Sensory COmpensation

What is it?

As humans we use our five senses, sight, touch, hearing, taste, and smell. All these senses deliver information perceived about the world to out brains to be processed and interpreted. If one or more of these five senses is damaged by trauma or disease, the data transfer stops, but the brain will continue to function normally.

Sensory Compensation

TRAIN YOUR BRAIN!

Now lets put it together!!

1. Engage in New Challenges and Develop “Whole Brain Thinking”

2. Practice Focused Attention

3. Explore

4. Exercise 3-4 days a week for 30-45 Minutes Per Session

5. Protect Your Brain - Learn to Meditate

6. Develop Stimulating Friendships

7. Laugh Often

8. Water and Feed Your Brain to Make It Grow!

9. Practice Positive Forward Thinking

10. Play some Games!

Emily JOhnston, Robyn royster, & Allison Craig

The brain responds to a sensory deficiency in the occipital lobe by enhancing the processing of other senses, such as hearing, touch, and smell.

• Due to the increase in stimulation to the other sensory areas Axonal Sprouting rapidly creates new neural pathways and the existing connections strengthen, leading to enhancement of those senses.

• The brain automatically focuses its energy and attention on the aspects of the brain that are constantly working.

Reorganization takes place through Axonal Sprouting

- Undamaged axons grow new nerve endings to reconnect the neurons whose links were severed through damage

- Undamaged axons grow new nerve endings and connect with other undamaged nerve cells to create new neural pathways

Diagnosis

Compensation with Sound!

• • Risk for Injury
• • Self Care Deficit
• • Social Isolation
• • Fear
• • Situational Low Self-Esteem
• • Powerlessness
• • Hopelessness
• • Readiness for Enhanced Coping

Sound cues improve our spacial awareness.

Planning

Assessment

Assess how long the client has had the visual impairment

Assess how the impairment affects the clients daily life

• Level of difficulty with ADLs
• Reading a clock, newspaper, walking from room to room

How has the impairment affected their life as a whole?

Job loss, inability to drive, loss of independence

• Assess for signs/symptoms of depression

• Overall goals for clients with recent vision impairment include making a successful adjustment to the new impairment, verbalize their feelings, identify their personal strengths and support systems, and verbalize and use appropriate coping strategies.
• Overall goals for clients with long term vision loss include attaining or maintaining an appropriate level of functioning.
• Do not assume clients other senses have compensated.

Levels and Direct to Reverberant Ratios are used to determine distance from a sound cue.

Nursing Implications

What are levels?

Evaluation

What are Direct to Reverberant Ratios?

Interventions

The ration of direct to reverberant sound also provides distance information. Direct sound energy travels in a straight line from the sound source to the listener, while reverberant sounds energy bounces from surfaces such as walls or objects before reaching the listener.

• The ratio of direct to reverberant sound decreases as the distance from the sound source increases and can provide both absolute and relative distance information.

• Levels provide listeners with more accurate distance information. Sounds with higher levels are perceived to be closer. As the level decreases the perceived distance increases.

• Level cues tell if one sound is closer or further than another, rather than how far away a sound is.

• • Did it work?
• • Is there anything I can do differently?
• • Is there a different goal my client could set?

• Decreasing risk for injury
• Assisting the client with obtaining assistive devices
• Enhancing coping skills
• Therapeutic communication to assist client in verbalization of feelings

References

Ackley, B.J. & Ladwig, G.B. (2014). Nursing diagnosis handbook: An evidence-based guide to planning care (10th ed.). Maryland Heights, MO: Elsevier Mosby.

Bionic Vison Australia (2014). How does healthy vision work? Retrieved from http://bionicvision.org.au/eye/healthy_vision

Engleka, G. (2014, January 1). Sensory Substitution - Seeing with Our Tongues. Retrieved October 13, 2014, from http://www.foxcenter.pitt.edu/research/sensory-substitution-seeing-our-tongues

Hammond, K. (2010). Neuroplasticity. Retrieved from http://web.stanford.edu/group/hopes/cgi-bin/wordpress/2010/06/neuroplasticity/

Kolarik, A. J., Cirstea, S., & Pardhan, S. (2013). Evidence for enhanced discrimination of virtual auditory distance among blind listeners using level and direct-to-reverberant cues. Experimental Brain Research, 224(4), 623+. Retrieved

from http://db24.linccweb.org/login?url=http://go.galegroup.com.db24.linccweb.org/ps/i.do?id=GALE%7CA338040326&v=2.1&u=lincclin_spjc&it=r&p=AONE&sw=w&asid=ecbdf92638fa037dd321bdc55ce265e6

Kupers, R., Pietrini, P., Ricciardi, E., & Ptito, M. (2011). The nature of consciousness in the visually deprived brain. Frontiers in Psychology, volume two. Retrieved from http://journal.frontiersin.org/Journal/10.3389/fpsyg.2011.00019/full

Lewis, S.L., Dirksen, S.R., Heitkemper, M.M., & Bucher, L. (2014). Medical-surgical nursing: Assessment and management of clinical problems (9th ed.). St Louis, MO: Elsevier Mosby.

Marieb, E.N. & Hoehn, K. (2007). Human anatomy and physiology (7th ed.). San Francisco, CA: Pearson Education, Inc.

Merabet, L.B., & Pascual-Leone, A. (2010). Neural Reorganization Following Sensory Loss: The Opportunity of Change. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898172/.

Society for Neuroscience. (2010, October 28). Blind people perceive touch faster than those with sight. ScienceDaily. Retrieved November 11, 2014 from www.sciencedaily.com/releases/2010/10/101026172021.htm

Compensation with Touch!

IN Conclusion

Touch is a combination of somatic senses (sensation of temperature, pressure and pain), kinesthetic senses (conception of their body in space), and visceral senses (stomach aches or nausea). The information from these senses is processed in the postcentral gyrus. This area gets more direct sensory input information than any other in the brain.

• Findings reveal that one way the brain adapts to the absence of vision is to accelerate the sense of touch. The ability to quickly process non-visual information enhances the quality of life of blind individuals who rely on the non-visual senses.

Types of Blindness

Color Blindness –

• A congenital lack of one or more cone type
• •X – Linked Condition
• 8-10% of males
• •Most common is red/green

Night Blindness

• Decrease in rod function
• Common causes- Vitamin A deficiency, degenerative retinal disease

One-Sided Blindness

• Loss of an eye – No input from that side
• Stroke affecting the visual cortex – Receiving information but unable to process
• Effect on peripheral vision?

How vision

"normally"

works

Severe Visual Impairment- the inability to read newsprint, even with glasses

• According to Lewis et al (2014), 6.5 million over age 65

Total Blindness- No light perception, no usable vision

Functional Blindness- Some light perception, no usable vision

Legal Blindness- Central visual acuity of 20/200 or less in the better eye with correction, or peripheral field of 20 degrees or less

• Estimate of 1.3 million in the US (Lewis et al, 2014)

In the US- Almost all blindness is a result of common eye diseases such as cataracts, glaucoma, diabetes, and age-related macular degeneration.

• Injuries- Less than 4%

1. Reflected light enters the eye and is focused onto the retina.

2. Photoreceptors on the retina process light into electrical signals.

3. Electrical signals leave the retina through the optic nerve and travel to the optic chiasm.

4. At the optic chiasm visual information is sorted and sent to the optic tract. Visual information from the left half of the visual field is sent to the right hemisphere and information from the right visual field is sent to the left hemisphere.

5. The optic tract carries the information to the LGN in the thalamus where synapses happens.

6. From the LGN information is sent to the occipital lobe, the primary visual cortex,

to be interpreted by way of optic radiations.

Once Upon A Time...

Neuroplasticity

It was believed that the brain stopped developing after the first few years of life, making the neural connections in our brain fixed in place as we aged. However, new research on animals and humans has overturned this mistaken old view: today we recognize that the brain continues to reorganize itself by forming new neural connections throughout life. This phenomenon, called neuroplasticity, allows the neurons in the brain to compensate for injury and adjust their activity in response to new situations or changes in their environment.

Whats that??

The brain’s natural ability to form new connections in order to make up for injury or changes in the environment. The ability of the brain to reorganize pathways between neurons as a result of new experiences.