Low Stimulation Guidelines
What is Overstimulation?
After a brain injury, your family member requires extra work to process and make sense out of their environment. If there is too much input or stimulation for them to deal with, they may become overstimulated, resulting in less-than-optimal functioning.
Remember, the brain is working when it is processing information of any kind. Don’t “overwork” the brain by giving it too much to process at any given time.
Low Stimulation Guidelines
The following list offers general suggestions for family, friends, and staff to reduce overstimulation. Please talk to your team members for more specific suggestions to implement with your family member.
- Keep lights dim or limit the number of lights that are used.
- Keep the door to the room closed and pull the curtain around the bed (if it’s a shared room).
- Encourage and allow frequent rest periods.
- Limit the amount of time the television or radio is turned on. Keep the volume low. Consider the “care channel” as a choice for the TV channel. Turn the TV or radio off when visitors are present.
- Limit the number of visitors in the room (usually no more than 2). Speak one at a time. Keep visits short.
- Always identify yourself when entering the room.
- Use a calm voice and speak slowly.
- Conversations in the room should be directed towards the patient. If the patient is not involved in the conversation step out of the room.
- Consider the amount of visual stimulation in the room, such as the number of pictures or banners on the wall, televisions or monitors in the room, etc.
Signs of Overstimulation
- Increased restlessness, as in increased movement or pacing
- Increased stiffening of the muscles
- Increased moaning or crying out
- Facial grimacing
- Blood pressure and pulse rate changes (not easily observed)
- Shutting down or closing off: A person may close their eyes, turn away and be very calm. This is one of the later signs of overstimulation and is just as important to detect
- Increased agitation, yelling, or anger
- Increased confusion or just not performing at their “best”
- Increased pulling at tubes, clothing, etc.
If you observe any of these symptoms, use the “low stimulation” guidelines for creating an optimal environment. Please don’t hesitate to ask your team members for help with re-establishing the best surroundings.
Activities to Do with Your Family Member
The following are some general suggestions; please speak with your team members to establish other appropriate activities.
- Give simple and repeated directions when you ask the patient to do something. It may take longer for the patient to understand what they hear, so allow extra time to respond before repeating information.
- Use a firm but gentle touch.
- Treat your family member appropriately; speak to them as you did before the injury. Tell them that something is going to happen before it actually does (combing hair, moving the patient, etc.).
- Call the person by name and repeat orientation information with them. Talk about where the patient is: date; day; why patient is in the hospital; how long they have been there; and about special interests, family members, and friends.
- Do NOT quiz the patient (i.e., asking them the date, time, etc.). Give them the correct information in conversation without testing them.
- A patient’s favorite scents can be used to provide olfactory (sense of smell) stimulation. You can use lotions or perfumes, but remember that heavy, constant scents can be overstimulating.
- Family pictures are helpful for visual stimulation. Please bring pictures of family with descriptions and therapy staff can arrange pictures so that they’re not overstimulating.
- Remember that it is okay to just sit with your family without conversation.
- Feel free to read to your family member, touch the patient, and reassure them. Do what is comfortable and normal in your interaction.
- Always consider the possibility of overstimulation and be aware of its characteristic signs (see above).
Revised: 1/2015
This resource is provided as a courtesy of Craig Hospital. For more information, contact the Craig Hospital Nurse Advice Line at 1-800-247-0257.
Disclaimer: The content in this document is intended for general informational purposes only and is not a substitute for professional medical advice or treatment for specific medical conditions. No professional relationship is implied or otherwise established by reading this document. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Many of the resources references are not affiliated with Craig Hospital. Craig Hospital assumes no liability for any third party material or for any action or inaction taken as a result of any content or any suggestions made in this document and should not be relied upon without independent investigation. The information on this page is a public service provided by Craig Hospital and in no way represents a recommendation or endorsement by Craig Hospital.