HJNO Mar/Apr 2025

HEALTHCARE JOURNAL OF NEW ORLEANS I  MAR / APR 2025 53 Melissa Brunvoll Marketing Director Assisted Living and Nursing Care Lambeth House Addressing safety without confinement Aprimary concern in shifting away from locked units is ensuring resident safety. However, advancements in dementia care technology and environmental design of- fer solutions that balance security with freedom: • Smart monitoring systems: GPS-en- abled wearables and discreet sensors can track residents’ locations without restricting movement. • Environmental design: natural bar- riers such as winding pathways and visually distinct landmarks help resi- dents navigate spaces safely while discouraging wandering beyond se- cure areas. • Staff training in de-escalation tech- niques: equipping caregivers with strategies to redirect and reassure residents, reducing the need for phys- ical restrictions. • Activity-based redirection: ensuring that residents have structured, en- gaging activities throughout the day can minimize anxiety and the desire to exit a facility. Occupying their time with familiar and enjoyable tasks re- duces stress and promotes emotional well-being. Implications for healthcare professionals Physicians and medical staff play a cru- cial role in advocating for dementia care practices that align with evidence-based approaches to well-being. Transitioning away from locked units requires a multi- disciplinary effort, including: • Educating families on the benefits of inclusive care to address concerns about safety and supervision. • Encouraging policy changes that pro- mote funding and regulatory support for nonrestrictive care models. • Collaborating with care facilities to implement staff training and infra- structure changes that support this approach. Conclusion The shift from locked memory care units to inclusive, community-oriented environments represents a progressive step in dementia care. By prioritizing au- tonomy, engagement, and dignity, health- care professionals can help shape a future where individuals with dementia live not in confinement but in environments that support their holistic well-being. As re- search continues to reinforce the benefits of non-restrictive models, it is imperative for the medical community to champion policies and practices that enhance both safety and quality of life for individuals liv- ing with dementia. n REFERENCES 1 Schlegel-UW Research Institute for Aging. “Sup- porting Comfort and Belonging for People Liv- ing with Dementia: a guide for team members to enhance the environment in senior living.” 2020. https://the-ria.ca/wp-content/uploads/2021/11/ Supporting-comfort-and-belonging-for-people- living-with-dementia-RIA-Resource-FNL-2.pdf 2 Wilson, J.; Jacobs, K. “Why Do We Segregate People Living with Dementia?” LeadingAge, Oct. 15, 2024. https://leadingage.org/why-do-we-seg- regate-people-living-with-dementia/ 3 Carson, J.; Sprigg, P. “The Quest Upstream: One Community’s Journey to Support Inclusive De- mentia Care.” Presented at the National Consum- er Voice for Quality Long-Term Care 43rd Annual Conference: Stand for Quality, Nov. 3-6, 2019. day with meaningful activities to sig- nificantly reduce their desire to leave a facility. Structured programs such as art and music therapy, gardening, exercise classes, and cognitive games can help maintain mental and physi- cal stimulation, contributing to a sense of purpose and reducing rest- lessness. In 2020, Lambeth House made the deci- sion to close its locked memory care unit, allowing residents with severe dementia the opportunity to safely reintegrate into a nonrestrictive and inclusive environment. The result of this forward-thinking deci- sion has been extraordinary. With a huge emphasis placed on daily activities de- signed specifically for residents with cog- nitive decline and diagnoses of dementia, staff members found that they were able to keep residents engaged, which in turn de- terred them from attempting to leave the environment because they felt happy, safe, and secure. The Carol Woods Retirement Commu- nity in Chapel Hill, North Carolina, has also embraced the integrated memory care ap- proach and has participated in The Quest Upstream, which is a participatory action research study led by Jennifer Carson, PhD, of the University of Nevada, Reno. This study aims to explore how inclusive, relationship-centered environments bet- ter support individuals living with demen- tia. 3 Their findings indicate that strong community bonds, flexible team commu- nication, and an emphasis on activities tai- lored to individual interests result in lower agitation, minimal psychotropic drug use, and reduced staff turnover.