dementia, model testing, wandering, observational methods, physical environment, NDB model


Background/Rationale: Guided by the need-driven dementia-compromised behavior (NDB) model, this study examined influences of the physical environment on wandering behavior. Methods: Using a descriptive, cross-sectional design, 122 wanderers from 28 long-term care (LTC) facilities were videotaped 10 to 12 times; data on wandering, light, sound, temperature and humidity levels, location, ambiance, and crowding were obtained. Associations between environmental variables and wandering were evaluated with chi-square and t tests; the model was evaluated using logistic regression. Results: In all, 80% of wandering occurred in the resident’s own room, dayrooms, hallways, or dining rooms. When observed in other residents’ rooms, hallways, shower/baths, or off-unit locations, wanderers were likely (60%-92% of observations) to wander. The data were a good fit to the model overall (LR [logistic regression] w2 (5) ¼ 50.38, P < .0001) and by wandering type. Conclusions: Location, light, sound, proximity of others, and ambiance are associated with wandering and may serve to inform environmental designs and care practices.


Original Citation: Algase, Donna L., Elizabeth R. A. Beattie, Cathy Antonakos, Cynthia A. Beel-Bates, and Lan Yao. "Wandering and the Physical Environment." American Journal of Alzheimer’s Disease & Other Dementias 25, no. 4 (2010): 340-346.