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Alzheimer's Care: A Family Affair

October 1, 2000
by Linda Zinn, Managing Editor
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        As I drive to my interview about the Snoezelen* approach to therapy for nursing home residents with Alzheimer's-practicing my pronunciation of the word Snoezelen (a bit like "snyooze-uh-lin") and dodging tractor-trailers on the interstate-I wonder what sort of facility I will encounter. Will it be all "spit and polish," with efficient staff scurrying around (eyes lowered, no time to smile, hurrying frantically to "get all the work done")? Or will it be a warm, inviting place where I'd be happy for someone I love to live?
I am welcomed at the front door by Duchess, O'Brien Memorial Health Care Center's unofficial greeter and official "house dog." The well-fed miniature collie belongs to the facility's accountant, whom she accompanies to work every day so she can hang out with residents, staff and guests.
O'Brien Memorial's secretary sees me there, patting Duchess, and asks if I need help. Almost at the same time a nurse peeks out of an office, smiles and asks if I'm being taken care of. As I wait a moment for Francine Kroner, the activities director and person who got the Snoezelen ball rolling at O'Brien Memorial HCC, I observe the goings-on in the lobby and hallway. There are hugs. And smiles. And kind words. And people stopping by to visit-people who look relaxed and glad to be *The word Snoezelen is derived from the Dutch words for "to snooze" and "to sniff." FlagHouse, Inc., is the sole U.S. distributor of the SNOEZELEN« concept and equipment.
At right: Activities Director Francine Kroner (left)
strolls through the courtyard with Josephine Nelson.   here, not people who look filled with dread at having to visit their loved one in "that place."
So far O'Brien Memorial is scoring high marks in the category of that "homelike" atmosphere we're all so fond of talking about.
Soon Kroner-Franni, as she is affectionately called by fellow staff members and residents-arrives. Another warm greeting from her, and we're off to the "Snoezelen room." I'm eager to hear more about this multisensory-stimulating therapy, developed in The Netherlands in the 1970s for calming mentally disturbed children and later extended to the care of individuals with Alzheimer's and other dementias. But I'm almost as fascinated by the ease with which I see staff interacting-with each other and the people they're caring for. It says something about O'Brien Memorial's administrators and staff that all the marketing brochures in the world can't convey: family.
Kroner shows me to the Snoezelen room, located in the facility's Alzheimer's unit, explaining that its purpose is to provide a calming atmosphere to those who enter it. For residents with Alzheimer's, Snoezelen has proven useful for helping reduce the agitation, confusion and combativeness that sometimes come with the disease. It has also been shown to reduce wandering and improve bathroom independence and willingness to eat.
I look around the room. Placed on a large table are colored, translucent plastic "ropes" containing strings of flashing lights. A softly illuminated aquarium takes up a large share of one wall, and lava lamps and other decorative lights-containing swirling bubbles and bouncing plastic fish and other eye-catching objects and patterns-sit on smaller tables. Sometimes aromatherapy scents fill the room and often soft nature sounds or music is playing. There's a rotating glass ball on the ceiling-a small version of the kind seen tossing bits of light around a ballroom. The window is covered with a black felt curtain with glow-in-the dark stars and planets attached. I'm thinking, have I been transported back to another time-say, the 1960s?
I'm not the first person to react this way initially. Kroner, who in 1998 won the RAP Innovative Award from the Resident Activity Personnel in Ohio organization for introducing Snoezelen therapy to O'Brien Memorial HCC that year, says that some individuals in a group of medical professionals from neighboring hospitals who came to see the Snoezelen room reacted by saying (with a hint of sarcasm), "What is this room, a flashback to the sixties? Where's the marijuana?" Kroner says, however, that before their visit was over, their tone became softer and more relaxed from being in the room, and they experienced firsthand the mellowing effects of Snoezelen. In fact, sometimes staff members come to sit in the room for that very reason, she says.
Residents receive one-on-one attention in the Snoezelen room and usually only one resident at a time visits the room. A resident is generally brought in by a staff member, who might talk softly with the resident or remain silent, depending upon what the resident needs and wants. Sitting together in the room provides an opportunity to massage a resident's skin with lotion, and this touching is also part of the therapy.
The room is open at all times so that residents can go there on their own throughout the day if they choose. Staff members supervise these impromptu visits, to make sure residents are safe and to observe their demeanor and behavior. A form is provided for these observations, so that the benefits of the therapy can be documented.
There is no set pattern of activity in Snoezelen therapy-no "wrong" way to experience it. It's meant to be a stress-free activity with no rules beyond keeping the experience safe. Kroner says each resident perceives the room differently, and it can be a new adventure each time.