NSE 12A/B Lecture Notes - Lecture 6: Macular Degeneration, Sensory Overload, Sensory Deprivation
10 Jan 2017
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Week 6 Objectives
1. Differentiate among the three components of any sensory experience:
a) reception
● Stimulation of a nerve cell (receptor)
● The nerve impulse travels to the brain
b) perception
● Integration and interpretation of stimuli on the basis of a person’s experiences
c) reaction
● output
2. Discuss the relationship of sensory function to an individual’s level of wellness.
● Meaningful stimuli allow a person to learn about the environment and are necessary for
healthy functioning and normal development
● Sensory alterations can affect an individual’s ability to manage and care for themselves in
their homes, decreased independence, and decreased use of necessary self-care practices
● Risk of lower self esteem, depression, and social withdrawal
3. Describe common causes and effects of sensory alterations.
● Visual and hearing loss affect communication, cognition, and mobility
● olfactory, tactile, and gustatory impairments result in nutritional problems with resultant
weight loss, dehydration, and skin breakdown
4. Discuss common sensory changes that occur with aging.
● Infants
○ Infants unable to discriminate sensory stimuli b/c nerve pathways are immature
● Older adults
○ Visual
■ Presbyopia: macular degeneration, visual changes as you age, needing
reading glasses
● 40-50 yrs
■ Reduced visual fields, increased glare sensitivity, impaired night vision,
reduced accommodation to depth perception, reduced colour
discrimination (shorter wavelengths)
○ Hearing loss (noise exposure, and over time loss of blood to cochlea)
■ Presbycusis
● Degeneration of ear structures
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■ Inability to hear high pitched sounds
■ Also background noise is harder to hear
○ Smell (after 50)
■ Reduced taste discrimination
■ Reduced sensitivity to odors
○ Proprioceptive (after 60)
■ Difficulty with balance, spacial orientation, and coordination
■ Tactile changes - pain, pressure, temp
● Cataract
● Glaucoma
●
5. Identify and describe the factors affecting sensory function.
● Most common type of sensory alterations are
○ Sensory deficits
■ Loss in normal function of sensory reception and perception
○ Sensory deprivation
■ Experiencing inadequate quality or quantity of stimulation
● Reduced sensory input (sensory deficit)
● Elimination of pattern or meaning from input (exposure to strange
environments)
● Restriction of the environment (bedrest, reduced variation)
■ Make cause HCP to think patient is psychologically ill and confused, or
under influence of drugs
○ Sensory overload
■ Receives multiple sensory stimuli and cannot and cannot selectively
ignore some of them
■ Prevents brain from appropriately responding
● May lead to delirium
6. Describe therapeutic interventions for preventing sensory deprivation and controlling sensory
overload.
● Sensory deprivation
○ Ensuring patients have necessary visual/hearing aids they require
● Sensory overload
○ Constant reorientation, control of excessive stimuli, and providing care in blocks
of time if possible
○ Providing clocks, calendars, dimming lights, family support, clear communication
7. Discuss ways to maintain a safe environment for patients with sensory deficits.
● Knowing the limits of their sensory deficits
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● Rearrange physical environment to accommodate the patient’s needs
● Use aids and safety equipment
● Promote meaningful stimulation through a modified environment
● Adaptations for visual loss
○ Alter lighting
○ Driving when appropriate and in familiar places
● Adaptations for reduced hearing
○ Sounds amplified, and lower in pitch
○ Services
● Adaptations for reduced olfaction
○ Use smoke and carbon monoxide detectors
● Adaptation to reduced tactile sensation
○ Temp on home water heater should be no more than 48.8*C
8. Identify common types of communication deficits
●
9. Describe strategies for caring for and communicating with clients experiencing
communication deficits related to:
a) visual and auditory deficits
● Visual
○ Check for use of glasses/contacts
○ Identify when you enter and leave the room
○ Speak in a normal tone
○ No relying on nonverbal communication
○ Use indirect light, avoid glare
○ Use appropriate font for writing
○ Speaking as you approach to prevent startling
● Auditory
○ Check for hearing aids
○ Reduce environment noise
○ Get patient attention before speaking
○ Face patient so mouth is visible
○ No chewing gum
○ Normal voice tone (no shouting)
b) impaired verbal communication secondary to speech and language deficits, (e.g., aphasia) *
● Aphasia: neurological linguistic deficit ex after a stroke
○ Expressive - can understand but cannot express thoughts or feelings in words
○ Receptive - difficulties in receiving and processing written and oral messages
○ Global - expressive and receptive
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Document Summary
Week 6 objectives: differentiate among the three components of any sensory experience, reception. The nerve impulse travels to the brain: perception. Integration and interpretation of stimuli on the basis of a person"s experiences: reaction. Output: discuss the relationship of sensory function to an individual"s level of wellness. Meaningful stimuli allow a person to learn about the environment and are necessary for healthy functioning and normal development. Sensory alterations can affect an individual"s ability to manage and care for themselves in their homes, decreased independence, and decreased use of necessary self-care practices. Risk of lower self esteem, depression, and social withdrawal: describe common causes and effects of sensory alterations. Visual and hearing loss affect communication, cognition, and mobility. Olfactory, tactile, and gustatory impairments result in nutritional problems with resultant weight loss, dehydration, and skin breakdown: discuss common sensory changes that occur with aging. Infants unable to discriminate sensory stimuli b/c nerve pathways are immature.
