Sensoristasis and imbalance in persons with dementia

Abstract

Purpose: To present a model of sensoristasis and imbalance for use by health care professionals to deliver care to older adults with irreversible dementing illness.

Organizing constructs: The Sensoristasis Model shows the need of people with dementia to experience a balance between sensory-stimulating and sensory-calming activity. This model builds on Lawton's environmental docility hypothesis and on Hall and Buckwalter's Progressively Lowered Stress Threshold Model.

Methods: The model was derived from empirical evidence, theory, and clinical experience. Levels of agitation of three acute care patients experiencing sensoristasis and imbalances in sensoristasis indicate tenets of the model.

Findings: Older adults with dementia experience intrapsychic discomfort because of imbalances in the pacing of sensory-stimulating or sensory-calming activity. Consequences of intrapsychic discomfort include agitated behaviors and episodic or premature decline in instrumental and social function.

Conclusions: Pacing of activity must be guided by interventions that facilitate optimum sensoristasis and often need to be adjusted during stress, environmental change, and progression of the illness. Interventions can ameliorate some of the negative consequences of imbalances in sensoristasis when optimal pacing is not attained.