by the Staff of the Brian Center Health and Rehabilitation/Brevard, Brevard, North Carolina
Using the Snoezelen philosophy-and setting-to transform severely disabled residents' lives Snoezelen is a combination of two Dutch verbs: snuffelen (to seek out, sniff, or explore) and doezelen (to relax). Its concept was defined in the late 1970s by two Dutch therapists. While working at an institute in Holland, the two therapists learned of the positive responses a colleague elicited from a severely challenged client while exposed to a sensory environment he had assembled. More than 25 years ago the Snoezelen concept was considered radical compared with traditional therapies. Today, after discovering Snoezelen's benefits, we can't imagine life without it.
Snoezelen is a wonderful environment, filled with sights, sounds, textures, and aromas and used to stimulate, calm, relax, or energize. This controlled environment has been designed within one room of the facility; the experience can be staged to provide a multisensory exposure or single-sensory focus by simple adaptation to one stimulus. The Snoezelen environment is safe, nonthreatening, and proven effective with long-term care residents with diagnoses such as dementia, stroke and traumatic brain injury, chronic pain, behavioral and mood disturbances, and sensory deprivation caused by physical conditions.
Reports on Snoezelen environments document accounts of residents who have stopped self-abusive behavior; of people who have "seen" (become aware of the physical environment), spoken, or smiled for the first time in years; and of those who have showed unusual (for them) peace, happiness, and contentment. The room can be used individually or for small groups for whom a similar outcome is desired. It can be used therapeutically or as a leisure activity. Snoezelen has no formal focus on therapeutic outcome. The focus is instead on assisting users to gain maximum pleasure from the activity.
Implementation of Snoezelen at our facility began with the receipt of a large state grant in May 2004. The program is ongoing and continues to grow and flourish.
Long-term care's changing population required that we find new and innovative ways to provide life-enhancing activity for a variety of people with varying needs. The administrator and the facility's interdisciplinary team reviewed our 2003 admission/referral data, which indicated a large number of admission denials because of a behavioral diagnosis. The team wanted to better understand what was involved in starting a behavioral unit and if a true need for one existed.
The administrator traveled to other parts of the state to consult with management staff from mental health facilities and state-run hospitals to determine the exact need for placement of behavioral patients. It turned out that they were having great difficulty getting any facility to accept patients with mental health diagnoses, since many facilities' staffs were not properly trained and had no programs to accommodate these patients' needs.
Next, the administrator and social worker visited local hospital-based behavioral programs to assess the need. They then attended a state mental health meeting that discussed placement for patients with a mental health diagnosis. Even the state mental health agency, they discovered, was looking for facilities for these patients.
While visiting an out-of-state hospital, the administrator discovered a Snoezelen room in the facility's behavioral unit. With great enthusiasm she shared her experience with the interdisciplinary team, who also visited the hospital for a Snoezelen experience. They were sold on the idea. They felt they could not only have a locked behavioral unit but a Snoezelen room, too.
Data were gathered, the business plan was written (very rapidly, actually), the pro forma statements were completed, and the plan was submitted to regional headquarters. Week after week, more meetings were held and more information was submitted. Yet funding for the Snoezelen room was not made available. The corporate decision makers did not fully understand the Snoezelen concept and its potential benefits at first.
Undaunted, the administrator was determined to find a way to include the room in the overall project. She heard of a state grant program that would consider a Snoezelen application, and the facility was awarded an almost $14,000 grant to fund its Snoezelen room.
The planning stages for the behavioral unit and Snoezelen room actually began the day the interdisciplinary team experienced the hospital's Snoezelen room. The team met many times and involved many other staff members and consultants. We knew we wanted to create an environment where we could ensure patients' safety and dignity-our first priority. We knew that staff members who worked with this new population would need a great deal of education and training to meet patients' special needs. We knew that additional staff would be necessary, too.
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