'ELOPEMENT' OPPORTUNITIES AMONG DEMENTIA PATIENTS IN NURSING HOMES: ARCHITECTURAL CONSIDERATIONS.
Contributors: Georgia Institute of Technology.
Published: 1992
Number of pages: 514
Subjects: Architecture.; Health Sciences, Nursing.; Gerontology.
Description: The propensity of some individuals with dementia to wander away or elope is a serious problem. Elopement places individuals at risk of serious injury, even death. This study examined architecturally-based opportunities for elopement and elopement control. The study utilized a sample of twelve nursing homes of mixed plan types that served populations of demented and nondemented individuals.

Data describing elopers, typical incidents and organizational factors related to a site's elopement problem were obtained through site visits. Two behaviorally-relevant architectural theories, Visual Access and Exposure and Space Syntax, guided a detailed plan analysis. Visual Access and Exposure was used to examine location-specific opportunities for staff and residents to see exits and routes to exits. Space Syntax was used to examine likely movement patterns of staff and residents, the depth of interior spaces from the exterior, and route options. The syntactic analysis included consideration of differences when fire exits are and are not assumed to be available as a means for potential elopers to reach the outside. Architecturally-based opportunities for elopement and elopement control were examined in the context of a site's admission and retention practices and staffing levels. The fit between architectural and organizational factors was mixed, suggesting that the design of the nursing homes vary in terms of how well they support a site's admission/retention practices. Staffing levels at some, but not all sites, may help to offset shortcomings in facility design.

Four general patterns of architecturally-based opportunities for elopement control were identified. All sites were characterized by one of two distinctly different types of location-specific opportunities for visual monitoring from the nurses station; comprehensive or strategic area control. The third pattern involves opportunities for serendipitous encounters and sightings when staff are in the hallways. The fourth pattern relies on the position of a key space, such as the nurses station, in relation to exit points, which permits "gate-keeping" at an exit. All sites can be characterized in terms of the effectiveness of their design with regard to the latter two patterns. Results are discussed in terms of future research and the creation of "least restrictive environments.".
Notes: Source: Dissertation Abstracts International, Volume: 54-02, Section: A, page: 0345.

Thesis (PH.D.)--GEORGIA INSTITUTE OF TECHNOLOGY, 1992.

School code: 0078.