remains unclear. Additionally, these interventions may pose challenges in the NICU environment due to complex treatments and monitoring requirements.AimsThis review aimed to understand the current evidence on sensory‐supported interventions in the NICU, identify the components of these interventions and determine their effects on the VEPIs.Study DesignA systematic search across nine electronic databases (PubMed, EBSCO, EMBASE, Web of Science, Scopus, Cochrane, Cochrane trial, IEEE Xplore DL and ACM DL) was conducted in December 2020 and updated in September 2022. The search gathers information on sensory‐supported interventions for VEPIs in the NICU.ResultsThe search yielded 23 systematic reviews and 22 interventional studies, categorized into auditory (19), tactile/kinesthetic (5), positional/movement support (7), visual (1) and multisensory (13) interventions. While unimodal and multimodal interventions showed short‐term benefits, their long‐term effects on VEPIs are indeterminate. Translating these findings into clinical practice remains a challenge due to identified gaps.ConclusionOur reviews indicate that sensory‐supported interventions have a transient impact, with intervention studies reporting positive effects. Future research should develop and test comprehensive, continuous multisensory interventions tailored for the early NICU stage.Relevance to Clinical PracticeMultimodal sensory interventions show promise for VEPIs, but long‐term effects need further study. Standardizing protocols for NICU integration and parental involvement is crucial. Ongoing research and collaboration are essential for optimizing interventions and personalized care.

Description and evidence on the supporting and enhancing neonatal intensive care unit sensory experiences (SENSE) program.

To describe the supporting and enhancing neonatal intensive care unit (NICU) sensory experiences (SENSE) program, associated research and opportunities for further study. A review of current materials on SENSE program implementation, publications related to SENSE development, and research on program implementation and patient outcomes was conducted to describe the SENSE program and its associated research. The SENSE program combines structured, evidence-based, multisensory interventions with parent engagement in order to optimise outcomes in the complex NICU environment. Through a stepwise and scientific process, the SENSE program was developed to include specific doses and targeted timing (based on the infant's postmenstrual age, PMA) of evidence-based interventions such as massage, auditory exposure, rocking, holding and skin-to-skin care for parents to provide their infants each day of NICU hospitalisation. It is adapted in context of concurrent medical interventions, infant behavioural responses, as well as NICU culture. The program is feasible to implement, acceptable to staff, and related to infants receiving more developmentally appropriate sensory exposures. Adaptations related to NICU culture and parent involvement have been reported. Research has identified relationships of the SENSE program to improved parent confidence, neurobehaviour and feeding at term age as well as improved communication 1 year of age. The literature related to the SENSE program is promising, but more research on efficacy and implementation is needed.

Characteristics, outcomes, facilitators and barriers for psychosocial interventions on inpatient mental health dementia wards: a systematic review

BackgroundThe National Institute for Health and Care Excellence guidelines state that psychosocial interventions should be the first line of treatment for people with dementia who are experiencing distress behaviours, such as agitation and depression. However, little is known about the characteristics and outcomes of psychosocial interventions or the facilitators and barriers to implementation on inpatient mental health dementia wards which provide care for people with dementia who are often experiencing high levels of distress.MethodsA systematic search was conducted on MEDLINE, CINAHL, PsycINFO, Psychology and Behavioural Sciences Collection, and Scopus in May 2023, following PRISMA guidelines. Reference and citation searches were conducted on included articles. Peer-reviewed literature of any study design, relating to psychosocial interventions in inpatient mental health dementia wards, was included. One author reviewed all articles, with a third of results reviewed independently by a second author. Data were extracted to a bespoke form and synthesised using a narrative review. The quality of included studies was appraised using the Mixed Methods Appraisal Tool.ResultsSixteen studies were included in the synthesis, which together included a total of 538 people with dementia. Study methods and quality varied. Psychosocial interventions delivered on wards included music therapy (five studies), multisensory interventions (four studies), multicomponent interventions (two studies), technology-based interventions (two studies), massage interventions (two studies) and physical exercise (one study). Reduction in distress and improvement in wellbeing was demonstrated inconsistently across studies. Delivering interventions in a caring and individualised way responding to patient need facilitated implementation. Lack of staff time and understanding of interventions, as well as high levels of staff turnover, were barriers to implementation.ConclusionThis review highlights a striking lack of research and therefore evidence base for the use of psychosocial interventions to reduce distress in this vulnerable population, despite current healthcare guidelines. More research is needed to understand which psychosocial interventions can reduce distress and improve wellbeing on inpatient mental health dementia wards, and how interventions should be delivered, to establish clinical and cost effectiveness and minimise staff burden.

Neonatal Care Unit Interventions on Preterm Development.

Prematurity is becoming a real public health issue as more and more children are being born prematurely, alongside a higher prevalence of neurodevelopmental disorders. Early intervention programs in Neonatal Intensive Care Units (NICUs) correspond to these uni- or multi-sensorial solicitations aiming to prevent and detect complications in order to support the development of preterm infants. This article aims to distinguish sensory intervention programs according to the gradient of the type of solicitations, uni- or multi-modal, and according to the function of the person who performs these interventions. Uni-sensorial interventions are essentially based on proprioceptive, gustatory, or odorant solicitations. They allow, in particular, a reduction of apneas that support the vegetative states of the preterm infant. On the other hand, the benefits of multi-sensory interventions seem to have a longer-term impact. Most of them allow the support of the transition from passive to active feeding, an increase in weight, and the improvement of sleep-wake cycles. These solicitations are often practiced by caregivers, but the intervention of parents appears optimal since they are the main co-regulators of their preterm child's needs. Thus, it is necessary to co-construct and train the parents in this neonatal care.

Using Multisensory Interventions to Address Anxiety, Agitation, and Pain in Adults Receiving Treatment for a Substance Use Disorder

This study examined the impact of activity-based multisensory-interventions (MSI) provided in a multisensory environment (MSE) on anxiety, agitation, and pain in adults receiving residential treatment for substance use disorder (SUD). Participants (N = 35) were randomly assigned to two groups and all received four, 30- to 45-minute individualized recreational therapy (RT) sessions over the course of two weeks during their residential stay. The experimental group participated in MSI in a MSE. A comparison group participated in RT sessions using table games (TG). Targeted outcomes were assessed using standardized, self-report measures and physiological data. Pre-and post- session assessments revealed significant reduction in anxiety, agitation, and pain, for individuals in both groups. Between groups comparisons documented a significant main effect for treatment (MSI, TG) on anxiety (p &lt;.001), agitation (p = .03), and pain (p = .05) measures with significantly greater symptom reduction for the MSI group. Individuals receiving MSI also presented with significantly reduced respiration rate following the intervention (p &lt;.01). Heart rate changes were non-significant for both groups. A participant survey at the conclusion of sessions yielded feedback that all individuals who received the MSI (n = 18) reported these sessions were a valuable addition to their SUD treatment.

The effect of maternal multisensory stimulations on bath stress in premature infants: A randomized controlled clinical trial

Bathing in Neonatal Intensive Care Unit (NICU) is a stressful experience to preterm infants. Reducing this stress is an important challenge in bathing preterm infants. The aim of present study was to evaluate the effects of maternal supportive interventions on the stress caused by swaddled bathing in preterm infants. In this randomized clinical trial, 48 preterm infants randomly allocated into control and intervention groups. In intervention group the mothers were asked to initiate multisensory supportive interventions 5 min before and through swaddled bathing. In controls the mothers were only present during bathing. To determine the level of stress, infant responses were recorded by camera 5 min before bathing and 5 min after bathing. Then infants' stress measured by using Newborn Stress Scale (NSS). Finding was shown that the level of stress in control group was especially increased after bathing that was statistically significant (p < 0.001). Although there was an increase in stress among interventions but it was not statistically significant (p > 0.05). Considering the positive effects of multisensory interventions in decreasing the stress of preterm infants, it can be recommended as cost-free and non-pharmacological care during infants bathing.

Breastmilk as a Multisensory Intervention for Relieving Pain during Newborn Screening Procedures: A Randomized Control Trial.

The study aim was to explore the effects of multisensory breastmilk interventions on short-term pain of infants during newborn screening. This is a randomized controlled trial. A total of 120 newborns were recruited and assigned by randomization to one of three treatment conditions: Condition 1 = routine care (gentle touch + verbal comfort); Condition 2 = breastmilk odor + routine care; or Condition 3 = breastmilk odor + taste + routine care. Pain was scored with the Neonatal Infant Pain Scale (NIPS). Data were collected from video recordings at 1 min intervals over the 11 phases of heel sticks: phase 1, 5 min before heel stick without stimuli (baseline); phase 2 to phase 6 (during heel stick); and phase 7 to phase 11 (recovery). Generalized estimating equations compared differences in pain scores for newborns over phases among the three conditions. Compared with the routine care, provision of the odor and taste of breastmilk reduce NIPS scores during heel sticks (B = −4.36, SE = 0.45, p < 0.001 [phase6]), and during recovery (B = −3.29, SE = 0.42, p < 0.001 [phase7]). Our findings provide new data, which supports the use of multisensory interventions that include breastmilk odor and taste in combination with gentle touch and verbal comfort to relieve pain in infants undergoing newborn screening.

Multisensory Stimulation in Dementia

Background &amp; Objectives: Dementia is a prevalent disorder around the world. However, its chronic and progressive nature mostly affects physical and psychosocial characteristics and public healthcare. Recently, multisensory interventions have been used in people with dementia as one of the nonpharmacological treatment methods. This narrative review intends to explain multisensory stimulation programs or Snoezelen for those affected with dementia. Methods: Keywords such as “sensory-based intervention”, “sensory stimulation”, “sensory processing”, “Snoezelen”, “sensory modulation”, and “dementia” were used in Scopus and PubMed databases with a sensitive search strategy in the articles published between 2000 and 2020. Results: The initial search retrieved 255 articles. After reviewing and rejecting some duplicates, 65 studies remained in the field of multisensory interventions in dementia. However, only 8 articles fulfilled the inclusion criteria. Conclusion: Multisensory stimulations in dementia can be used as an adjunctive strategy alongside other therapies. Sensory diets can be applied in common home environments. For this purpose, it is better to use Dunn’s sensory processing model. So, along with individual components, context and occupations are also considered.

Behers' "Spiritual care for people living with dementia using multisensory interventions: A practical guide for chaplains" (book review)

Behers' "Spiritual care for people living with dementia using multisensory interventions: A practical guide for chaplains" (book review)

Richard Behers, &lt;i&gt;Spiritual Care for People Living with Dementia Using Multisensory Interventions – A Practical Guide for Chaplains&lt;/i&gt;

Richard Behers, &lt;i&gt;Spiritual Care for People Living with Dementia Using Multisensory Interventions – A Practical Guide for Chaplains&lt;/i&gt;

Improving living and dying for people with advanced dementia living in care homes: a realist review of Namaste Care and other multisensory interventions

BackgroundSeventy percent of people with advanced dementia live and die in care homes. Multisensory approaches, such as Namaste Care, have been developed to improve the quality of life and dying for people with advanced dementia but little is known about effectiveness or optimum delivery. The aim of this review was to develop an explanatory account of how the Namaste Care intervention might work, on what outcomes, and in what circumstances.MethodsThis is a realist review involving scoping of the literature and stakeholder interviews to develop theoretical explanations of how interventions might work, systematic searches of the evidence to test and develop the theories, and their validation with a purposive sample of stakeholders. Twenty stakeholders - user/patient representatives, dementia care providers, care home staff, researchers -took part in interviews and/or workshops.ResultsWe included 85 papers. Eight focused on Namaste Care and the remainder on other types of sensory interventions such as music therapy or massage. We identified three context-mechanism-outcome configurations which together provide an explanatory account of what needs to be in place for Namaste Care to work for people living with advanced dementia. This includes: providing structured access to social and physical stimulation, equipping care home staff to cope effectively with complex behaviours and variable responses, and providing a framework for person-centred care. A key overarching theme concerned the importance of activities that enabled the development of moments of connection for people with advanced dementia.ConclusionsThis realist review provides a coherent account of how Namaste Care, and other multisensory interventions might work. It provides practitioners and researchers with a framework to judge the feasibility and likely success of Namaste Care in long term settings. Key for staff and residents is that the intervention triggers feelings of familiarity, reassurance, engagement and connection.Study registrationThis study is registered as PROSPERO CRD42016047512

Pain-Relieving Interventions for Retinopathy of Prematurity: A Meta-analysis.

Retinopathy of prematurity eye examinations conducted in the neonatal intensive care. To combine randomized trials of pain-relieving interventions for retinopathy of prematurity examinations using network meta-analysis. Systematic review and network meta-analysis of Medline, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and the World Health Organization International Clinical Trials Registry Platform. All databases were searched from inception to February 2017. Abstract and title screen and full-text screening were conducted independently by 2 reviewers. Data were extracted by 2 reviewers and pooled with random effect models if the number of trials within a comparison was sufficient. The primary outcome was pain during the examination period; secondary outcomes were pain after the examination, physiologic response, and adverse events. Twenty-nine studies (N = 1487) were included. Topical anesthetic (TA) combined with sweet taste and an adjunct intervention (eg, nonnutritive sucking) had the highest probability of being the optimal treatment (mean difference [95% credible interval] versus TA alone = -3.67 [-5.86 to -1.47]; surface under the cumulative ranking curve = 0.86). Secondary outcomes were sparsely reported (2-4 studies, N = 90-248) but supported sweet-tasting solutions with or without adjunct interventions as optimal. Limitations included moderate heterogeneity in pain assessment reactivity phase and severe heterogeneity in the regulation phase. Multisensory interventions including sweet taste is likely the optimal treatment for reducing pain resulting from eye examinations in preterm infants. No interventions were effective in absolute terms.

Real-Time Technology Video-Coding Tools for Programming Multisensory Interventions Incorporating Exotic Local Fruits and Vegetables in Early Childhood: Implications for Pediatric Obesity Prevention Research

Real-Time Technology Video-Coding Tools for Programming Multisensory Interventions Incorporating Exotic Local Fruits and Vegetables in Early Childhood: Implications for Pediatric Obesity Prevention Research

Effectiveness of meaningful occupation interventions for people living with dementia in residential aged care: a systematic review.

The ability to participate in valued activities, whether for work, leisure or family, is an important aspect of personal identity. In dementia, progressive memory loss means that abilities developed over a lifetime begin to be lost as well, contributing to the loss of self and identity. Some studies have reported that activities or interventions tailored to be meaningful to the person with dementia (defined as any activity important to the individual) are more effective in addressing behavioral and psychological symptoms of dementia (BPSD) and improving quality of life (QoL) than those that are not so tailored. However, the effectiveness of individualizing interventions or activities for this population is not known. In response to consumer feedback by the Consumer Dementia Research Network that this question ought to be addressed, this review was undertaken, the aim of which was to determine the effectiveness of meaningful occupation interventions for people living with dementia in residential aged care facilities (RACFs). People living with dementia in RACFs (nursing homes).Any intervention that was individualized to be meaningful to the participant, versus any active control condition or usual care.Experimental and observational studies. Quality of life, BPSD (such as agitation, aggression, depression, wandering and apathy), mood, function, cognition and sleep. The search strategy aimed to identify both published and unpublished studies, with the following 12 databases extensively searched: PubMed, CINAHL, PsycINFO, ISI Web of Science, OTSeeker, Embase, Cochrane CENTRAL, clinicaltrials.gov, Mednar, OpenSIGLE, New York Academy of Medicine Library Gray Literature Report, ProQuest Dissertations and Theses. The search strategy was limited to papers published in English between 2004 and January 31, 2015. All studies were assessed independently by two reviewers for relevance, eligibility and methodological quality. Data from included papers were extracted using a standard data extraction tool. Where possible, study results were pooled in statistical meta-analysis. Alternatively, results are presented in narrative and tabular form. A total of 5274 citations were identified; after removal of duplicates, assessment for relevance and eligibility, 61 studies underwent critical appraisal. Thirty-four studies met the quality criteria and were included in a quantitative synthesis. A wide range of interventions were evaluated including individualized recreational activities (13 studies), reminiscence therapy (RT) (seven studies), music therapy interventions (six studies), training staff to develop individual care plans using person-centered care (PCC) or similar approaches (three studies), animal-assisted therapy (two studies), multi-sensory interventions (MSIs) (two studies) and social interaction (one study), all of which measured a number of different outcomes. Overall, and in spite of most studies being small-scale and of relatively brief duration, all interventions with the exception of Snoezelen therapy (a MSI) reported some benefits for people with dementia living in RACFs. The most frequently reported benefits were reductions in agitation (the most frequently assessed outcome), passivity and depression, improved QoL and increases in pleasure and interest. However, the majority of studies generally implemented the intervention, whether it was individualized activities, music or RT or other, in conjunction with one-to-one social interaction, and the relative importance of the intervention in comparison to one-to-one social contact for effectiveness cannot be determined from this review. Providing meaningful or individualized tailored activities for people with dementia living in RACFs appears to be effective for a range of behavioral and psychological symptoms. The strongest evidence was for individualized activities/recreational interventions for a range of BPSD; preferred music for agitation, depression and anxiety; and RT for mood and cognitive functioning. Insufficient evidence precluded making recommendations regarding animal-assisted (dog) therapy and training staff to develop individual care plans using PCC or similar approaches, while there was no good quality evidence to show that Snoezelen was effective for any outcome. What remains unclear, however, is whether any of these interventions is more effective than the provision of one-to-one social interaction.

The effectiveness of meaningful occupation interventions for people living with dementia in residential aged care: a systematic review protocol.

The ability to participate in valued activities, whether for work, leisure or family, is an important aspect of personal identity. In dementia, progressive memory loss means that abilities developed over a lifetime begin to be lost as well, contributing to the loss of self and identity. Some studies have reported that activities or interventions tailored to be meaningful to the person with dementia (defined as any activity important to the individual) are more effective in addressing behavioral and psychological symptoms of dementia (BPSD) and improving quality of life (QoL) than those that are not so tailored. However, the effectiveness of individualizing interventions or activities for this population is not known.In response to consumer feedback by the Consumer Dementia Research Network that this question ought to be addressed, this review was undertaken, the aim of which was to determine the effectiveness of meaningful occupation interventions for people living with dementia in residential aged care facilities (RACFs).People living with dementia in RACFs (nursing homes).Any intervention that was individualized to be meaningful to the participant, versus any active control condition or usual care.Experimental and observational studies.Quality of life, BPSD (such as agitation, aggression, depression, wandering and apathy), mood, function, cognition and sleep.The search strategy aimed to identify both published and unpublished studies, with the following 12 databases extensively searched: PubMed, CINAHL, PsycINFO, ISI Web of Science, OTSeeker, Embase, Cochrane CENTRAL, clinicaltrials.gov, Mednar, OpenSIGLE, New York Academy of Medicine Library Gray Literature Report, ProQuest Dissertations and Theses. The search strategy was limited to papers published in English between 2004 and January 31, 2015.All studies were assessed independently by two reviewers for relevance, eligibility and methodological quality.Data from included papers were extracted using a standard data extraction tool.Where possible, study results were pooled in statistical meta-analysis. Alternatively, results are presented in narrative and tabular form.A total of 5274 citations were identified; after removal of duplicates, assessment for relevance and eligibility, 61 studies underwent critical appraisal. Thirty-four studies met the quality criteria and were included in a quantitative synthesis. A wide range of interventions were evaluated including individualized recreational activities (13 studies), reminiscence therapy (RT) (seven studies), music therapy interventions (six studies), training staff to develop individual care plans using person-centered care (PCC) or similar approaches (three studies), animal-assisted therapy (two studies), multi-sensory interventions (MSIs) (two studies) and social interaction (one study), all of which measured a number of different outcomes. Overall, and in spite of most studies being small-scale and of relatively brief duration, all interventions with the exception of Snoezelen therapy (a MSI) reported some benefits for people with dementia living in RACFs. The most frequently reported benefits were reductions in agitation (the most frequently assessed outcome), passivity and depression, improved QoL and increases in pleasure and interest. However, the majority of studies generally implemented the intervention, whether it was individualized activities, music or RT or other, in conjunction with one-to-one social interaction, and the relative importance of the intervention in comparison to one-to-one social contact for effectiveness cannot be determined from this review.Providing meaningful or individualized tailored activities for people with dementia living in RACFs appears to be effective for a range of behavioral and psychological symptoms. The strongest evidence was for individualized activities/recreational interventions for a range of BPSD; preferred music for agitation, depression and anxiety; and RT for mood and cognitive functioning. Insufficient evidence precluded making recommendations regarding animal-assisted (dog) therapy and training staff to develop individual care plans using PCC or similar approaches, while there was no good quality evidence to show that Snoezelen was effective for any outcome. What remains unclear, however, is whether any of these interventions is more effective than the provision of one-to-one social interaction.

The Effects of Infant Massage on Maternal Distress: A Systematic Review

Massage therapy is one of the oldest touch therapies, and it has been used for many conditions. We have systematically reviewed articles on infant massage to evaluate its effects on maternal distress, and also on mother-infant relationship. Infant massage has been known to benefit mothers and infants regarding several health variables such as depression, parenting stress, weight gain for the infant, hormones and anxiety as well as functionality of the immunity system. However, tactile-only stimulation must be distinguished from multisensory interventions that include a tactile component, for tactile-only stimulation without social contact is associated with higher levels of stress, and it is also overstimulating for infants. The significance of this systematic review lies in the important role of massage therapy in human health, as it highlights a crucial yet often underestimated effect in psychological and biosomatical variables.

The use of multi‐sensory interventions to manage dementia‐related behaviours in the residential aged care setting: a survey of one Australian state

To describe the use of multi-sensory interventions in residential aged care services (RACS) for the management of dementia-related behaviours in residential aged care in Victoria, Australia. The popularity of multi-sensory interventions has spread worldwide, including for use in residential aged care, despite limited evidence to support their efficacy. This study reports the findings of the first stage of a two-stage project that was undertaken to describe and evaluate the use of multi-sensory interventions for the management of dementia-related behaviours in all residential aged care facilities in Victoria, Australia. A computer-assisted telephone interview survey was developed and administered to residential aged care facilities in Victoria, Australia, to collect descriptive data on the use of multi-sensory interventions for the management of dementia-related behaviours. A diverse and eclectic range of multi-sensory interventions are currently being used by residential aged care facilities. The findings suggest the use of multi-sensory interventions are used in an ad hoc manner, and there is no universal definition of multi-sensory interventions, little formal training for staff administering the interventions and no guideline for their use, nor evaluation of their impact on residents' behaviour. Multi-sensory interventions have been widely adopted for use in RACS in Victoria, Australia, and are currently being used without formal guidelines and little evidence to support their use in clinical practice. In the absence of a formal definition of what constitutes a multi-sensory intervention, training for staff and careful assessment and monitoring of residents who receive multi-sensory interventions, we recommend further research and development of policy and procedures to safe guard the use of multi-sensory interventions for people with dementia.

When Leaders Are Challenged: Dealing With Involuntary Members in Groups

Leading groups can be challenging and difficult. Leading groups in which members are involuntary and negative increases the level of difficulty and creates new dynamics in the group leading process. This article proposes specific skills and strategies for dealing with three specific issues related to involuntary members in groups: groups where all members are involuntary; groups where some members are involuntary; and groups with open membership where involuntary members join groups that are already in progress. The emphasis is on leaders using creative and multi-sensory interventions to insure that members are actively engaged in the group process.