A Randomized Controlled Trial of Visual Cues, Signage, and Spaced-Retrieval Education within Long Term Care Communities to Assist with Wayfinding

项目概要/摘要 定位并成功地行进到目的地的能力，称为寻路，对于 老年人认知障碍搬迁到一个新的住所，如独立或协助生活是一个 有认知问题的老年人最容易遇到困难， 路上了通常这些长期护理社区的设计并不是为了方便寻路，因为它们很复杂， 混乱，缺乏独特性。寻路问题可能会导致个人的世界缩小，导致 生活空间变小（社区内旅行的空间范围），参与度和依赖性降低 其他人的日常生活活动。拟议项目的总体目标是评估 显着的视觉线索和空间检索（SR）对老年人的寻路能力和生活空间， 在老年人社区中的寻路问题。突出的线索，如生动的图片，雕像和明亮， 有特色的标识可以使老年人居住社区更有纪念意义和特色。本研究 三个具体的目标：a）检验有和没有间隔提取教育的显著线索对 在长期护理中有寻路缺陷的老年人最初和随着时间的推移的寻路能力 社区;和B）确定显着视觉线索和SR对生活空间的影响;和c）确定 最适合干预的受试者特征;以及 对干预措施的反应性较低的风险人群，以便干预措施能够适当地针对性。 临床试验分为三组，将随机分配9个护理社区，包括 第1组（对照;护理社区无变化）;第2组（放置彩色和熟悉的物体和标牌 在护理社区内）;和组3（组2线索加SR）。参与者将是 那些在寻找出路方面存在问题的社区他们将被要求反复找到他们的方式， 一年内的具体目的地。寻路性能，包括参与者找到 测试位置和研究组之间的误差比较。生活空间也将被测量， 对比一下武器。据推测，个人谁是在护理社区，这是加强 与没有显著线索的护理社区相比，具有显著线索的护理社区将改善寻路。在 此外，间隔提取，这是一种基于证据的记忆策略，被假设为积极影响 受试者使用的线索和提高寻路性能。最后，假设寻路 能力将与生活空间相关联。本研究的长期目标是测试基于证据的 改善老年人住宅的干预措施，使有寻路问题的老年人更容易 学习和记住他们的环境，这样他们就可以保持独立。

Project Summary/ Abstract The ability to locate and travel successfully to a destination, known as wayfinding, is a significant problem for older adults with cognitive disorders. Relocating to a new residence such as independent or assisted living is a time in which older adults with cognitive problems are most vulnerable to experiencing difficulties finding their way. Often these long term care communities are not designed to facilitate wayfinding as they are complex, confusing, and lack distinctiveness. Wayfinding problems can cause an individual's world to shrink, leading to a smaller life space (the spatial extent of travel within the community), decreased engagement, and dependence upon others for activities of daily living. The overall goal of the proposed project is to assess the contribution of salient visual cues and Spaced Retrieval (SR) on wayfinding ability and life space in older adults with wayfinding problems who live in senior communities. Salient cues, such as vivid pictures, statues and bright, distinctive signage can make senior residential communities more memorable and distinctive. This study has three specific aims: a) To examine the effect of salient cues with and without spaced retrieval education on wayfinding ability initially and over time in older adults who have wayfinding deficits in long term care communities; and b) To determine the effects of salient visual cues and SR on life space; and c) to determine subject characteristics that are most amenable to the intervention; and which subject characteristics place persons at risk for less responsiveness to the intervention so that the intervention can be appropriately targeted. There are three arms to the clinical trial to which nine care communities will be randomly assigned, including Arm 1 (control; no change to the care community); Arm 2 (colorful and familiar objects and signage placed within the care community); and Arm 3 (Arm 2 cues plus SR). Participants will be individuals within the communities who exhibit problems finding their way. They will be asked to find their way repeatedly to specific destinations over a period of a year. Wayfinding performance, including how fast the participants find the test location and the errors they make compared between study Arms. Life space will also be measured and compared between Arms. It is hypothesized that individuals who are in care communities which are enhanced with salient cues will improve wayfinding when compared to care communities without salient cues. In addition, Spaced Retrieval, which is an evidence-based memory strategy, is hypothesized to positively influence subjects' use of the cues and improve wayfinding performance. Finally, it is hypothesized that wayfinding ability will correlate with life space. The long term goals of this research are to test an evidence based intervention to enhance senior residences so that older adults who have wayfinding problems can more easily learn and remember their environments so that they can maintain independence.