How a nursing home keeps dementia patients from wandering to another floor

The fake bus stop outside a nursing home is a well-known example of how health care facilities use choice architecture to keep Alzheimer’s patients from wandering off the property. Another example popped up in the NYT recently, this time about a home in Phoenix, Arizona, that uses carpeting to keep dementia patients from leaving their floor.

And Beatitudes installed a rectangle of black carpet in front of the dementia unit’s fourth-floor elevators because residents appear to interpret it as a cliff or hole, no longer darting into elevators and wandering away.

“They’ll walk right along the edge but don’t want to step in the black,” said Ms. Alonzo, who finds it less unsettling than methods some facilities use, bracelets that trigger alarms when residents exit. “People with dementia have visual-spatial problems. We’ve actually had some people so wary of it that when we have to get them on the elevator to take them somewhere, we put down a white towel or something to cover it up.”

When elevator doors open, Beatitudes staff members stand casually in front, distracting residents with “over-the-top” hellos, she said: “We look like Cheshire cats,” but “who’s going to want to get on the elevator when here’s this lovely smiling person greeting you? It gets through to the emotional brain.”

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  • debbie

    where is the research on this solution. would like to try it need prood

  • Warrington Nursing Homes

    Excellent blogspot.It was very informative.Keep sharing such good aarticles.

  • jess

    What about hospice patients ? My gram (grandmother) was in a nursing home in CT and I heard that at night time patients were constantly yelling. Daytme, she eats with demented patients and food all over her face. Even the adminstrator chasing after young girls..keep your grand daughters away!…and he is mean mean mean double mean. Hats off to Bickford Healthcare in CT for making it more pleasant for my gram..NOT

  • Judy

    In our long term care facility, on the dementia unit, we have wanderers going into other patients rooms. We have tried yellow material barriers, and mats on the floor that they should perceive as black holes, so they won’t enter. Nothing works!. We can’t put sliding gates in the door frames, as they may jam their fingers. Any ideas from other homes??

  • Peace and Love

    Like the black carpet ideas and while it may seem restrictive, in another way it is sharpening the person’s senses with ‘keep away’ thoughts. Found this page while looking for a solution to dementia father putting anything he has put in his pocket into the toilet, anything at all. Haven’t tried turning off the water valve, but those valves are not designed to be used with great frequency, I’d worry about wearing it out with horrendous consequences. Turns out, father had this same problem in his last apartment, continually stopping up the toilet. There is a device that goes on the back of the toilet tank that permits hand washing with the tank fill water. I thought of that $150 device that might distract him. Any advice would be great. Worst problem I have encountered. He unplugs everything electrical, but I’ve printed out giant stop signs and that’s working so far. I have a tip to share….I bought a Porch Lite that is meant to be mounted. I put it in the floor as a hands-free light, but what’s more, outside his bedroom door –permits me to know when he sits up in bed, and then goes to the bathroom, it comes back on to Guide his way, but ‘tells’me he has gotten on the right path back, ‘Amazon -it’ very clever motion detecting device….should be in every home with an elder.

  • Sandy

    My 93 year old father has been charged with abuse in him nursing home. He is unable to walk and is confined to a wheelchair. He has no history of abuse at any level. A wanderer has entered my fathers room many many times and in essence frightened him. At 3.30 am, the same many wandered into Dads room, waking Dad up from a sound sleep, hovering over him in his bed, in the dark. Frightened, Dad started yelling for help. Before help came he took his reaching stick and hit the intruder to protect himself. First offence. His reaching stick was taken away and he was the guilty party because he should have remained calm and rang the buzzer. No consideration was given to Dad that he was in his own room, asleep in his own bed, woken from a sound sleep and physically unable to get away from this man who was hovering over him in the dark. It was all my fathers fault. The intruder has dementia so he is not at fault because he didn’t know what he was doing. The same man threatened to punch my Dad in the face in front of me.
    Now another man is constantly trying to get my Dad out of his room because he thinks it is his room. Dad was in his wheelchair, between the window and the bed when this man entered his room. The wanderer grabbed Dad around his neck from behind. Dad rang the bell and as the attacker continued he grabbed his reaching stick and hit him to try to stop the attack. Once again Dad is at fault. This time the police were called and and assault charge was discussed. I have just returned from vacation and am about to go the see Dad. Don’t know what to do. Shouldn’t the home be responsible for protecting my fathers privacy in his own room? Do they not understand that my Dad was threatened and acted out of fear. The home only has compassion for the wanderer.