MSE Room Making a Difference in Residents’ Lives at Signature of Fentress County

As part of the CMS grant program, Signature HealthCARE of Fentress County recently installed an MSE room. During the month of March, members of the therapy team and a group of caregivers received training to utilize the room with their residents. After only a few short weeks, the rehab department has seen many significant and positive outcomes. Crystal Bilbrey, RSM and Stephanie Barker, OTR recently contacted me to talk about the amazing results they have gotten with some of their residents. Some of them, Mrs. W, stands out to them most of all. Mrs. W, a 98-year-old resident with a diagnoses of Alzheimer’s disease was admitted to Fentress County from another skilled nursing facility. At the time of her admission, she had not walked for over a year, had several falls, spent most of her time curled in a fetal position, and was very fearful of her surroundings and her caregivers. She exhibited behaviors when staff attempted to do her ADLs, on one occasion even biting a caregiver that was trying to assist her. She was mostly non-verbal with some garbled speech and occasional one word utterances. She often experienced periods of anxiety and crying. When she was seated in her wheelchair, her posture was poor and she gazed down toward the floor. Her upper body range of motion was limited and she was unable to feed herself. Her scored on the Mini Mental Status exam indicated severe cognitive impairment.

After only eight visits to the MSE, Mrs. W is now transferring with minimal assist, ambulating 25 feet, and feeding herself! On her initial visits to the room, Stephanie Barker, OTR, used the bubble tubes to engage Mrs. W. During one 20-30 minute session sitting in front of the tubes and watching their glow on the wall, Mrs. W stated, “I’m sitting by the fireplace.” She appears to enjoy running her hands up and down the tubes, experiencing the tactile stimulation they provide. This activity has increased her ROM, trunk flexion and rotation, and overall posture. As a result of Stephanie’s use of the projector and color wheels to display moving images on the walls, Mrs. W has also begun keeping her head in an upright position, moving her head from side to side, and using her peripheral vision. Stephanie has seen the effects of the room on Mrs. W last for hours after her visits. Now, even when Mrs. W is not in the MSE and Stephanie takes her down the halls of the facility, Mrs. W continues to look from side to side and use her peripheral vision to see and experience the world around her. She is more verbal and consistently uses short phrases to communicate with her caregivers. She has had no further episodes of biting, has lessened her anxiety and fearfulness, and appears more calm and interactive.

In addition to the amazing results achieved with MRs. W, some other observations made by Stephanie and Crystal include residents who have experienced decreased heart rate and blood pressure as a result of time spent in the room. There is also a resident who has significant sundowning behaviors. The number of episodes he experiences has been reduced by spending time in the MSE engaged with the bubble tubes. Stephanie and Crystal report he loves wrapping his arms and legs around the tubes and would stay in the room for hours if he could! Lastly, they told me of a resident who was refusing to eat. Stephanie used the essential oils from the room to provide aroma therapy to stimulate her appetite. Not only has she gained six pounds so far, she has even eaten some foods she previously refused to eat!

As I tell the therapists and caregivers when I train them to use the MSE room, there probably is not one resident in our facilities that could not benefit from using the room in some way. From those with dementia and other neurological impairments to our short term patients experiencing depression and pain, the room can and does provide the sensory stimulation needed to improve and in many cases resolve these issues.

My heartfelt thanks go out to Crystal, Stephanie, and the team at Fentress County for sharing their successes and making such an incredible difference in the lives of their residents. I know I am looking forward to hearing more success stories and being able to share them with all of you!

If you have questions about the MSE room or the Serenity program, please contact Susan Kane, Serenity Therapy Consultant at or 502-381-1641.