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Sonas Programme for dementia
A well-known symptom of dementia is cognitive impairment and behavioural changes. These in turn can lead to difficulties in people with dementia expressing themselves, particularly via verbal communication.
Whilst those with dementia can be withdrawn and harder to communicate with, the desire to communicate and the human need to be involved in society will remain, irrespective of the degree of dementia induced cognitive impairment (Strom et al., 2017). A lack of ability to communicate effectively can make those with dementia seem unreachable and as a result can lead to reciprocal lessening of communication from carers, in the worst cases leading to “social death” (Spicker et al., 2000). As the severity of dementia increases, those with it tend to be more sedentary and hence become more isolated and bored which creates to a cycle resulting in social deprivation.
Medications used to treat behavioural symptoms associated with dementia are often antipsychotics, as these can cause serious side effects, psychosocial interventions are a preferred form of therapy. Psychosocial refers to the interplay between individual behaviours and thoughts (psycho) and social factors (social). One of these therapies is the Sonas Programme, a therapeutic activity which can be either delivered to groups, or individuals with moderate to severe dementia. The classes consist of stimulation of all senses, gentle exercise activities, social engagement, and relaxation. Qualification courses to become trained to deliver the therapy can be completed either online (level 1) or as a mixture of face-to-face sessions and online training (level 2). The courses aim to include an understanding of communication, what it’s like to have dementia, the improvements sensory stimulation can cause and the Sonas Programme (https://dementiapathways.ie).
The Sonas Programme was devised by Mary Threadgold in 1990 for those with significant communication or cognitive difficulties which has, over time, become apparent to be helpful for those living with dementia. The training programme originally included the letters APC as it aimed to activate the participants potential for communication, the name was changed to Engaging Dementia in 2018 to reflect its evolving activities, although the Sonas programme remains a key element and its principles are still at its heart; “To facilitate communication, engagement and connection for people with dementia and their care partners, through education, resources and community activities.” (Strøm et al., 2020).
In a 24-week study of how communication abilities changed over time when attending Sonas programme sessions, communication skills were seen to improve but a peak was reached at 16 weeks, as such, the activities should be attended for at least 16 weeks to achieve maximum benefit (Strøm et al., 2018). More recent evidence has shown that in addition to improving communication skills, the Sonas programme also caused a significant decrease in depression within 12 weeks (Goyal 2021). These results show the power of cognitive stimulation for improving both the communication difficulties and the depressive symptoms caused by dementia.
Attendance of the two-day course to become a Sonas Programme Licensed Practitioner costs €450, or alternatively some care homes provide the sessions for their residents. Provision of these sessions for those with dementia may help prevent the down-ward spiral of social withdrawal seen in many, and its simplicity holds great potential for widescale training of staff in relatively short time scales with a hope to provide a holistic care that can improve the life of people with dementia and their loved ones.
References
Goyal, A. R., Engedal, K., Benth, J. Š., & Strøm, B. S. (2021). Effects of the Sonas Program on Anxiety and Depression in Nursing Home Residents with Dementia: A 6-Month Randomized Controlled Trial. Dementia and Geriatric Cognitive Disorders Extra, 11(2), 151-158.
Spicker A: Dementia and social death. Self Agency Soc 2000;2:88–104
Strøm, B. S., Engedal, K., Benth, J. S., & Grov, E. K. (2017). Effect of the sonas programme on communication in people with dementia: a randomized controlled trial. Dementia and geriatric cognitive disorders extra, 7(1), 122-135.
Strøm, B. S., Benth, J. Š., & Engedal, K. (2018). Impact of the Sonas Programme on Communication over a Period of 24 Weeks in People with Moderate-to-Severe Dementia. Dementia and geriatric cognitive disorders extra, 8, 238-247.
Strøm, B. S. (2020). Overview of research on the Sonas® programme.
