A Cluster Randomized Controlled Trial of Visual Cues, Signage, and Spaced Retrieval for Wayfinding Within Long-Term Care Communities.

Background and objectives: Wayfinding can be challenging in many long-term care communities (LTCCs) due to size, poor visibility, inadequate wayfinding design, as well as cognitive impairment of some residents. The purpose of this study was to investigate the effects of distinctive cues and signage placed at key points within care communities, with and without a trained memory strategy called spaced retrieval (SR), on wayfinding ability and life-space.

Research design and methods: 15 LTCCs were randomized to control (arm 1), cues (arm 2), or cues + SR (arm 3). Data were collected at baseline, and months 1, 3, 6 and 12. Wayfinding speed and accuracy (co-primary outcomes) were tested on three routes (simple, moderate, and complex) in each site. The secondary outcome was self-reported life-space. Longitudinal linear mixed-effects and generalized linear mixed-effects models were used to analyze repeated measures of the outcomes in relation to trial arm.

Results: Wayfinding speed was significantly greater on the simple route for the cues condition compared to control. On the moderate and complex routes, there were no differences in speed among trial arms. In terms of errors, participants in cues and cues + SR conditions performed significantly better than control participants, and arm cues + SR performed better than cues alone. There were no differences in life-space among arms.

Discussion and implications: The addition of age-friendly signs and art-cues assisted residents of LTCCs to find their way more effectively than no intervention, and there were fewer errors with SR.