Blog: why is the emergency exit so attractive for people with dementia?

Emergency exits are often placed in full view. Therefore, they attract the attention of many people with dementia. Most emergency exits also have added accents like a glass window and an emergency signal sign. Both draw even more attention to the door. The result is that there are always 1 or 2 residents in a group who stand in front of the emergency exit. This often several times a day. They want to go outside.

Someone with dementia reacts intuitively. With a door the notion arises to want to go through this. A resident will try this again and again, because the memory no longer registers that this has been done already (and failed).

In itself this is not such a problem, as long as both the resident as the care does not suffer from this. However, in 90% of the cases this leads to much agitation with the resident. After all, this person wants to go through the door and this is not possible. And therefore he/she feel uncomfortable. This is often reflected in the high dosage of medication and more care request. So, this latter requires more of the care provider. They have to remove these people from the door, distract them and calm them down, whereby the process is repeated again later. And please do not forget that it is not nice for the caregiver to see that their dearest does not feel at home or uncomfortable.

At the moment we could move the emergency exit out of sight of the resident, there would no longer be a notion to want to go through. If we could also move the attention for the emergency exit to more pleasant things we might be able to remove the urge to go outside anyway.

Removing agitation will in any case lead to less care pressure on the care provider and possibly also to less medication. But also to more comfort of the resident and a feeling of being ‘home’. Moving the attention to more pleasant experiences naturally only contributes to this.

The question is, how can we do this. How can we ensure that emergency exits are out of sight? Three ways to deal with this are:

1) In existing situation we can look for the possibility to ‘hide’ the exit. We know situations where the door is disguised a bookcase or dresser, but also attaching a painting or painting the door in the colour of the wall can already have a big impact. Although this seems as fooling older people, it can provide much result in a simple and cost effective way.

2) If we move the focus on the door to something else, this will distract the attention from the door. If we place for example paintings, showcases, sound and/or seats earlier in the corridor, in other words creating attention, then someone with dementia would have more eye for this than for the door.

3) If we look at large-scale renovations or newly built projects another solution could already be found in the organisation of the map. For example, place the door alongside the corridor and not at the end. Consider the design of the door, for example by not placing a window, by matching the colour to the wall and by choosing subtle emergency lighting.

By applying the aforementioned solutions there will be less urge to stand near the emergency exit or to want to go through outside. Especially in situations where the care pressure is already higher and there is less sight on older people, this can make a huge difference.

Anja Dirks - 01 January 2016
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