Some 5.2 million Americans are currently living with Alzheimer’s disease. According to the Alzheimer’s Association, that number could increase by as much as 200% by 2050 as the U.S. population ages. That presents a growing challenge for nursing homes, assisted living facilities, and family members to provide adequate care for these individuals.
Many Alzheimer’s patients require round-the-clock care.
Dementia Patients May Wander Off
One of the most frequently-cited issues with patients who have Alzheimer’s or dementia is a tendency to wander away from home. Sometimes they want to go to a place they believe is “home” but is no longer where they live. Other times, they become confused and start walking in a random direction because they don’t recognize their surroundings. Naturally, this behavior puts these people at risk of harm caused by weather conditions, passing vehicles, or unscrupulous individuals.
To combat this problem, elder care facilities have taken proactive steps to prevent their residents from wandering away in the first place. Common practices include placing curtains or pictures in front of doors to disguise exits from patients. Other precautions utilize audible alarms either on certain doors or inside devices attached to the patients themselves. Some facilities even erect “fake bus stops” outdoors on their property in the hopes that confused patients will stay at these spots and “wait” for transportation instead of wandering away.
Even though it doesn’t make sense to us, it may make sense to them.
Can Floor Mats Help?
There’s a new technique that is being tried at some assisted living centers and nursing homes – and it involves dark-colored floor mats.
The strategy involves placing these floor mats (or black pieces of carpet) near doors, elevators, and other areas where caregivers want to discourage patients from proceeding unaccompanied. Patients who have dementia or Alzheimer’s have long been observed to have cognitive problems that affect their visual-spatial perceptions. As a result, these individuals tend to avoid, walk around, or be wary of darker-colored areas on floors because they perceive them to be deep pits or steep cliffs. A facility may use this lack of awareness as a method of keeping patients safe by preventing them from wandering out of buildings and/or into places where they may be harmed.
Do Alzheimer’s and dementia patients see a bottomless pit instead of a floor mat?
But is this “dark mat” technique ethically sound?
Pros of Dark Floor Mat Approach
Some experts believe that it’s consistent with similar methods of dealing with Alzheimer’s and dementia patients. After all, it’s not uncommon for caregivers to use deception as a way to reduce patients’ discomfort. For example, a nurse may tell a patient who demands to see her (long dead) husband that “he went out, but will be back soon” in order to calm her anxiety and divert her attention until she becomes lucid again.
And it certainly can be argued that utilizing dark floor mats to discourage patients’ movements is more humane than other techniques such as locking them in rooms or wards, equipping them with alarm devices, or incapacitating them with anti-psychotic drugs. And it also strikes a nice balance of maximizing patient protection while offering the highest possible degree of independence.
Cons of Dark Floor Mat Approach
But others in the elder care field worry that the dark floor mat practice crosses ethical lines. They feel that playing on the fears of an Alzheimer’s or dementia patient – even if the fears aren’t based in reality – serves to exert undue control over these older adults. This concept of “patient infantilization” is something every reputable elder care facility tries to avoid whenever possible so that the person’s dignity is preserved.
There are also practical concerns regarding the dark mat strategy. The illusions of danger may persist even when the patients are accompanied or permitted to pass through these areas (such as exiting the back door to go on a field trip), which may cause unnecessary fear or anxiety. Plus, what would happen in the event of an emergency (like a building fire) if a patient was scared off from exiting the facility due to a dark floor mat?
They’ve been around for a long time, they deserve to be cared for while maintaining their dignity.
One Goal: Meeting the Needs of Alzheimer’s/Dementia Patients
Both sides agree that more data would be useful in mediating this dispute; because there isn’t any hard scientific data that has been compiled on whether the dark mat approach is actually effective. It’s also important that key members of the community that care for Alzheimer’s patients be involved in any discussions about this method’s ethical dilemmas. This conversation would have to include physicians, researchers, medical ethicists, caregivers, and patient family members. It’s just one of the myriad of problems facing America over the next few decades as the nation struggles to provide the highest quality of care for the growing number of people who suffer from Alzheimer’s or dementia.
Image 3 Credit: http://www.ultimatemats.com
Written by Chris Martin