An environmental investigation of wayfinding in a nursing home

ABSTRACT

The objective of this pilot study was to obtain preliminary information on wayfinding information placement for NH (nursing home) residents by finding where older adults with mild dementia look during a wayfinding task. Wayfinding problems (e.g., an inability to find or recognize a destination) are common among NH residents. These behaviors have been related to falls and fractures [Buchner and Larson 1987] and are a significant source of staff stress [Bright 1986]. Wayfinding problems are person-environment problems from deficits in spatial orientation making it difficult to maintain a cognitive map of the route to a desired location, as well as with deficits that impact abilities to plan and carry out goal-directed travel and to ignore irrelevant and distracting stimuli [Liu et al. 1991; Passini et al. 1995]. Design-for best practices advocate supporting preserved wayfinding abilities. However, little attention has been given to the information placement in the NH environment to ensure that it is likely to be seen. A case report states that NH residents with dementia look down as they walk around a NH unit, looking on hallway floors and the lower part of walls (below waist level) where wayfinding information is almost never placed [Adachi 1999]. Optimal information placement has the potential to positively impact the independence, safety, and QOL of residents as well as improve staff satisfaction.

REFERENCES

• 1: Adachi K. 1999. Eye movements and wayfinding in persons with dementia using an eye-reflection camera, Proc of the 30th Ann Conf Environmental Design Research Ass. p. 28.
• 2: Buchner, D. M. and Larson, E. B, 1987. Falls and fractures in patients with Alzheimer's disease. JAMA 257:1492--1495.
• 3: Bright R. 1986. The use of music therapy and activities with demented patients who are deemed "difficult to manage." Clinical Gerontologist 6:131--144.
• 4: Liu, L., Gauthier L., and Gauthier S. 1991. Spatial disorientation in persons with early senile dementia of the Alzheimer's type. Am J Occup Ther 45(1):67--74.
• 5: Passini, R., Rainville, C., Marchand, N., and Joanette, Y. 1995. Wayfinding in dementia of the Alzheimer's type: Planning abilities. J Clin Exp Neuropsych 17:820--832.

INDEX TERMS

Primary Classification:
  I. Computing Methodologies
  I.2 ARTIFICIAL INTELLIGENCE
        I.2.10 Vision and Scene Understanding

Additional Classification:
  I. Computing Methodologies
  I.2 ARTIFICIAL INTELLIGENCE
      I.2.8 Problem Solving, Control Methods, and Search
          Subjects: Plan execution, formation, and generation
  I.4 IMAGE PROCESSING AND COMPUTER VISION
      I.4.8 Scene Analysis
      I.4.9 Applications

General Terms:
Algorithms, Design, Theory