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 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 (number of pictures, banners) etc.
**Remember, the brain is working when it is processing information of any kind. Don’t “over work” the brain by giving too much to process at any given time.
Signs of Over-stimulation 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.
Signs of Over-stimulation
- 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 eyes, turn away and be very calm. This is one of the later signs of over-stimulation 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 he/she hears, so allow extra time to respond before repeating information.
- Use firm gentle touch.
- Treat your family member appropriately; speak to him/her as you did before the injury. Tell them that something is going to happen before it actually does (combing hair, moving patient, etc.)
- Call 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 – asking them the date, time, etc... Give them the correct information in conversation without quizzing them.
- Patient’s favorite scents can be used to provide olfactory stimulation (sense of smell). You can use lotions or perfumes but remember that heavy constant scents can be over-stimulating.
- Family pictures are helpful for visual stimulation. Please bring pictures of family with description and therapy staff can arrange pictures so not to be over stimulating.
- Remember that it is OK to just sit with your family without conversation.
- Feel free to read to your family member, touch patient, and reassure him/her. Do what is comfortable and normal in your interaction.
- Always consider the possibility of overstimulation and be aware of signs of “overstimulation”