INTRODUCTION Human beings rely on a variety of sensory stimuli to give meaning and order to events occurring in their environment.

The sensors are tightly interwoven in forming the perceptual base of our world.When sensory function is altered,the persons ability to and function within the environment changes drastically.Sensory deprivation is a type of sensory alterations. SENSORY DEPRIVATION The reticular activity system in brain stem mediates all sensory stimuli to the cerebral cortex,so even in deep sleep,clients are able to receive stimuli.When a person experiences an inadequate quality or quantity of stimulation,such as monotonous or meaningless stimuli,sensory deprivation occurs. DEFINITION Sensory deprivation is a state of reduced sensory input from the internal or external environment,manifested by alterations in sensory perception. Sensory deprivation generally means a lessening or lack of meaningful sensory stimuli,monotonous sensory input,or an interference the processing of information(Rodemich,1997) Sensory deprivation is the delebrate reduction or removal of stimuli from one or more of the senses (Wikipedia dictionary) NORMAL SENSORY PERCEPTION Sensory perception depends on the sensory receptors,reticular activating system(RAS),and functioning nervous pathways to the brain.The RAS influences awareness of stimuli,which are received through the five senses;sight,hearing,touch,smell,and taste.Kinesthetic and visceral senses are stimulated internally. FACTORS AFECTING SENSORY PERCEPTION -Environment:

sensory stimuli in the environment affect sensory perception.For example,a teacher may not notice the noise in a consistently noisy environment such as school cafeteria.But the same teacher may perceive a loud television set very differently in his or her own home which is usually quiet. -Previous experiences: Previous experience affects sensory perception in that people more alert to stimuli that evoke a strong response.For example,a person may drive to work by the same route each day,noticing little along the way.A person may listen to the radio inattentively until a favorite song is played,then listen to every word. -Age: Perception of sensation is critical to the intellectual,social and physical development of the childrenInfants learn to recognize the face of the mother or caregiver and establish bonding essential to later emotional development.Adult have many learned responses to sensory cues.Normal physiologic changes in older adults put them at higher risk for altered sensory function -Variations in stimulation: If a person experiences less than the usual stimulation,that person is below his or her optimum state of arousal and may be at risk for sensory deprivation. -Medications and illness: Some antibiotics including streptomycin and gentamicin can damage the auditory serve.Central nervous system depressants,such as narcotic analgesics,decrease awareness and perception of stimuli. Certain diseases such as atherosclerosisand diabetic mellitus can impair neuro sensory pathways. -Lifestyle and Personality:

One person may enjoy a lifestyle of abundant stimulation surrounded by many people,frequent changes,bright lights and noise.Another person may prefer less contact with crowds,less noise and slow-paced routine.People with different lifestyles perceive stimuli differently Cigarette smoking causes atrophy of taste buds,decreasing sensory perception of the taste.Chronic alcohol abuse may lead to peripheral neuropathy. Stressstress and anxiety can have a negative influence on a persons behavior and thought patterns.Depending on the type and degree of the stress,the person either find ways to cope with the situation or becomes overwhelmed and may become disoriented. -Culture: An individuals culture often describes the amount of stimulation that a person considers usual or normal.A sudden change in cultural surroundings experienced by immigrants,specially where there are differences in the language,dress and cultural behaviors,may also result in sensory overload.

FACTORS CONTRIBUTING TO SENSORY DEPRIVATION Visual or auditory impairements that limit or prohibit perception of stimuli Drugs that produce sedative effect on the CNS and interfere with the interpretation of stimuli Trauma that result in the brain damage and decreased cognitive function Isolation(either physical or social)that results in the creation of a non stimulating environment ETIOLOGYGERIATRIC SENSORY DEPRIVATION

Sensory deprivation in the elderly client can result from numerous causes,depending on the sense affected Visual deficitsIt can result from certain physiologic changes to the pupils and iris that occur with aging.also the lens,cornea,and vitreous humor become less permable to the light with age,impairing night vision and the ability to adjust from lightness to darkness.Certain diseases also affect vision.Example-trancient ischemic attacks can producetransient blindness.Cerebrovascular accident,diabetes or primary ophthalmic problems can result in diplopia.glaucoma,macular degeneration,and vitamin A and D deficiencies can also cause visual deficits. Hearing deficitsThe amount of time required to process sound increases with age.Consonants are particularly difficult to distinguish.acoustical nerve trauma,ototoxic medications,infections and malignant tumors also can cause hearing loss.Hearing deficits in older adults can also begin during middle age from degenerative changes in the ear,resulting in the progressive atrophy of the sensory brain cells and supporting cells.Later the neurons of the vestibulocochlear nerve and the higher auditory pathways atrophy,which cause sensory neural hearing loss. OlfactoryThe leading cause of the sense of smell is accidental injury about 1 in 16 clients with head trauma permanently losses the ability to smell.Influenza,brain tumors,allergies,smoking,environmental factors contribute to the problem. GestatoryBecause the sense of smell is closely tied to the sense of taste,the loss of the sense of smell typically interferes with the ability to taste.As a person ages total number of taste buds decline and the taste buds themselves deteriorate.smoking,vitamin D deficiency,decreased saliva production,dentures and certain medications also dull the sense of taste. Tactile-

This may result from neuropathy,disease,injury,or circulatory insufficiency IN THE HOSPITAL ENVIRONMENT. Any time a client experiences an interference with or a diminution of sensory output,that a person may be at riskfor sensory deprivation.in the hospital such occurrences fall in to two categories altered sensory perception: this occurs in conditions like spinal cord injury,sleep deprivation and chronic illness -deprived environments:These can have negative effects on a persons sensoristasis.A person who is immobilized or isolated for any reason is deprived of the usual amount of stimulation and may show manifestations of sensory deprivation. CLIENTS AT RISK FOR SENSORY DEPRIVATION Clients who -are confined in a non stimulating environment -have impaired vision or hearing -have mobility restriction -are unable to process stimuli -have emotional disorders-have limited social contact TYPES OF SENSORY DEPRIVTION Reduced sensory input(eg;visual or hearing loss) Elimination of order or meaning from input(eg;exposure to strange environment) produces monotony and boredom

CLINICAL SIGNS OF SENSORY DEPRIVATION

-Excessive yawning,drowsiness,sleeping -Decreased attention span,difficulty in concentrating, decreased problem solving -impaired memory -periodic disorientation,confusion,irritability -pre occupation with somatic complaints -hallucinations-visual,auditory,tactile,olfactory,gustatory -crying,annoyance over small matters -Boredom and apathy,emotional lability EFFECTS OF SENSORY DEPRIVATION Cognitive: -reduced capacity to learn -poor task performance -regression Affective Bordom,panic, Perceptual -visual or motor coordination -color perception -spatial and time judgement DIAGNOSTIC STUDIES The following studies may be performed to evaluate clients health status:

 Snellen-eye examination-to evaluate visual impairment Comprehensive audiology examination-to identify hearing impairment.Screening technique include a self estimate of hearing by the client,pure tone audiometry,speech perception tests,and poor tone air(Weber) and bone conduction(Rinne tuning fork)tests Scrach and sniff test-to identify smelling impairment.Scents tested include vinegar,coffee,perfume;Smelling impaired client can typically identify only one scent. Taste tests-to identify sweet,bitter,sour and salty taste deficits;client sips a mixture of sucrose,quinine,hydrochloric acid,sodium chloride and water. Computed technology(CT)scan-to rule out secondary causes for changes in sensation,such as brain tumor. POTENTIAL COMPLICATIONS Vision:-presbiopia-a gradual decline in the ability of the lens to accommodate or to focus on closed objects.Individual is unable to see near object clearly. -night blindness,glaucoma,macular degeneration -retinitis pigmentosa,conjunctivitis,cataracts Hearing;-impaired communication Smell;-inability to detect toxins or environmental hazards Taste;-malnutrition,dehydration Touch;-sensory overload,skin trauma