An environmental investigation of wayfinding in a nursing home

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.