U.S. Department of Veteran’s Affairs (VA)


Various, USA





As the global population ages rapidly, the U.S. Department of Veteran’s Affairs (VA) estimates that 1.1 million Veterans will have dementia by 2029. Due to their progressive cognitive decline, people living with dementia have difficulty adapting to environmental stresses, which can often worsen their symptoms. Multi-sensory environments (MSEs) are flexible, purposefully-designed environments that help calm people by helping them reach sensory equilibrium using visual, auditory and olfactory stimuli, such as ergonomic, vibro-acoustic furniture, color-changing LED lights, music, fiber optics, aromatherapy and bubble tubes. Our team conducted a 20-week research study with the VA to understand the effect of MSEs environments on Veterans with dementia.

two women talk in a dark room with colored lights

After publishing a literature review, we conducted an interview-based qualitative study using direct feedback from care teams on the clinical barriers that would prevent the use of MSEs for Veterans with dementia. Finally, we conducted an observational clinical trial on the effects of MSE intervention on behavior during assisted bathing.

a dark room with colored lights

On average, the research demonstrated that positive behaviors increased and negative behaviors decreased in the MSE. Medical staff can use the findings to improve MSE implementation, healthcare design teams can support better behavioral outcomes by incorporating sensory elements with environments where problem behaviors are known to occur, and families may be able to assist their loved ones with dementia by using MSEs at home.

Summary of Findings

  • Multisensory environments may be impactful as non-pharmacological dementia therapy.
  • At the VA, dedicated MSE rooms were preferred by staff respondents over mobile carts.
  • Training, staff engagement, a clear maintenance plan and access to the MSE were critical barriers to uptake.
  • MSE within the bathing environment may reduce problem behaviors and increase positive behaviors.
  • Veterans seemed to favor the bubble tubes, aromatherapy and solar wall projector, which staff also perceived as being the most effective in reducing problem behavior.


  • Lesa N. Lorusso, Ph.D., Gresham Smith
  • Ronald Shorr, MD, MS, VA NF SG GRECC
  • Nam-Kyu Park, Ph.D., University of Florida
  • Sheila Bosch, Ph.D., University of Florida
  • Sherry Ahtentzen, Ph.D., University of Florida
  • Maureen Conroy, Ph.D., University of Florida