How do you prevent residents living with dementia from going into other residents’ rooms?

This common problem has been raised on HelloCare’s Aged Care Worker Support Group, with a member reaching out for advice. A resident in her care was leaving her room and going into other residents’ rooms – and doing just that.

“Wondering how those working in memory support stop people from wandering into other residents’ rooms and pretty much trashing the rooms and taking items like ornaments, clothes, anything they can carry,” she wrote.

“It drives me insane to see rooms that we’ve left tidy and neat, to walk past later and see everything messed up. We don’t always have time to go back and tidy them again.”

Did members have any advice to help her manage the situation, she asked?

“It’s the biggest question in the world,” says Colin McDonnell, Dementia and Wellbeing Consultant with Calvary Care.

When a resident leaves their room and enters another’s room, they are in the act of ‘purposeful walking,’ he told HelloCare.

Exploring their environment

Professor Lee-Fay Low, dementia care expert and leader of the University of Sydney’s Ageing and Health Research Group, told HelloCare, “People with dementia sometimes like exploring their environment. 

“They usually don’t realise they are going into someone else’s private space, and may miss cues like names on doors.”

The key to prevention is to help the resident find “meaningful activities” they enjoy, McDonnell said. 

That requires understanding the person, looking at the behaviour, and working out what’s behind the behaviour.

Residents have to have access to meaningful activities they can perform or environments that are appealing to them, such as a garden. Residents stuck in “confined, restricted areas” will become “bored” and will go out looking for something more appealing to do.

Music is also “brilliant” for entertainment and distraction, says McDonnell.

Professor Low agrees. 

“Providing residents with dementia with engaging and interesting things to do would stop them from exploring private rooms,” she said. 

Sometimes residents will get up in the night and try to enter another resident’s room. 

“As they’ve woken up, they might be hungry,” suggested McDonnell. 

“It’s probably best to give them a sandwich and say, ‘Would you like to go back to bed?’”

Medications are usually not successful in preventing residents from purposeful walking, unless there is an underlying psychotic issue, says McDonnell.

Using wayfinding

Wayfinding – visually signposting public spaces such as courtyards – and making them appealing may also entice residents to go to those spaces rather than other bedrooms. 

“There are nice examples of using decorations on and around doors to help resident’s find their own rooms,” suggested Professor Low.

Long corridors can cause problems for residents walking around aged care homes because when they reach the end of the corridor, there’s often nowhere to go other than private bedrooms.

Locks or not?

“I see no harm in locking doors,” the original poster of the question wrote.

It’s never OK to lock a resident who tends to walk around a lot in their rooms, says Professor Low.

However, some aged care homes have door sensors for which residents can wear a sensor on a bracelet or fob, which allows the door to unlock, preventing anyone else (other than staff) from entering the room.

Professor Low says residents should also have the right to lock their bedroom door if they wish.

“It’s their right to privacy and security, though staff should have a key and there should be agreement as to when they might use that key. For example, [staff might use the key] to attend to routine cleaning after letting the resident know, or in an emergency.” 

A resident who enters another’s room without their consent, or even against their wishes, is evidence of an unmet need. Understanding the person’s history, their story, their interests and preferences is the most important part of an aged care worker’s role. It underpins all else.

Aged care staff who do not get to know their residents and understand why they might be motivated to leave their rooms “are not doing their job,” says McDonnell.