Wandering dementia residents

[Jackamus]

I am currently trying to get the CQC interested a solution that we have developed that will stop dementia residents wandering in and out of each others rooms and the attendant problems it poses. Although the CQC cannot endorse any particular product they could offer practical support.
Typical problems are:
1 Loss of privacy.
2 'Borrowing' items.
3 Residents who are bed ridden.
The first two items may be controlled by residents themselves but the third item cannot.
One potentially serious problem was a resident who took some chocolate biscuits from another resident's room. This in itself may not have been a problem but it the resident who took the biscuits was a diabetic or had a dietary problem then this could have been serious.
I would like to find out what the relatives of residents feel about the importance of these issues and finding a solution?

 

[Jessbow]

I am currently trying to get the CQC interested a solution that we have developed that will stop dementia residents wandering in and out of each others rooms and the attendant problems it poses. Although the CQC cannot endorse any particular product they could offer practical support.
Typical problems are:
1 Loss of privacy.
2 'Borrowing' items.
3 Residents who are bed ridden.
The first two items may be controlled by residents themselves but the third item cannot.
One potentially serious problem was a resident who took some chocolate biscuits from another resident's room. This in itself may not have been a problem but it the resident who took the biscuits was a diabetic or had a dietary problem then this could have been serious.
I would like to find out what the relatives of residents feel about the importance of these issues and finding a solution?

To be Honest, in the grand scheme of things, they are trivialities.

Problem is, once a PWD no longer recognises that room as their own and the door wont just open, you might well get into a situation where anxiety levels are raised because a door wont just open


Borrowing items is just part and parcel in my opinion. My late mother was as likely to 'claim as mine' as others were to claim her stuff as theirs. There was never malice aforethought.

What would your solution be?

 

[Amethyst59]

I must admit, I feel the same as the above writer. It’s not the thing that is the most worrying. The home my husband is in has a system that can be turned on and off, so if my husband leaves his room, or moves around in his room, at night, the staff are alerted. There are a couple of his things missing, but nothing valuable, and I expect they will turn up sometime.

 

[Jackamus]

I pressed the Return button by mistake. My reply will be later.

 

[Jackamus]

I must admit, I feel the same as the above writer. It’s not the thing that is the most worrying. The home my husband is in has a system that can be turned on and off, so if my husband leaves his room, or moves around in his room, at night, the staff are alerted. There are a couple of his things missing, but nothing valuable, and I expect they will turn up sometime.

In response to the two above comments perhaps I should have mentioned that my wife has been in a dementia unit with Alzeimers for the last 4 years hence my knowledge regarding this issue.

I have observed other residents trying various doors including emergency doors. However I have not been aware of any anxiety on their part. I have also observed some residents pressing the buttons on the digital unit lock in an attempt to open the door!

The 'part and parcel' issues stated by the above comment need not be part of life in a dementia unit. I also agree that their may be 'no malice of forethought' but if something of value or dangerous like off- limit food, could be of great concern to care home staff the resident's relatives.

My solution is a special door handle (that we have patented) that allows only the resident to enter their own room. Naturally it has manual overrides for the use of staff and visitors. This will stop a problem that has been around for decades.

There is another situation when a resident is bed ridden as indeed my own wife is but the care home always leave the door open to her room for easy monitoring by staff. The care home use either a pressure mat or PIR sensor to detect if a person enters the room and sound an alarm. However the problem with this is that it is unlikely that staff will drop whatever they are doing to go and investigate. Our solution is a retractable door barrier mounted at waist height to the door frame and can be drawn across when needed. This will prevent casual intrusions.

 

[Beate]

I hope they'll come and investigate when someone falls over the waist height barrier!
It's bad enough having to be restricted in your movements in a care home, but having door barriers come up isn't something I envisage being popular with people, including staff and visitors who will have to manually override locked doors or barriers all the time. Have you surveyed staff yet to see what they think?

 

[2jays]

That waist height barrier sounds a good idea. A stair gate fitted at waist height was fitted in a friends house so their blind person didn’t accidently fall down the stairs and I understand it was very successful.

I’m also giggling, because of the thought that my mum would have been found stuck under the barrier if it was fitted on a door.

Not a good thought really, and I shouldn’t giggle..... but I am

 

[Beate]

You know, there is an interesting case in Graham Stokes' Andd Still The Music Plays. He is often called to care homes when an individual solution is needed for a resident. There was the case of a lady who hated to be amongst other residents. All she wanted to do was be in her own room. Staff obviously still had to check on her, but they debated how to minimise intrusion by other residents. They rejected a child gate straight away for being a hazard to mobile residents and for it looking restrictive - then they came up with a beaded curtain, collapsible if moved so no one could get tangled in it. It seemed to work, and other residents ignored her room.

 

[Jessbow]

.

My solution is a special door handle (that we have patented) that allows only the resident to enter their own room. Naturally it has manual overrides for the use of staff and visitors. This will stop a problem that has been around for decades.

There is another situation when a resident is bed ridden as indeed my own wife is but the care home always leave the door open to her room for easy monitoring by staff. The care home use either a pressure mat or PIR sensor to detect if a person enters the room and sound an alarm. However the problem with this is that it is unlikely that staff will drop whatever they are doing to go and investigate. Our solution is a retractable door barrier mounted at waist height to the door frame and can be drawn across when needed. This will prevent casual intrusions.

How does this 'special door handle' work? Like a cat flap, where the occupant has a magnet /fob or something?

Door barrier would be a hazard to be climbed over surely? How is it different to a stair gate?
As we to assume another PWD wouldnt fathom how to release it? ( Just the same as they fiddle with numerical key pad locks)

 

[canary]

My mum was in a dementia unit for 3 years and I just accepted all the residents going in and out of each others rooms (my mum was as bad as the rest) as part and parcel of dementia living. I think its going to be almost impossible to stop it and I felt it was not that important anyway. It seems to worry the relatives more than the residents IMO. I made sure that everything mum had was named and that she didnt have anything valuable or irreplaceable - most things arrived back eventually.

I too am curious as to how your door handle would work. Do they have to carry something that is micro-chipped?

 

[Canadian Joanne]

I am another who is wondering how the door handle works. If the person has to carry a micro-chipped item, I can see how easily the item would get misplaced or deliberately discarded. It could be discarded because the PWD would not recognize what it was for.

I can understand your dislike of people wandering in and out of your wife's room but I don't see a solution other than something that would restrict the residents even more than they already are. It IS part & parcel of life with dementia and is not a very important thing.

My mother was in her nursing home for over 13 years. While she was mobile, she also went through a phase of wandering into others' rooms. We did the best we could.

 

[love.dad.but..]

Dad was a constant wanderer into other rooms and picked things up and sometimes if he was tired would sleep on a bed or chair. He wasn't the only one. Staff knew who they had to watch and divert but it happens I could see it was very irritating for others and their relatives and one relative in the early days berated me about dad which was very upsetting...dad wasn't making a conscious choice just that encouraged to think of as his home why wouldn't he go into the rooms not able to distinguish between his..others ...communal areas but as with other residents who had other challenges that dad didn't have I always thought there is always something that may or may not be accepted by some and am not being dismissive but I was glad I didn't have to see or help dad with serious physical aggression. I can't see that a gate would be acceptable because of high risk of the determined fairly mobile like dad was trying to climb over or spending ages trying to fiddle with it to undo it...very annoying for room resident. At dad's NH bed bound residents often had their doors left open not just for staff monitoring but those who were able to look around could interact with everyone walking by as I and other relatives often did so less isolating I would have thought.

Thinking how dad was not sure how your handle idea would work.

 

[nellbelles]

Because my husband was averse to coming out of his room the manager fitted a door stop to keep his door open so he could interact with anyone walking past his room.

 

[Jackamus]

My thanks to all of the above for their valuable comments. It has provided much data for our research. It can be seen that every relative of a resident has a different experience but they nearly all fall into the same class and that is problems caused by wandering.

We have spoken to several care homes about our system and all of them have been enthusiastic. The only criteria being cost.

When first investigating the problem it was first established that the system would have to be automatic since it would not be possible to expect residents to use cards, keys or smart phones.
It must be understood that this is not a door lock but a simple method of immobilising the door handle. Also trying improve the privacy and therefore dignity of residents.

Below is a description of the system:
The door handle comes in two versions both of which can be retrofitted to replace virtually any door handle. It makes no difference if the door has a standard mortice lock with a euro-cylinder or just a simple latch.

The first is a wireless handle operated by a wristband or fob worn by the resident. The wristband can only be removed using two hands and is waterproof which means it can be worn 24 hours a day.
It can be manually operated using a pass key or keying a pass number.

The second is a face recognition handle that does not need a fob or wristband and can be manually operated in the same way as the wireless handle.

Both handles are battery operated.

However for the handles to be 100% effective it is necessary for the door to be closed. Many residents often do not shut the door after leaving their room which negates the purpose of the handle.

This is solved by using an independent door closer that will close the door when the regulation fire door closer is in the 'Free' position. This will detect when the room is unoccupied and close the door.

The door barrier is a simple tape retracting cassette which stretched across the door and fixed by a secure catch easily operated by staff ( see image below). This is only intended for use with residents who are bed ridden and that the door is deliberately left open for whatever reason.
The question of the barrier being a hazard is no different than the hazard of a resident trying to climb on or get under a coffee table, or settee, or chair or tripping on those yellow plastic 'Wet Floor' signs constantly found in corridors. A level of common sense needs to be applied when assessing risk.
As was mentioned in a previous comment some care homes have used a stair gate. We think this is unnecessary. One excuse offered by a care home manager was that it could make a resident feel like they were in prison!

 

[Jackamus]

Because my husband was averse to coming out of his room the manager fitted a door stop to keep his door open so he could interact with anyone walking past his room.

The one area that I have not covered are residents who like to be visited by other residents. Again a level of common sense must be applied by staff in catering for such situations. We do not claim that our system is a 'one size fits all' but almost.

Because the this issue has been around for decades that there is a mindset that it cannot be solved. as I said all the care homes I have spoken to have been enthusiastic.

 

[love.dad.but..]

My thanks to all of the above for their valuable comments. It has provided much data for our research. It can be seen that every relative of a resident has a different experience but they nearly all fall into the same class and that is problems caused by wandering.

We have spoken to several care homes about our system and all of them have been enthusiastic. The only criteria being cost.

When first investigating the problem it was first established that the system would have to be automatic since it would not be possible to expect residents to use cards, keys or smart phones.
It must be understood that this is not a door lock but a simple method of immobilising the door handle. Also trying improve the privacy and therefore dignity of residents.

Below is a description of the system:
The door handle comes in two versions both of which can be retrofitted to replace virtually any door handle. It makes no difference if the door has a standard mortice lock with a euro-cylinder or just a simple latch.

The first is a wireless handle operated by a wristband or fob worn by the resident. The wristband can only be removed using two hands and is waterproof which means it can be worn 24 hours a day.
It can be manually operated using a pass key or keying a pass number.

The second is a face recognition handle that does not need a fob or wristband and can be manually operated in the same way as the wireless handle.

Both handles are battery operated.

However for the handles to be 100% effective it is necessary for the door to be closed. Many residents often do not shut the door after leaving their room which negates the purpose of the handle.

This is solved by using an independent door closer that will close the door when the regulation fire door closer is in the 'Free' position. This will detect when the room is unoccupied and close the door.

The door barrier is a simple tape retracting cassette which stretched across the door and fixed by a secure catch easily operated by staff ( see image below). This is only intended for use with residents who are bed ridden and that the door is deliberately left open for whatever reason.
The question of the barrier being a hazard is no different than the hazard of a resident trying to climb on or get under a coffee table, or settee, or chair or tripping on those yellow plastic 'Wet Floor' signs constantly found in corridors. A level of common sense needs to be applied when assessing risk.
As was mentioned in a previous comment some care homes have used a stair gate. We think this is unnecessary. One excuse offered by a care home manager was that it could make a resident feel like they were in prison!
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Your ideas are interesting however with regard to a wristband and dementia from my experience with dad...you will have to take into account some wanderers will be frightened and resistent to having anything placed on the wrist plus although you envisage it would need 2 hands the determination to stick with an obstacle for a long time..strength..and even dementia confused guile of dad had to be seen to be believed. Dad's NH had such a barrier to the open plan kitchen...am afraid it didn't delay for very long determined resident access...only worked long enough for staff to hopefully notice a resident was working out a way to bypass its' use

 

[Jackamus]

Your ideas are interesting however with regard to a wristband and dementia from my experience with dad...you will have to take into account some wanderers will be frightened and resistent to having anything placed on the wrist plus although you envisage it would need 2 hands the determination to stick with an obstacle for a long time..strength..and even dementia confused guile of dad had to be seen to be believed. Dad's NH had such a barrier to the open plan kitchen...am afraid it didn't delay for very long determined resident access...only worked long enough for staff to hopefully notice a resident was working out a way to bypass its' use

I accept that there will be difficult cases and as I said before it is not a 'one size fits all' system and as such it would wrong to deprive other residents from its benefits.

 

[love.dad.but..]

I accept that there will be difficult cases and as I said before it is not a 'one size fits all' system and as such it would wrong to deprive other residents from its benefits.

I agree and it would be interesting to see if it would work in a care home with residents at different stages and presentation. Are you hoping to get it to a trial stage?

 

[canary]

I suspect that this system would work best in a home that takes both dementia and non-dementia residents and also homes that only take people in the early stages. In these sort of homes the management often views going into other peoples rooms as a big problem and it is often a reason to ask residents with dementia to leave (other problems are resistance to personal care and being up at night), so I could see that these sort of places would be enthusiastic, although I suspect that it would only enable people with dementia to stay there for an extra few months, before there were other problems

My mum was in a dedicated dementia unit that would look after people right up to the end and could deal with almost anything. For them, going into other peoples rooms was no big deal as they had far more challenging behaviour to deal with. TBH I couldnt see them being prepared to go for this sort of system

 

[Jackamus]

I agree and it would be interesting to see if it would work in a care home with residents at different stages and presentation. Are you hoping to get it to a trial stage?

I am a pensioner living on a state pension and have used my own savings to finance this project.
We have made prototypes and are still refining them. We hope that soon we will be able to make a demonstration video of the system being used in a care home.
When we have done this we will be looking to find an investor to take it to full production.