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What is Snoezelen Therapy and is it Helpful in Alzheimer's Disease?

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Updated June 12, 2014

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Question: What is Snoezelen Therapy and is it Helpful in Alzheimer's Disease?
Answer:

Snoezelen is a type of therapy that was developed in the Netherlands in the 1970s by institutions caring for severely disabled people. Using light, sound, scents, and music to initiate sensual sensations, the idea of snoezelen is to have both relaxing and activating effects that promote well-being. Snoezelen is used for people with autism and other developmental disabilities, dementia, and brain injuries.

The word "snoezelen" (pronounced SNOO-zeh-lehn) is a contraction for the Dutch words for sniffing out (snuffelen) and dozing (doezelen). Sometimes called multi-sensory stimulation rooms, snoezelen rooms are felt to be calming and soothing for people with Alzheimer's disease and other dementias, especially those with late-stage dementia who wander, experience sundowning, and are agitated.

One description of a snoezelen room refers to "glow-in-the-dark stars shining faintly," "colored bubbles rising in a tall lighted column before a mirror," and "fiber-optic strands winking orange, yellow, and rice-white." Floors of snoezelen rooms may be adjusted to stimulate the sense of balance.

Snoezelen rooms are especially common in Germany, but have also established themselves in nursing homes and assisted living facilities in Canada and the United States. One disadvantage to snoezelen therapy is its cost: The rooms are expensive to set up, averaging approximately $25,000. The list of separate items suggested to set up a room found on the International Snoezelen Association's web site numbered 24, including 10 floor mats, one "padded stage for Bubble units," and four ballpond walls. All snoezelen rooms are structured environments. They may contain a panel of colorful lights, bubble tubes or walls, and a projector and color wheel, which throws images, usually, pictures, across the ceiling and walls of the room.

The time a patient spends in a snoezelen room can vary. Some facilities allow patients to visit a snoezelen room as they wish; others work with small groups of patients or one-on-one for short daily sessions with a recreation therapist. A short session, lasting 15 to 30 minutes, has been found to be effective in decreasing Alzheimer's patients' tendency to wander for up to four hours afterward.

While not a cure for Alzheimer's by any means, snoezelen promotes well-being without resorting to medications. The evidence base for snoezelen therapy for dementia-related agitation is actually fairly good: There have been three randomized controlled trials, all of which showed positive short-term benefits. For comparison, a 2008 review article that summarized evidence for many non-medication strategies in dementia found that the evidence supporting snoezelen therapy was as good as the evidence supporting music therapy, behavioral management therapy, and staff training/education.

Sources:

Meeks, TW, Jeste DV, "Beyond the Black Box: What is the Role for Antipsychotics in Dementia?", Curr Psychiatr 7;6:50-65, June 2008.

International Snoezelen Association, accessed Feb.4, 2011 http://www.isna.de/index2e.html

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