Dementia is a condition that affects millions of people around the world, causing changes in their memory, thinking and behavior. One of the challenges that people with dementia and their caregivers face is wandering, which can lead to accidents, injuries or even death.
Wandering is often triggered by confusion, boredom, anxiety or curiosity. People with dementia may wander because they are looking for something familiar, trying to escape from a stressful situation, or following a habit or routine. Sometimes, they may not even realize that they are wandering.
One of the ways to prevent wandering is to use black mats in front of unsafe areas, such as outside exits. This technique is based on the observation that people with dementia may have visual perception problems, meaning that they may see things differently than they really are.
For example, they may see a dark space on the floor as a hole, and avoid stepping on it due to a fear of falling. This can create a natural barrier that discourages them from leaving the safe zone. This technique is considered an alternative to antipsychotic drugs and lockdown units, which may have negative effects on the person’s dignity, health and well-being.
However, this technique may also raise ethical concerns, as it uses fear and deception to control the person’s behavior. Some people may argue that this is disrespectful and manipulative, and that it may not work for everyone or in every situation.
Chuck Klosterman, a columnist for The New York Times Magazine, addressed this dilemma in his The Ethicist column. 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.”
He added: “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.”
The Alzheimer’s Society, a leading charity for people with dementia and their carers, also offers some advice on how to support a person experiencing changes in perception. They suggest: “By responding in a supportive way, you can keep up their confidence and help them to cope with the misunderstanding.”
They also recommend some ways to make the home environment safer and more comfortable for people with dementia, such as using bright colors, clear labels, familiar pictures and avoiding patterns or clutter.
The use of black mats is not the only solution for wandering, but it may be a helpful option for some people with dementia and their caregivers. As Psychiatric Times noted: “The third, a verbal interpretation of the visual deception created by a black mat, is a threat rather than a distraction. Demented patients’ avoidance of dark mats, tiles, or even lines on the floor has long been observed-and sometimes exploited clinically-although we could not locate any studies of the effectiveness and safety of this maneuver.”
Relevant articles:
– How to safeguard against visual pitfalls – Alzheimer’s and Dementia, Alzlive.com, December 12, 2012
– How can dementia change a person’s perception?, Alzheimer’s Society, no date
– A Dark Side of Dementia Care, Psychiatric Times, April 15, 2014