On March 2, a dementia question popped up on Chuck Klosterman’s The Ethicist column in New York Times Magazine.
The question posed a dilemma about using black floor mats to prevent wandering:
“A new technique to control the wandering of dementia patients involves placing black floor mats in front of unsafe areas, such as outside exits. Due to a fear of falling, persons with dementia will not walk on dark spaces on the floor (they tend to see them as holes). This is an alternative to antipsychotic drugs and lockdown units. Since this technique uses fear and a disability to guide behavior, but with the intent of safety, is it ethical?” (The New York Times)
Mr. Klosterman replied that he think it’s ethical, “and — on balance — superior to the alternative solutions.”
Further, he wrote: “When dealing with ethical dilemmas involving those who have lost the ability to reasonably lobby on their own behalf, one must consider what they would most likely prefer if they were still in a position to do so. This is why I support the use of these black mats: It presents the best compromise between dignity and utility for all involved parties (both patient and caregiver).
“If a dementia patient were in a position to describe how she would want to be treated, I’d assume she would want the maximum level of independence, the highest degree of protection and the greatest potential for mental clarity. This concept comes closest to achieving those goals.”
As a blogger on Dementia Dynamics, a business that offers a training service to companies for their workforce (so that employees can be better, safer caregivers), posted: “As various forms of dementia progress, they may cause the patient to have visual perception problems. Notice that I didn’t say sight problems. Often, patients can see perfectly well, but the way their brains interpret what they see malfunctions.”
The website offers these 10 surprising decor tips to aid in independence and prevent wandering:
- If the wall behind a white commode and sink is painted a light color, the commode and sink may be “invisible” to the patient. Paint the wall behind that same sink and commode a medium tone and suddenly, the sink and commode become “visible” again, hopefully allowing the patient to retain their independence longer.
- If you fill a clear glass with water, the patient may not be able to see it. Use a colored cup.
- If you place dark pants on a dark bedspread, they may be “invisible” to your loved one. The same holds true for light colored clothes on light colored sheets.
- You can also use this “invisibility” to your advantage. If you paint doors and door knobs the same color as the wall — or even continue a wallpaper border across a door painted the same color as the wall — the patient may not perceive that the door is there at all reducing the risk of wandering.
- Watch your tablecloth or placemat colors. Make certain the plate doesn’t blend in with the background.
- Patterns tend to confuse dementia patients. For instance, the pattern on the carpet may look like snakes to the dementia patient. A patterned plate may keep the patient from eating.
- Shiny floor finishes (think tile or highly polished wood) may look like water or ice to the patient. Dull finishes are best.
- A black mat in front of a door may look like a hole to the dementia patient. Many people have placed black mats in front of the doors leading outside and eliminate their loved one’s problems with wandering away!
- Place a traffic stop sign on the inside of exterior doors. Often the color, word or shape — one of the three — will reach the patient’s mind and keep them from exiting through the door.
- Place reflector tape from the patient’s bed to the bathroom and use a nightlight, so the bathroom path will be visible at night.
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