FRIDLOVA, K. 2015. Basal Stimulation for Caregivers, Therapists, Speech Therapists and Special Educators. A Practical Guide for Workers in Social Services, Long-term Care and Special Schools. Association of Social Services Providers of the Czech Republic 2015. Kleinwächter: Frýdek-Místek, 216 pp. ISBN 978-80-904668-9-0
The publication is the result of the author's many years of practical experience with the concept of basal stimulation. It is intended as a comprehensive guide for implementing the concept into therapeutic or nursing practice. The author states: "Basal stimulation is a concept that is constantly evolving, adapting to new results of scientific research, the needs of practice, the changing dynamics of society, and the care associated with it." This publication is written based on current theses of the authors of the concept and foreign colleagues – experts who develop the concept in various areas ranging from care for premature infants, persons with disabilities, intensive care for persons with neuromuscular deficits, to care for the elderly and palliative care. The publication also includes the author's personal experience with the concept from the perspective of a caregiver, educator, certified lecturer and supervisor of the concept. Additional material for writing the publication comes from the knowledge of foreign colleagues who were the first certified lecturers of the concept and today are themselves authors of professional publications.
The publication begins with the chapter Introduction to Basal Stimulation, which discusses the concept of basal stimulation as a scientific pedagogical-nursing concept that offers professionals in healthcare, social services and special educators qualified and professional procedures. The author describes basal stimulation not as a method, nor as a technique, but as a concept that is body-oriented, because the body is the main object of activities of therapists, nurses and educators. The chapter is divided into three subchapters. The first characterizes the concept of basal stimulation, the second discusses the history, the founders of the concept and its development in the Czech and Slovak Republics. The third subchapter focuses on the international association of basal stimulation.
The second chapter addresses the support of the basal level of human perception through the concept. The author states: "Perception of oneself is a fundamental prerequisite for movement and communication." It consists of three subchapters. The first describes perception, prenatal development of perception and its essence. The second describes movement, prenatal development of movement and its physiology. The third subchapter discusses communication, namely the prenatal form of communication and communication within the concept of basal stimulation.
The third chapter begins with a description of the nursing, therapeutic and pedagogical process and its composition of 6 elements. Next, Maslow's hierarchy of needs, a description of the 10 central goals, their division into two categories relating to the person or the surrounding world, and the interaction process between client and therapist. The chapter is divided into three subchapters. The first subchapter deals with the basic and advanced elements of basal stimulation, the second with the developmental areas of a person, and the third with the central goals and elements of the concept.
The fourth chapter describes the theoretical foundations of the concept of basal stimulation. It is divided into five subchapters. The first subchapter discusses neurophysiological foundations, covering the development of the nervous system, the structure and functions of the nervous system, and physiological behavior and memory. The second discusses genetic elements of developmental psychology, the third subchapter is devoted to the Bobath concept, the fourth to insights from psychology, and the fifth to daily life.
The fifth chapter is the biography of a person in the concept of basal stimulation. The chapter is divided into three subchapters. The first examines the image of a person, the second the importance of biographical data for the structure of an individual plan, and the third focuses on sensobiography.
The sixth chapter describes somatic stimulation. The author states the goals of somatic stimulation. The chapter is divided into five subchapters. The first subchapter discusses somatic perception, the second addresses the body schema, the third deals with somatic dialogue, the fourth discusses the initial touch, and the fifth about somatic stimulation according to the concept of basal stimulation. The author elaborates in more detail on calming somatic stimulation, stimulating somatic stimulation, neurophysiological stimulation, symmetric stimulation, developmental stimulation, diametral stimulation, positioning in the concept of basal stimulation, contact breathing, and massage stimulating breathing. For all stimulations, the author states the goals of the stimulation, indications for the application of the stimulation, principles during stimulation, risks if any are known, and the execution of the stimulation itself. The conclusion of the sixth chapter is devoted to the modification of somatic stimulations that can be performed.
The seventh chapter deals with vestibular stimulation. It is divided into two subchapters. The first addresses vestibular perception and the second vestibular offerings. The author describes various ways of performing stimulation depending on the client's condition.
The eighth chapter provides information on vibratory stimulation and consists of two subchapters: vibratory perception and vibratory offering. The author describes the use of aids and the risks associated with the use of vibratory stimulation. She also discusses the trilogy, where somatic, vibratory and vestibular stimulation are performed simultaneously.
The ninth chapter discusses optical (visual) stimulation and is divided into two subchapters. The first is devoted to visual perception, addressing visual impairment and manifestations of changes in visual perception. The second subchapter deals with optical offerings and provides information on principles when working with children with visual impairment, on visual orientation bridges that aid orientation, and on the influence of colors on the human body.
The tenth chapter describes auditory (hearing) stimulation and is divided into three subchapters. The first discusses auditory perception, the second discusses auditory offering, and in the third subchapter the author elaborates in detail on the application of basal stimulation during the Himalayan expedition Dhaulágirí 2012. She describes the possibilities of auditory stimulation, discusses the combination of somatic and auditory stimulation, and the prerequisites for effective auditory stimulation. She also presents the ten commandments of communication with people with dementia.
The eleventh chapter is devoted to oral stimulation and is divided into three subchapters. The first subchapter examines oral perception, the second food intake, and the third oral stimulation. The author describes the prerequisites for successful oral stimulation, oral cavity care through oral stimulation, the procedure for clients who do not open their mouths, and suitable/unsuitable aids for stimulation. She further describes the principles of stimulation, taste stimulation and the goals of taste stimulation.
The twelfth chapter focuses on olfactory stimulation and is divided into two subchapters. The first describes olfactory perception and the second olfactory stimulation. The author addresses the close relationship between oral and olfactory stimulation and the importance of working with biography, as we may evoke negative stimulation.
The thirteenth chapter discusses tactile-haptic stimulation and consists of two subchapters. The first subchapter provides information on tactile perception and the second on tactile-haptic offering. The author focused on the goals of stimulation, objects that can be used for stimulation. She describes the symptom of tactile-haptic stimulation deficiency, its manifestations and also presents the solution by providing a substitute tactile-haptic offering.
Chapters 6 through 13 are supplemented with images depicting the execution of individual stimulations with descriptions.
The fourteenth chapter is devoted to the implementation of basal stimulation into practice. The chapter has five subchapters. The first addresses basal stimulation from the perspective of a physician, the second discusses basal stimulation in the work of a physiotherapist and occupational therapist, the third discusses basal stimulation in speech therapy, the fourth about basal stimulation in the education of pupils with severe combined disabilities, and the fifth about basal stimulation in nursing care.
The fifteenth chapter provides information on the transfer of the concept into practice. The author describes what the concept offers therapists, how to obtain comprehensive information and based on it make decisions about offering basic or advanced elements of the concept. She further describes one's own attitude and strategy as an important factor in the integration of the concept. Subsequently, the author states what fourteen years of practice in the Czech and Slovak Republics has demonstrated.
I began working with the concept of basal stimulation in 2012, after completing the basic course in basal stimulation. In my early days, I worked primarily with clients with severe and multiple disabilities in a social services home, where I used basal stimulation as a tool for developing communication and eliminating inappropriate behavior of clients in a group. During this work, I conducted qualitative research to determine the effect of basal stimulation on client behavior and communication, which is part of my diploma thesis. The result was a reduced occurrence of inappropriate client behavior and the complete disappearance of physical aggression. Improvement in communication among clients in the group and also with staff. The clients themselves perceived positive changes in their behavior, were in a more positive mood, and working with them became easier for the staff. After gaining some experience, I completed an advanced course in basal stimulation.
In 2014, I began working with the target group of seniors. During this work, I completed deepening courses I and II in basal stimulation. I focused particular attention on permanently immobile clients and those who had suffered a stroke. Permanently immobile clients and those with reduced perception gradually began to perceive when the concept was applied, first themselves and later their immediate surroundings. In clients after a stroke, we achieved substantial changes in mobility and a significant restoration of function on the affected side.
At present, I am striving to reintegrate basal stimulation into client care at my new workplace.
The publication serves me as inspiration and assistance in developing individual plans, nursing and care plans. It is suitable for everyone, because basal stimulation does not have to be performed only by a certified worker, but can also be performed by a trained layperson from the immediate social environment. It provides insight into the issue, a wealth of theoretical knowledge and practical advice needed for its implementation.
Author: Mgr. Kamil Bednár The author is a social worker, certified basal stimulation practitioner, quality manager and social rehabilitation instructor