Six out of 10 people with dementia will wander and risk becoming disoriented, according to the Alzheimer’s Association. In senior housing settings, disorientation can lead to exit-seeking behaviors, which can increase anxiety, hostility toward others, fatigue and elopement.
But for new as well as established memory care communities, there are design elements that can help make residents feel more comfortable in their community, specifically by preventing wandering and exit-seeking without making the community feel imprisoning.
Interactive Exit Diversions
At Watercrest Senior Living’s Market Street Memory Care Residences, various design elements are incorporated to address one specific aspect of exit-seeking behaviors—saying goodbye to visitors, Michele Thompson, Watercrest COO and national certified dementia practitioner, told Senior Housing News. Vero Beach, Florida-based Watercrest operates seven communities in Florida.
“Saying goodbye to any visitors can be very emotional for residents and their families,” Thompson said. “We have created a diversion in the market plaza areas of the communities to help with this.”
Each Market Street community has a central market plaza, which includes multiple seating areas, a ton of natural light, calming sounds of nature, trees, a gelato cart, newsstand, bakery and various other storefronts. This is the area where many residents visit with family members.
To decrease the amount of anxiety that takes place as visitors leave, there is a safety vestibule between the market plaza and the main reception area where family members exit.
“The area is similar to a holding room where you have to enter a code on a keypad to get through, so if a resident were to follow you in there they wouldn’t be able to get through,” Thompson explained. “Those with dementia may follow and be very difficult to redirect, so that’s why the vestibule is necessary.”
But the key about the vestibule is that it is designed to look like a post office. There is an actual newsstand where residents can look at newspapers and magazines to help take away the emotional edge.
Know Your Population
Though design of memory care communities is extremely important, those working with memory care residents need to be provided with the proper training and continued support, Thompson said.
“It comes down to knowing your population and recognizing who is at higher risk of exit seeking,” she explained. “At Watercrest we give more in-depth training on Alzheimer’s care that helps workers learn how to better communicate with residents. Your approach in memory care environments is huge.”
Market Street Memory Care residences also uses engagement as a way of combating exit seeking.
“If we know someone is triggered by a certain time of day, which is very common in residents with dementia, we can make an individualized program to keep them engaged,” said Thompson. “Our biggest rule, though, is that we don’t overstate or embellish with fibbing. If we know a certain resident used to be a cook and they seem to be getting agitated and wandering around, we may ask them to help prepare a meal.”
Market Street residences also have life skills stations set up throughout the community to help engage residents to decrease stress and anxiety. For example, one community has a large veteran population so there is a themed area with memorabilia like medals of honor.
“These stations are meant to have items that can be picked up and taken around with residents. We’ve seen these stations can help engage communication among other residents and bring a sense of calm to to those feeling especially anxious,” Thompson explained.
Life skill stations are also utilized to divert attention when visitors are leaving, she added.
“For communities thinking about implanting something like life skill stations, however, it’s great to have stuff, but if the things aren’t useful to residents there is no point,” Thompson said. “You have to put in the work to get to know your residents and what their lives were like before they got dementia.”
In addition to interactive diversions to calm residents’ nerves in memory care communities, some facilities opt for a more classic diversion like disguising exits.
Creative Art Co., located in Ontario, Canada has been creating murals for various industries since 2010 and saw a large need for exit diversions in memory care facilities throughout Canada and the United States. The company has recently started printing and selling adhesives to U.S. memory care providers.
“We work with communities across the board, some higher end in Ontario like Revera and Extendicare, as well as dementia wards,” Brian Romeril, co-owner of Creative Art Co., told SHN. “Dementia wards are coming to us because they usually have more limited resources. We can create very large pieces as well as smaller ones at lower price points.”
Brian and his wife, Karen, are the artists behind the exit diversions. Some popular diversions include turning either an exit door or elevator door into a book case or china cabinet.
“The diversions help reduce the anxieties felt by residents who feel the immediate need to escape due to their dementia,” Romeril said. “The diversions can help give dementia residents peace of mind.”
Written by Alana Stramowski
(Photo of the Market Plaza at Market Street Memory Care Residences of Viera—located in Melbourne, Florida)