The Nighttime Wanderer: How Environmental Factors Can Trigger Challenging Dementia-Related Behaviours
Whether it’s the warmth of sunlight that can brighten a bad mood, the comforting smell of a home-cooked meal that triggers both nostalgia and stomach-growling, or a classical tune that relaxes listeners with every note—the environment that surrounds us at any given moment has a profound effect on how we feel and behave.
Recently, a professional caregiver (“James”) related to me an experience that highlighted this very point. He and other staff at the care home where he worked were perplexed by the behaviour of one of the residents, a gentleman (“Alan”) who, at nighttime, would leave his own bed and enter the bedroom of a female resident across the hall. Alan would use her washroom and then crawl into bed with her. While other staff members believed that Alan was trying to “get fresh” with the female resident and even considered prescribing medications to calm his libido, James suspected that there was a different motivation underlying this strange behaviour.
He decided to survey Alan’s living environment and entered his room to take a look around. James asked himself, “What could be causing this resident to leave the comfort of his own room?” Then it dawned on him! When Alan’s door was kept open during the night, to allow staff to keep an eye on him, it also blocked the entrance to Alan’s washroom. Connecting the dots, James realized that Alan was entering the lady’s room at night because he was looking for a washroom, and once he had used her washroom he mistook her bed for his and went to sleep there.
As a creative solution, Alan’s washroom door was replaced with a curtain, kept wide open at night, and staff members were told to only keep the door to his room halfway shut so it wouldn’t block the washroom entrance. They also inserted a night light into Alan’s washroom to illuminate it so that Alan would be drawn to it at night instead of someone else’s washroom. After the solution was found and implemented, both Alan and the female resident were finally able to get a proper night’s rest in their own beds.
Instead of making assumptions, James did what all caregivers should do in such a case, he asked the key question “Why?” and made the effort to dig deeper into finding the trigger for Alan’s nighttime escapades. He also did not make the mistake of overlooking the importance of environmental factors in affecting behaviour. The happy result was two residents who were comfortable in their living environments and a staff who finally had clarity in identifying the cause and solution to a challenging behaviour.
