“Given the significant advancements in the field of neuroscience, it is now widely recognized that the different sensory-rich experiences human beings encounter every day help to ‘nourish’ the nervous system.”
AJ Ayres, 2005
As anyone who has ever been around someone with a cognitive impairment can surely attest, communication can be a challenge. Another challenge is their behavior. So what if I told you that the two are linked together and that you may have tools to manage these issues with items in your hall closet or storage box in your garage.
Think about your emotions and your sensory processing systems… who hasn’t eaten ice cream to soothe a broken heart or cheated on their well-intended diet at the smell of freshly baked apple pie? The sensory input that we don’t even notice plays such an important role in our daily lives and has such a strong influence over our actions and behaviors. Therefore, one can understand how the body does not do well when such important information is withheld or given in a way that can be perceived as harmful.
We Experience The World Through Sensory Systems
There are eight sensory systems found in the body. They include the common ones, tactile, vision, auditory, olfactory, and gustatory and the not-so-common ones are vestibular, proprioceptive, and interoceptive. The job of each system is to receive stimuli from the outside of the body and send it to the brain. The brain needs this sensory input in order to determine if situations are safe, secure, etc. This input helps you self-regulate your emotions.
| Sensory Systems | Definition |
|---|---|
| Vestibular | Movement system: senses balance, to provide information about movement |
| Proprioceptive | Muscle and joint system: senses body position, location, and force of movement |
| Tactile | Touch system: the skin, largest sensory organ |
| Visual | Seeing system: the dominant sensory system |
| Auditory | Hearing system |
| Gustatory | Tasting system |
| Olfactory | Smelling system |
When functioning properly, our sensory systems alert us to our preferences; like when soup is too hot or too cold. With elderly persons who have neurocognitive disorders, it’s very common for their sensory inputs to trigger a responsive behavior.
Learning how sensory systems align with behavior can help us understand how a patient experiences their world. Sensory inputs tell us at what level they are experiencing stimuli and can be categorized as over-responsive, under-responsive, and sensory craving.
“Understanding sensory input can help us see behaviors as a form of communication.”
Three Types of Sensory Inputs
- Over-responsive – an exaggerated response of the nervous system.
- Under-responsive – insufficient or inadequate response of the nervous system.
- Sensory Craving – high level of input is needed to provide sensation from the nervous system.
In the chart below, find what behaviors are over-responsive, under-responsive, or sensory craving in order to understand what the behavior of your loved one is communicating. See if you can figure out what your loved one may be trying to tell you. They may be trying to communicate what they want through behavior.
| Over Response | Under Response | Sensory Craving | |
|---|---|---|---|
| Vestibular | Refuses to swing or do any activity with feet off ground | Wakes up with intense movement | Rolls self out of bed |
| Proprioceptive | Unable to sit | Slouches Sits in one position | Always moving Likes to lay in cushions, pillows |
| Tactile | Avoids touching messy textures Doesn’t like types of clothing (tags..) | Unaware of messy body Unaware of clothes being on wrong way | Fidgets with objects Touches everything |
| Visual | Avoids lights Pupil dilation | Complains of eye fatigue Can’t focus on objects | Looks in mirror or reflective objects for long periods Spins around, watches fans intensely |
| Auditory | Covers ears Make loud noises to drown out loud noise | No awareness of name being called | Makes noise in quiet environment Responds intently to fast or loud music |
| Gustatory (taste) | Eats bland food Prefers limited textures | Prefers spicy, sour | Overstuffs mouth |
| Olfactory (smell) | Agitation or anxiety with strong odors | Doesn’t notice foul smells | Seeks out strong perfumes or colognes |
Improve Behaviors And Communication With Alerting And Calming Strategies
A way to improve behaviors can be as simple as offering a piece of ice to suck on, going outside, or spraying essential oils. As a nurse practitioner at ElderHealth, I like to use calming and alerting strategies to help improve the sensory experience of the patient. Now you can too! Consider incorporating alerting and calming strategies from the chart below into your loved one’s day. See if the behaviors and your communication improves.
| Sensory System | Alerting | Calming |
|---|---|---|
| Vestibular | Dancing, power walks, bouncing on a therapy ball, fast car rides | Rocking chair, hammock, porch swing, swaying to slow music |
| Proprioceptive | Light touch to palm of hand, hold cold items, cool shower, apply a cool washcloth to face, pet a cat or dog, hand fidget items | Weighted vests or ankle weights, snuggle under blankets, play with putty, a soft toy, stress ball |
| Tactile | Cold bath, ice, biting popsicle, sour, spicy foods | Heavy blankets, massage, stress ball, soft toy animal |
| Visual | Bright lights, flashlight, bright colors, art | Dim lights, wear sunglasses |
| Auditory | Fast pace music, speak in a high and low voice, sound producing objects | Soft music, singing or humming, cover ears for unexpected noises, headphones, ear plugs |
| Gustatory (taste) | Drinking ice water, sour, chewy, salty, cold foods, blowing bubbles | Drink warm liquids, chewing gum, chewy or crunchy foods, decaffeinated tea or coffee |
| Olfactory (smell) | Strong smells (peppermint) | Soothing scents (lavender), oils, candles |
References:
Champagne, Tina (2018) Sensory Modulation in Dementia Care
Sensational Brain. Sensory Modulation Disorder: Education and Intervention ⋆ SensationalBrain
