By Sally Fraser-Mackenzie

Despite the fact that most of my work is based in SI and paediatrics, I’ve always had a strong passion for mental health and the elderly. I have been working closely with some elderly clients in the past few years. Through regular sessions, I have seen how gentle sensory integration can improve the quality of life in the elderly.

When the elderly are confined to their old age homes and have no relatives in town to take them out, their worlds become very small, limited and restricted. Gentle outings, such as a quiet drive looking at buildings or nature, and going down memory lane, can be so visually stimulating and an expansion of their day. A facilitated walk with a walking frame to a nearby coffee shop is the highlight of the month! A warm smile and a new activity can be enough for the day.

But what of COVID times? Many of my elderly clients have had extra lock down in their care homes, despite the easing of the Alert levels. They can’t manage smart phones and don’t have computers, so telehealth sessions are nearly impossible – unless a carer has a device and data, and is tech-savvy, and can be available to facilitate an appointment. Even then I have had a few instances of my clients falling asleep while I was talking to them on a video call, and no matter how I sang and danced, I couldn’t rouse them. Better sessions have included playing dominoes over a video call – “These are your dominoes, which one would you like to play?”, and memory games like Kim’s game which can be surprisingly effective. But despite all these efforts, my clients have deteriorated physically and mentally, becoming more sleepy, opting out of interactions, talking less, showing less interest and showing all the signs of depression. Their families are also struggling to communicate with them.

One old age home has claimed they will stay in lock down Level 5: no one allowed in or out, no walks around the block, relatives only allowed when they are on their death beds, for the next 2 years! Where does that leave an frail, elderly lady of 88 desperate to see her family? Well, it leaves me rather defiant, and determined to keep bringing her some quality of life, contact and smiles. But how? Between her carers and me, we have arranged illicit meetings on either side of the fence near the back compost heap! We sit about 4m apart, in a lovely patch of sunshine. I bring my camping chair, sometimes we both bring a cup of tea, and she smiles and chats a little. Despite the lack of contact and the big fence in between us, it works!

At another care home, I am permitted to see my client once a week briefly in the visiting bay through a Perspex screen where I can’t hear him very well, but it’s an outing for him in a way. He gets to go in his wheelchair up in the lift and to the conference room where the visiting bay is, which is something of a sensory expansion at least. The visitor’s bay is chilly, and I am almost sitting outside, while he is inside, so I usually dress warmly. Last week, I visited and they had double booked the visitors bay, so I was allowed right inside to his room. It was a cold day, and I had a spencer on, a top and my puffy jacket, and of course my mask. After multiple hand sanitizations, I had to then don a shield as well, a white synthetic coat with tight long sleeves and gloves. I was ushered into his warm room, and immediately started steaming up! I was completely overheating in all this but couldn’t take anything off, and we spent most of the session laughing at my claustrophobia, the steamed-up shield, and how crazy this all was!

Sensory Integration doesn’t have to be fancy paediatric equipment. It can also be the gentle world around us, the birds in the trees, fresh air or a breeze, the smell of roses and the movement of walking. These can be enough for our elderly, and through these difficult times, they are even being deprived of these, needing to stay shut in their rooms. My heart breaks for them as they have so little autonomy, little choice and minimal stimulation. As OT’s though, we can continue to be creative and inventive finding ways to overcome these barriers for the sake of the sanity of our elderly.