"There is always a reason why someone is doing something": The importance of life history and personhood when supporting people with dementia to "wander" in care homes.

Abstract

Up to 60% of people living with dementia who reside in care homes will 'wander' at some point. A person-centred approach should be taken to support each person's individual needs through tailored interventions when wandering. This study aimed to identify care home staff perspectives on what supports safe wandering for people living with dementia in care home environments. As part of a larger study, and using a person-centred framework, semi-structured qualitative interviews were conducted with staff (N = 19) recruited from care homes in the North of England who provide care for older people. Transcripts were analysed using framework analysis. Four themes were identified, and two of these themes are presented here. Staff highlighted the importance of ensuring that personhood is at the centre of care delivery when supporting residents to wander. Clear leadership from management and meaningful involvement of families allowed staff to provide better support for residents. Staff also reflected on the importance of identification of unique impacts of dementia on each individual when providing person-centred care. The delicate balance between safety and well-being was consistently considered and reviewed. We identified a range of individual factors that contribute towards safe and supported wandering for people living with dementia. Positive risk taking, supported by policies and procedures, such as resident safety and meaningful activity, may allow staff to manage the benefits and risks associated with wandering.