The Multi Sensory Environment (MSE) in dementia care: the role of design

Lead Research Organisation: Kingston University
Department Name: Sch of Design

Abstract

The proposal builds on previous research carried out by Kingston University's Designed Environment Research Group with its successful track record for investigating the environmental needs of people with dementia, and prior research undertaken by the Co-I exploring engagement strategies for the latter and the effect of MSEs on functional performance. This new project will conduct a focused investigation into the concept and design of MSEs and their current and future demanding role within homes caring for residents with dementia.

The timely relevance of this research rests on a broader consideration of the rapid growth of an ageing population, the rising number of people affected by dementia, and the over-prescribed use of antipsychotic medication in dementia treatment. Cost-effective interventions supporting dementia care are urgently needed. Carers, therapists and designers are therefore keen to investigate the MSE in this context.
The observed benefits of MSEs within dementia care are improved function and alleviated psychological and behavioural symptoms e.g. challenging behaviour, depression, increased appropriate communication, improved staff morale (Collier et al 2010). MSEs, incorporating sensory equipment which targets the primary senses, are now widely used and specified but evidence suggests that they often fail to succeed because of inadequate/poor design and haphazard arrangements (Dalke et al 2010). Conversely, there has been a lack of research into design innovations regarding the future development of MSEs for those living with dementia.

The project will investigate to what extent the above criticisms can be substantiated via a study involving 15 care homes in Greater London with some type of MSE facility. The facilities will be examined and staff observed/interviewed (using a specifically designed questionnaire). The intention is to evaluate service and usage in relation to MSEs' joint function as both a resource for meaningful leisure activity and a therapeutic intervention for users with dementia. This study aims to establish whether the improved overall design of MSEs could add value to the experience on offer maximising the benefit for these particular users and their carers.
More importantly, because little documented design guidance for MSEs for older people with dementia exists, the overall purpose of the proposed research is to establish new knowledge from which coherent, user-centred design solutions can be developed. The proposed study has the potential to inform the development of design ideas and recommendations for a MSE template tailored towards people with dementia, their physical and emotional needs. In order to improve the MSE experience the design development would not be confined to solutions that place additional technology in a room. It would involve designing the space as a whole to achieve aesthetically inspiring, stimulating environments which are sufficiently flexible and adaptable to the specific individual needs of users. Embracing an inclusive design approach, such spaces should generate a sense of wellbeing and engagement not only for people with dementia but also for staff and relatives sharing the experience of the service users.

The research findings and results will be written up in a Design Sourcebook, and assist occupational therapists, activity co-ordinators, managers and designers of care homes by informing their practice and strategic planning, particularly when making improvements to existing MSE facilities or setting up new ones. Another main output will be an exhibition-related event at the end of the project where the research results will be presented to a wider audience of professionals in the field, policy makers and the general public.
Societal and economic impacts would increase during the course of a follow-on research project linked to performing trials with focus groups and subsequently providing proof-of-concept and implementation strategies.

Planned Impact

This project examines the design of MSEs used in dementia care and investigates whether and how the benefits of MSEs can be maximised through design interventions. Anticipated impacts include:
1) contribution to improved quality of life, health and wellbeing of individuals living with dementia, their carers and relatives
2) increased awareness of the needs of people affected by dementia
3) greater knowledge and expertise which feeds into the development of cost-effective treatment and therapy methods in dementia to reduce expensive and health-threatening drug dependency
4) fostering the dialogue between practitioners in design and health care

The research will contribute towards improved services and environments for those living with dementia. Hence they and their carers will be the ultimate beneficiaries of the research. As a design-led project about aesthetic and sensory experiences it will provide easier access to the problems surrounding dementia and improve the wider public's engagement and understanding of the latter.

The project will also support the national economy and contribute to solving a problem on a national scale by influencing evolving care strategies that encourage alternative therapy and treatment in dementia care in order to reduce the burden of cost-intensive and health-threatening drug dependency. Policy makers in the Department of Health/Adult social care, the NHS and the private sector are therefore potential beneficiaries of this research.

Other important beneficiaries are care homes and day centres (e.g. Worcester Snoezelen Centre, The Space Centre Preston) directly involved in caring for older people with dementia and integrating MSEs in their daily routine. Effective interventions including enhanced sensory experiences for older people can improve services offered by care homes and day centre's - potentially increasing the number of residents or visitors and subsequently the organisation's income. For this reason leading UK and international providers of health and social care services (e.g. Project Partner Care UK, BUPA, Sunrise) will be interested in the project findings, as they have the means to invest in further collaborative research and development optimising care practice in their homes.

Organisations fostering research and/or offering support, consultation, networks, training, or counselling to those affected by dementia will find the research helpful as it will inform their practice and advisory services. This includes community interest companies e.g. Innovations in Dementia CIC, private consultancies e.g. Age Matters, and charities e.g. Dementia UK, Alzheimer's Society, Age UK, and the King's Fund.

Occupational therapists, care professionals, and health care managers will benefit from the research presented via their professional forums such as the British Association of Occupational Therapists, the Institute of Healthcare Management, and the International Snoezelen Association. The latter also represents a potential pathway to international impact, in regions such as the Middle/Far East and South America, where the use of MSEs is accelerating, and in Europe and USA where MSEs are widely established.

Disseminated through their professional organisations and networks (e.g. Design Council, RIBA) the research will inform and benefit the practice and work of designers, architects, and project managers directly or indirectly involved in healthcare design.

Beyond the funding period, impacts will amplify through the involvement of stakeholders, existing/new partnerships with some of the beneficiaries mentioned above, and essential collaborations with other researchers strengthening international links. The project will provide the rationale needed to perform more extensive and deeper investigations, incl. a large-scale, multi-centred study exploring the therapeutic design of MSE - both within the client group as well as others such as autism and learning disabilities.
 
Title Sensory Rooms (Kingston University) 
Description Parts of the exhibition 'Sensory Rooms: Designing Interventions to support dementia care' originally shown at the Inside Out Festival were displayed at the Platform Gallery located at the entrance to Knights Park Campus, home to Kingston University's thriving Faculty of Art, Design and Architecture (FADA). The week long exhibition was running from 24 April to 2 May 2015. Alongside the exhibition the research was also presented to FADA staff at the faculty's Research Away Day on 30 April 2015. 
Type Of Art Artistic/Creative Exhibition 
Year Produced 2015 
Impact Results and methods of this interdisciplinary, collaborative research were presented and shared with staff and students of the faculty. 
URL http://blogs.kingston.ac.uk/mse/?p=742
 
Title Sensory Rooms (University of Southampton) 
Description The research was showcased during the Discovery Day (2-3 July 2015) run by the Rehabilitation and Technologies Research Group at University of Southampton. The day aimed to publicise the group's research to stakeholders, patients, clinicians, funders, commercial partners and other academics. The second day was a University open day sothe show was also viewed by potential students. 
Type Of Art Artistic/Creative Exhibition 
Year Produced 2015 
Impact showcasing methodes and results of an intersiciplinary research project - a collaboration between design and health care 
 
Title Sensory Rooms: Designing Interventions to support dementia care - Inside Out Festival 
Description Sensory Rooms is an exhibition that has been developed to provide ideas on how new approaches to design could result in the creation of environments that would better suit the needs of people living with dementia. It showcases the results of a recently funded research enquiry into the current provision of multi sensory stimulation for this age group, in particular the design of multi sensory spaces (often referred to as 'Sensory Rooms'). The overall purpose of the research has been to establish new knowledge from which coherent, user-centred design solutions can be developed. 
Type Of Art Artistic/Creative Exhibition 
Year Produced 2014 
Impact raising awareness regarding the issue of providing the right sensory stimulation for people with dementia giving design advice on appropriate environments tailored towards people with dementia 
URL http://www.insideoutfestival.org.uk/2014/events/sensory-rooms-designing-interventions-to-support-dem...
 
Description We discovered that sensory rooms in care homes are often not set up in a way to be enjoyed by people with dementia, Existing facilities offer only a limited range of sensory stimulation and often are not age appropriate. There is limited knowledge and training regarding sensory stimulation amongst staff and we therefore developed a guide book advising on the design of multi sensory environments for people with dementia.
Exploitation Route The Guide book is aimed at care practitioners working in care homes which are in need of information, advice and inspiration.

Research results can be taken forward by other designers and architects developing environments for people with special sensory needs, as well as by health care professionals to improve care methods and environments.
Sectors Communities and Social Services/Policy,Environment,Healthcare

URL http://kingston.ac.uk/sensoryrooms/
 
Description The Guide book has been a useful tool for carers, care practitioners and other professionals for their daily work caring for people with dementia helping them to set up the right environment. It has also been helpful for the development of new sensory products. Impact of research activities and outcomes on setting up sensory environments: - Testimonial from a care worker at one of the participating care homes:"The new room benefited from the advice given in the guide book, especially regarding to de-clutter and remove inappropriate items, and how to arrange the space. We have now also installed a LED projector as advised and are about to put up a tactile curtain enabling us to divide the space. Feedback from residents has been positive. The space is now used for relaxation which helps to reduce challenging behaviour and stress. This applies not only to residents with dementia but also to residents with other mental health issues and Asperger's Syndrome. Residents do not call it 'Sensory Room' though, rather 'quiet room', 'beautiful room', 'lovely room' etc. A resident who used to express his distress by shouting and abusing others, feels better and calmed down when spending time in our new space. One day, when he felt particularly distressed, he asked me: Can I go to the Paradise room now?" - Further, we have been contacted by a member of staff at the nursing facility The Rose Blumkin Jewish Home (RBJH) in Omaha, USA seeking our permission for the guide's information to be used to create a new Sensory Room: "I work at a skilled nursing facility and we are currently looking into creating a sensory room for residents with dementia. I will be assisting the committee board in the development of a sensory room by selecting different sensory enhancements and supplies." - The information from the guide was also used by Historic Royal Palaces in the creation of the health and wellbeing programme 'Sensory Palaces,' which enables audiences who face barriers such as dementia to engage with the heritage of the historic palaces. - Our research has been used to support a successful lottery funding application: "Following conversation with Dr Anke Jakob, and having secured additional funding, we will develop a sensory room for people living with dementia. Research (Jakob, 2013) suggests that whilst people in the mid to late stages of dementia find many physical activities challenging, it can be effective to support the sensory side of these activities. Once established, the Sensory Room will be a community resource, with no requirement for on-going funding. No other facility exists in Leeds." - A current partnership with Coombe Hill Manor care home (SIGNATURE CARE ltd) has emerged from initial contact made by care home staff, based on the guide book they had studied. We are now in the process of collaboratively designing and installing a new multisensory space for their residents. Impact on sensory product development: - ActiveMinds: "In 2015 we began to develop a new product range which was very much inspired by the conversations I had with researchers Dr Anke Jakob and Dr Lesley Collier during my visit of the exhibition 'Sensory Rooms: Designing Interventions to support dementia care' in Somerset House, London in 2014 and the panel discussion event taking place alongside the exhibition. For me it was particularly revealing to learn about the lack of multi-sensory experiences and activities appropriately designed to cater for the specific sensory needs of people living with dementia. The lessons around the poor effectiveness of many sensory rooms in care homes that are also very costly for them, helped us think about how we could create a more affordable product that were multi-sensory experiences. Our new product range 'Sensory Products for Dementia' which includes Scentscapes®, Sensory Scenes and Sensory Snap, aims to respond to these needs supporting the wellbeing of and the care for people living with dementia. (Alice Osborne, Head of Design) https://www.active-minds.org/uk/sensory-activities/scentscapes/ https://www.active-minds.org/uk/sensory-activities/sensory-scenes/ https://www.active-minds.org/uk/sensory-product-sensory-snap/ - ROMPA: "The staff here at Rompa have found your book to be an extremely valuable resource throughout many aspects of our jobs. Our sales consultants have found it to be an essential tool when working with staff in care homes, to help explain the concepts of sensory environments and also as a guideline for selecting the correct products for their environment. We have also had really positive feedback from customers we have sent the book out to, via the link you provided. It really seems to affect the choices they make with regards to product and room design. I also would like to share with you feedback from our New Product Development Team. They have all had a copy to look through, and I am happy to say that this has impacted their decision making when designing new products for our catalogue 'Meaningful Activities for Older Adults; Third Edition'. (Ryan Smyth Commercial and Marketing Assistant) https://www.rompa.com
Sector Environment,Healthcare
Impact Types Cultural,Economic

 
Description Care UK 
Organisation Care UK
Country United Kingdom 
Sector Private 
PI Contribution Knowledge exchange delivered guide book with advice on designing multi sensory environments in care homes for people with dementia invited care workers from this organisation to participatory workshop and to exhibition and panel discussion
Collaborator Contribution access to care homes for survey and interviews with staff; sitting on Advisory Panel of Experts
Impact Guide book 'How to make a Sensory Room for people with dementia' Multi - disciplinary collaboration: Design, Occupational Therapy, Social Care
Start Year 2013
 
Description Advisory Panel Meetings 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact presenting and validating research results to date and thier possible impact

Contact was made to the Health Innovation Network through the panel members
Invitation to the Worcester Snoezelen
Year(s) Of Engagement Activity 2013,2014
URL http://blogs.kingston.ac.uk/mse/?p=535
 
Description Designing Interventions to support dementia care: Presentations and Panel Discussion - Inside Out Festival 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Coinciding with the exhibition Sensory Rooms: Designing Interventions to support dementia care, the event featured short presentations and a panel discussion focusing on how multi-sensory stimulation and design can be delivered in an effective and successful way within a dementia care context, the challenges care homes are facing, and what isuues bneed to be addressed.
This event brought together academic researchers and Dementia Care professionals to explore and debate issues of environmental design on the quality of life and well-being of people with dementia, as well as on their carers and support staff.
Speakers included:
Dr Lesley Collier - Senior Lecturer and Researcher in Occupational Therapy at University of Southampton
Dr Hugo de Waal - Clinical Director for Dementia at Health Innovation Network South London
Fiona Fowler - Trainer for Dementia Care, Managing Director at Dementia Works ltd.
Dr Anke Jakob - Design Researcher at Kingston University London
Maizie Mears-Owen - Head of Dementia Care at Care UK
Karin Tancock - Professional Advisor for Older People and Long-term Conditions at College of Occupational Therapy
Chair: Professor Paul Chamberlain - Design Director Lab4living and Head of Art and Design Research Centre at Sheffield Hallam University.

The short presentations were followed by an animated discussion with the audience.

raising awareness
Year(s) Of Engagement Activity 2014
URL http://www.insideoutfestival.org.uk/2014/events/designing-interventions-to-support-dementia-care-pre...
 
Description Exhibition: Sensory Rooms, Inside Out Festival London 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Sensory Rooms was an exhibition that has been developed to provide ideas on how new approaches to design could result in the creation of environments that would better suit the needs of people living with dementia. It showcased the results of a funded research enquiry into the current provision of multi sensory stimulation for this age group, in particular the design of multi sensory spaces (often referred to as 'Sensory Rooms'). The exhibition sparked discussion and questions with the audience.

The exhibition launched the Guide Book 'How to make a Sensory Room for people living with dementia' offering advice and ideas on how to construct and design a multi sensory space tailored towards people with dementia.


raising awareness of the problem surrounding the need of providing appropriate sensory stimulation for people with dementia
Year(s) Of Engagement Activity 2014
URL http://www.insideoutfestival.org.uk/2014/events/sensory-rooms-designing-interventions-to-support-dem...
 
Description Exhibition: Sensory Rooms, University of Southampton 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact dissemination of research results to stakeholders, patients, clinicians, funders, commercial partners and other academics and students


increased awarness of the impact of appropriate sensory design for environments in care homes
Year(s) Of Engagement Activity 2015
 
Description Focus Group Workshop: Multisensory stimulation for older people with dementia 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Workshop with staff (Activity coordinators) from 4 different care homes:
- Presentation of research findings to date.
- Interactive creative session developing a range of ideas for multisensory stimulation and discussed with the participants what should be improved and introduced to a care environment to increase the wellbeing of residents in care and nursing homes.

After the workshop participants felt inspired and felt a need of getting more information.
Year(s) Of Engagement Activity 2014
URL https://blogs.kingston.ac.uk/mse/?p=390
 
Description How to make a Sensory Room for people with dementia - Guide book for care practitioners 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact giving advice on setting up multi sensory environments in residential homes caring for people with dementia

care home staff welcomed the guide; some care homes have started to transform their sensory rooms into multi sensory environments suitable for older people with dementia.
Year(s) Of Engagement Activity 2014
URL http://kingston.ac.uk/sensoryroom/
 
Description Presentation Health Innovation Network (HIN) - South London Care Home Network Forum 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact 45 min presentation at the sixth South London Care Home Network Forum, at Coin Street Neighbourhood Centre, SE1. The theme for this forum was 'Sensory'.
About 80 people, mainly health care practitioners including care home managers and staff, attended this event. There were many questions regarding the set up of a multisensory space in a care home, the audience was very interested in the research outcomes.
Year(s) Of Engagement Activity 2017
 
Description Presentation KTN 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Talk by Anke Jakob at KTN symposium "Materials and Design for Alzheimer's": In November 2015, KTN ran this symposium looking at the issues faced by people with Alzheimer's disease or dementia, with a view to identifying ways in which materials innovation (and design innovation in general) can improve matters.
This was a preliminary event preceding the launch of an initiative to stimulate the market for everyday products which are inclusive of people living with Alzheimer's and other forms of dementia. The programme is inspired by the Prime Minister's Challenge on Dementia 2020 and Innovate UK's Long Term Care Revolution Challenge.

KTN is the UK's innovation network, established by Innovate UK to build better links between science, creativity and business across the economy - from energy and transport to healthcare and robotics.
Year(s) Of Engagement Activity 2015
URL https://connect.innovateuk.org/web/design-exchange/article-view/-/blogs/materials-and-design-for-alz...
 
Description Presentation Karten Network 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Anke Jakob was invited to talk about sensory environments and research outcomes at a regional network event which took place at Schonfeld Square Foundation, North London, in November 2015.
The Karten Network ( Supporting organisations working with disabled people) is a network of IT centres for disabled people. The centres are funded through the Ian Karten Charitable Trust, with the purpose of improving the quality of life and independence of adult people with congenital or acquired physical, cognitive, sensory, learning disabilities or mental health problems. The Karten Centres provide a supportive learning environment together with access to the latest in adaptive computer technology, and are located in a wide range of host organisations.
The audience included care practitioners from a number of different care organisations.
Year(s) Of Engagement Activity 2015