Messenger - Vol. 1, No. 3, Page 8 Spring 1992 Can everyday objects spark fleeting memories? Most of the time, his uncomprehending eyes stared into space as he wandered through the nursing home halls. That's how he spent his days, inanimate but in motion. It was only when he was put to bed that he reacted, and then he became abusive. He fought with nurses every night until one nurse gave him a plastic collapsible drinking cup. He responded by manipulating the cup, apparently making contact with the world outside himself, and when it was time for bed, he complied. This patient's response to the cup she had given him suggested to nurse Rosemary (Jami) Noble, Delaware '84, that memory-impaired patients might be stimulated more by everyday objects than by children's toys. She reasoned that more frequent moments of awareness and activity would improve their quality of life. As a staff nurse at the Governor Bacon Health Center during the late 1980s, Noble had noticed other patients responding to common everyday objects. Brightly colored plastic containers with easily removable lids, combs, plastic mirrors, textured fabrics seemed to stimulate them, and she began making boxes full of these things. "I used empty soft margarine containers and Mott's applesauce cups. Miller's Furniture gave me fabric samples they were going to discard," Noble says. The boxes were so well-received that Noble found herself making more and more until she began running out of money. In her effort to find funding, she contacted the National Institute of Health's Center for Nursing Research, and they advised her to patent the idea. That suggestion made her think that her activities box might be marketable, but she had no documentation to show that the objects in the box had a tangible effect on memory-impaired patients. So, she turned to her alma mater, the University of Delaware. College of Nursing Dean Betty Paulanka (who was then an associate professor) and assistant professor Laura Griffin were already researching ways to improve the quality of life for the memory-impaired, and Noble's activity box fit right in. "We were trying to find nursing strategies that would stimulate the four senses, giving these patients a period during the day when they would experience qualitative intervention," Griffin says. So, Paulanka and Griffin created a research project that would provide Noble the data she needed while testing their theory that sensory stimulation strategies might prevent some of the functional disability resulting from extensive memory loss. Paulanka and Griffin wanted the data to show which age-appropriate, sensory stimulation objects were selected most often and whether that selection was consistent. They also wanted to learn if clients responded to the stimulation of one sense more often than others, if they preferred age-appropriate objects and how long each person responded to each object. Beginning their observations last spring at a long-term care facility with a specialized unit for the memory-impaired, they selected 18 individuals who were 60 years or older and who had been diagnosed with Alzheimer's disease or other organic brain syndrome disorders that limited their ability to perform everyday activities. They observed each person over a two-week period, four times each week for at least 10 minutes each time. To assess mental status and function level during each encounter, Paulanka and Griffin subjected their data to the Cognitive Function Scale and the Mini Mental State Exam. The objects used in the study included a calculator, a music box, foam rubber pastel blocks, a stuffed animal and a cedar block. According to the two researchers, the people they observed appeared to be stimulated by the objects and demonstrated preferences for some objects over others. This pilot project indicates that nursing intervention strategies may have more to offer the memory-impaired than what is now believed, the researchers say. Griffin and Paulanka are submitting grant proposals to the Alzheimer's Disease and Related Disorders Association and the National Institutes of Health so that they can carry on their research. Griffin says their hope is that "more individualized boxes may create more connective memories, improve the quality of life for the memory-impaired and spark interaction with their families or friends who visit." -Barbara Garrison