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
     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