The purpose of this project is to develop and test Clear Cues (CC), a signage system for care communities that supports way finding in people with dementia. Way finding is a process through which people use information in the environment to help them get to their desired destination. It's both the user experience of choosing a path and the design elements that aid orientation. A poorly designed environment can have adverse effects such as extreme reactions and aggressive behaviors by the cognitively impaired elderly. The long-term care (LTC) environment often acts a barrier to independence and way finding for people with dementia. Design features in LTC settings, such as many similar doorways along corridors, lack of windows to the outside, and poorly planned or improvised signage, resulted in poorer orientation. The search for information to aid orientation may cause frustration, anger or agitation. Poor way finding abilities jeopardize resident safety and cause burden to nursing home staff. Although people with dementia perform worse on way finding, they do attend to similar features of the built environment and make equal use of features such as signs. This suggests a need for a way finding system that incorporates best practices and evidence-based design. While the Americans with Disability Act of 1990 and the literature suggest generic guidelines for signage that is applicable to all buildings with older adults, specific recommendations for the use of signage in environments for cognitively impaired older adults are few and contradictory. While the effectiveness of some of the cueing systems has been empirically tested, more research is needed to provide guidelines, particularly for training staff to work with residents to help them recognize and effectively use environmental cues. Creation of Clear Cues will provide a unique and much-needed product that can benefit dementia care providers. Clear Cues would deliver an essential research base to way finding products, provide methods of ensuring appropriate placement of products, and educate staff in effective methods of training residents in the use of the product. The research team will implement CC in two LTC communities. Interviews with staff and human factors testing of 30 residents with dementia will inform creation of a CC prototype. Twenty new residents with dementia will be assessed in their way finding abilities for three routes within these communities before and after implementation of CC. The primary outcome will be an assessment of the amount of assistance needed by residents to navigate these routes. Objectives of this Phase I project are 1) Test the effects of Clear Cues in two dementia care communities by measuring the amount of assistance and time needed by residents to navigate from place to place before and after installation of CC;and 2) Conduct staff training on the use of and cueing for the Clear Cues system and test the effectiveness of the training through measures of knowledge acquisition and application.
Poor environmental navigation (or way finding) abilities have been found to impact resident safety, result in conflict between residents and cause burden to nursing home staff. The purpose of this project is to develop and test Clear Cues, a signage system for care communities that supports way finding in people with dementia. This project would contribute an essential research base to way finding, provide methods of ensuring appropriate use and placement of signs, and educate staff in effective methods of training residents with dementia in way finding.