Wandering near an exit

Question

In the late afternoon, a resident with dementia walks back and forth near the exit door of the unit, saying she needs to go home to cook dinner. The door alarm is on. What should the nursing assistant do?

1. ARely on the door alarm to sound, and continue the task already in progress.✗ Incorrect

   Alarms help, but they do not replace staff supervision.

2. BTell the resident firmly to sit in a chair and stay there.✗ Incorrect

   An order to sit still does not deal with the reason she is walking, such as anxiety or frustration, and offers her nothing to redirect her attention.

3. CStay with the resident, calmly guide her away from the exit to a pleasant activity, and report the behavior to the nurse.✓ Correct

   Correct. Supervision, calm redirection and activity address safety and the cause of the wandering.

4. DOpen the door and let her step out for a few moments to calm down.✗ Incorrect

   Leaving a safe area unsupervised is an elopement and risks exposure, injury or traffic.

Answer

C. Stay with the resident, calmly guide her away from the exit to a pleasant activity, and report the behavior to the nurse.

Rationale

Residents with dementia may walk toward an exit because they are confused about where they are, or because they feel frustrated, anxious or bored. The aide stays nearby, redirects the resident to an enjoyable activity, and informs the nurse. Door alarms only alert staff, so someone must still watch and respond promptly.