The effects of visual barriers on the exiting behavior of residents in a dementia care facility

Unsafe exits from dementia care units present problems for residents and pose ethical dilemmas for caregivers. The purpose of this experimental research was to determine whether visual barriers reduced the exiting behavior of residents in a long-term care facility. A visual barrier was defined as one that appeared to be an obstruction, but that did not impede egress through the door. The study was conducted in a 30-bed dementia care unit and was limited to the emergency exit door where an alarm sounded each time the panic bar was touched. An “exit" was defined as a resident touching the panic bar and sounding the alarm. The sample consisted of 3 females and 6 males who attempted to exit the unit at least once during baseline condition. All residents were diagnosed with some form of dementia.

The tests were conducted under three visual barriers and one baseline condition. Each condition was observed for seven days from 2:00 to 4:00 p.m. The schedule was as follows:

Baseline Condition: No experimental manipulation was used. This observation provided a comparison for the three test conditions.

Test Condition 1: Mini-blinds that covered the glazing of the door.

Test Condition 2: Cloth panel that covered the panic bar of the door.

Test Condition 3: Both the mini blind and the cloth panel.

During baseline collection, 9 residents triggered the alarm for a total of 120 attempted exits. Test condition 1 decreased exiting to 73 attempts. During test condition 2, 5 attempted exits occurred, and 18 attempted exits occurred during test condition 3. Statistical analysis included Friedman’s Rank test for correlated samples and Wilcoxon Sign Rank tests for treatment versus control comparisons. Test conditions 2 and 3 significantly reduced attempted exits while test condition 1 was not statistically significant.

In conclusion, visual barriers were a safe and effective method for deterring resident exiting for this particular nursing home.