Wandering and the Physical Environment

Abstract

Background/Rationale: Guided by the need-driven dementia-compromised behavior (NDB) model, this study examined influences of the physical environment on wandering behavior. Methods: Using a descriptive, cross-sectional design, 122 wanderers from 28 long-term care (LTC) facilities were videotaped 10 to 12 times; data on wandering, light, sound, temperature and humidity levels, location, ambiance, and crowding were obtained. Associations between environmental variables and wandering were evaluated with chi-square and t tests; the model was evaluated using logistic regression. Results: In all, 80% of wandering occurred in the resident's own room, dayrooms, hallways, or dining rooms. When observed in other residents' rooms, hallways, shower/baths, or off-unit locations, wanderers were likely (60%-92% of observations) to wander. The data were a good fit to the model overall (LR [logistic regression] w 2 (5) ¼ 50.38, P < .0001) and by wandering type. Conclusions: Location, light, sound, proximity of others, and ambiance are associated with wandering and may serve to inform environmental designs and care practices.

Contribuições teóricas sobre o envelhecimento na perspectiva dos estudos pessoa-ambiente

“…Despite Carp's remarks in the 1970s against the association of the concept of environmental docility to pathologies alone, it is still common for researchers to focus their studies on populations affected by dementias or chronic diseases. These studies seek to describe the availability and usability of neighborhood resources, examine associations of objective aspects of the environment with quality of life in old age, and verify the influences of the physical environment in terms of behavior and mobility (Algase, Beattie, Antonakos, Beel-Bates, & Yao, 2010;Van der Pas et al, 2016;Van Leeuwen et al, 2014). For this to happen, the hypotheses of environmental docility and proactivity align with claims that indicate the need to promote healthy environments (Lawton, 1986;Torres, 2015;Torres & Elali, 2015).…”

Assessing wandering risk among individuals with Alzheimer's disease and dementia: a pilot study

“…Elopement most broadly refers to the act of an individual wandering off when that individual should be supervised as a result of disability or declining function. Elopement is a possible outcome of wandering off . The potential for adverse consequences for individuals who wander off and subsequently elope can range from psychological distress for the individual and their families to serious injury or death .…”

“…Elopement is a possible outcome of wandering off. [5][6][7] The potential for adverse consequences for individuals who wander off and subsequently elope can range from psychological distress for the individual and their families to serious injury or death. 8 As a possibly life-threatening event that is preventable, comprehensive approaches that include the assessment of wandering risk are strongly encouraged.…”

Testing Tele‐Savvy: Protocol for a randomized controlled trial

“…Tele-Savvy posits that caregiving is a clinical role, for which most caregivers are unprepared. Incorporating the expertise of several disciplines, including nursing (Algase, Beattie, Antonakos, Beel-Bates, & Yao, 2010; Beck et al, 2002; Kovach, Noonan, Schildt, & Wells, 2005); psychology (Burgio, Stevens, Guy, Roth, & Haley, 2003; Coon, Thompson, Steffen, Sorocco, & Gallagher-Thompson, 2003; Teri, Logsdon, Uomoto, & McCurry, 1997); and occupational therapy (Gitlin, Kales, & Lyketsos, 2012; Gitlin, Winter, Burke, Chernett, Dennis, & Hauck, 2008; Gitlin, Winter, Corcoran, Dennis, Schinfeld, & Hauck, 2003), Tele-Savvy seeks to promote caregivers’ understanding that their person’s behavior is affected by dementia’s progressive impact on their cognition, function, behavior (e.g., BPSD), and personality. Information about dementia progression and etiology of associated changes in the person’s cognition and behavior is intended to alter caregivers’ primary appraisal of the threat.…”