Meaningful wandering for residents with Alzheimer’s disease in memory care facilities

Background: For individuals with Alzheimer’s disease, the built environment can be a powerful therapeutic tool. Existing research shows that helpful environmental conditions can 1) ease negative behaviors associated with the disease, 2) improve safety, and 3) reduce stress levels and prescribed medication. This research examined ways that improved design of the built environment can benefit people with Alzheimer’s disease, specifically regarding their wandering behaviors. Wandering, often considered negative, is one of the most common but least understood behaviors associated with Alzheimer’s.

Methods: Information addressing this topic was obtained through multiple methods. 1) A literature review focused on design features hypothesized to support wayfinding and 2) New information collected during on‐site visits to an assisted living facility including: Documentation of existing features in communal areas; observations of resident behaviors in those areas; and staff interviews. Both the observational and interview information address the nature of resident wandering behavior, when and where residents appear to be more or less anxious, and how the residents appear to respond to specific design features.

Results: The literature review revealed that many of the design recommendations supporting beneficial wandering overlap with those suggested for improved wayfinding. Studies have indicated that wayfinding strategies can counteract memory and cognitive mapping deficiencies in individuals with Alzheimer’s. Information from study findings and the literature review were used to develop or refine recommendations for the design of assisted living facilities for those with mid‐range Alzheimer’s. Providing safe and stimulating environments for wandering might relieve some negative symptoms of Alzheimer’s disease. Until a cure is found, the need for supportive housing for those with the disease will continue to increase.