Preliminary findings of some studies with clients with dementia,  seem to suggest that weighted items may assist with mangement of agitation, aggression and anxiety by providing deep pressure sensory input which provides a sense of comfort and security.
Weighted blankets and lap bags/pads are increasingly being used in this area, though more study is needed.The desired  key therapeutic outcomes for use of the weighted lap bag/pad and or weighted blanket with the dementia client are

• Relief from the negative effects of such feelings as anxiety and agitation, without the need for restraint or seclusion
• Increased sense of well being and self control.
• Improved  sleeping patterns

Occupational therapists and physiotherapists have explored the therapeutic use of weight for many years, primarily with children and adolescents with learning disabilities, autism and developmental disorders.They used weighted vests and blankets and as recently  as 1999 occupational therapists have offered the weighted blanket as a therapeutic modality to adolescent, adult and geriatric consumers in acute inpatient mental health settings . In 2008 an OT called Tina Champagne and her colleagues carried out research on the use of weighted blankets with adults as there were no protocols established in regards to application of safe amounts of weight to apply to the person in a seated or lying position – there were guidelines for weighted vests (up to 10% of body weight) available however these could not be generalizable to the use of weighted blankets. As a result of the study’s findings, Champagne produced some  guidelines for use of weighted blankets, lap pads and weighted vests or wraps that cover the amount of weight to use (no more than 10% of total body weight for lap pads) , weight distribution,  wearing schedules, texture and visual aspects of the cover, application of the weighted item and individualisation of the treatment program. One key aspect of the use of weighted modalities, she pointed out,  with any client group, is that the client should not use a weighted item if they suffer from moderate to severe circulatory, respiratory, thermoregulatory or orthopaedic problems. When in doubt, a doctor’s opinion should be sought. Interested readers may like to get a hold of Tina Champagne’s handbook “Sensory Modulation and Environment: Essential Elements of Occupation” for a full discussion on her research and guidelines.(See reference at end of this article)

The weighted lap pad (weighing 3.35kg)  provided by our company is different from most lap pads offered in Australia in that the removable fabric cover has a top side decorated with different textured fabrics and ribbons, laces, etc to provide a tactile sensory experience as well as the internal weighted lap pad inside providing the deep pressure input. The underside of the cover is a type of  terry towelling fabric, which provides a moisture absorbancy role whilst the pad is sitting in the lap. Most other suppliers of weighted lap pads provide only a single colour,  single texture fabric cover. The lap bag itself is a polyurethane shell filled with plated steel shot that is fully encased in stitched rows. View our weighted lap pad .

When a weighted lap pad is purchased from us, the purchaser is directed to consult with the Dementia Behaviour Advisory Service (a program run by Alzheimers Australia) in their state in regards to the guidelines for use of Weighted Blankets and Lap Bags in Dementia Care. Printed  guidelines are available that outline definition of weighted therapeutic modalities, the therapeutic goals, the therapeutic outcomes, the indications for use of this therapy, and the individuals most likely to benefit from this sort of therapy. Instructions are given as to how to introduce a weighted lap bag or blanket, interaction and use of the lap bag or blanket, evaluation and documentation, special notes and precautions and cleaning.

One key piece of information in making a decision as to purchasing a lap bag or wieghted blanket for the client with dementia  is that the item is not used as a restraint. The individual must have the ability to remove the lap pad if desired, ie. have self control over its use.

 Further reading

• 
  Champagne, T., Mullen, B., & Dickson, D. (2007). Exploring the safety and effectiveness of the use of weighted blankets with adult populations. 2007 American Occupational Therapy Associations Annual Conference. (pp. 1-80).  
•  Mullen, B., Champagne, T., Krishnamutry, S., Dickson, D., & Gao, R.X. (2008). Exploring the safety and therapeutic effects of deep pressure stimulation using a weighted blanket. Occupational Therapy in Mental Health, 24(1), 65-89. 
• Champagne, T., & Stromberg, N. (2004). Sensory approaches in inpatient psychiatric settings: Innovative alternatives to seclusion & restraint. Journal of Psychosocial Nursing, 42(9), 34-46. 
• Champagne, T. (2011) Sensory Modulation and Environment: Essential Elements of Occupation, 3rd Ed. revised. PsychCorp. Sydney, Australia.