Mrs. E lives on the first floor of a lovely brick home, with her daughter above on the second story. Together they have traveled and collected art that hangs in her home. On our first visit, Mrs. E and her daughter shared pieces with me, each one rich with memories of a trip. We sit at the kitchen table for our visits. Her daughter has placed a container filled with exquisite pens and stencils close at hand. As we talk, Mrs. E laments that she no longer has the hand eye coordination she relied on in the past, and that her handwriting is unsteady. She explores each pen but is not happy with the quality of the lines.

Mrs. E is somewhat overwhelmed by the idea of creating art on a large page, so instead we explore a resource called Zentangles. Zentangles are small pieces created by filling structured patterns with patterns of dots and lines. Each tile is small, which is not so overwhelming, and multiple tiles can later be assembled in a mosaic to create a larger piece of art. As I modeled mark making, Mrs. E became more confident. She used the pens close at hand and then tried the felt tip “sharpie” I had been using. The sensory response of the felt tip sharpie was so positive that I later left the pen for her to enjoy! We continued to fill shapes with patterns of dots and lines. The repetitive motion of this mark making stimulates the parasympathetic nervous system which creates a relaxation response. Mrs. E exhibited less tension in her posture and smiled more often as she worked. I left additional shapes for her to work with on her own.



Recently, team members were problem solving related to this patient’s anxiety during a team meeting. They were glad to learn about this resource and planned to reinforce the use of this strategy with Mrs. E and her daughter to lessen anxious behaviors.