How Should Toilets be Labelled for People With Dementia?

Abstract

A mailed survey of 28 residential facilities for ambulant people with dementia questioning the types of labelling of residents' toilets yielded 24 replies: 42% (10) had no labelling, “Toilet” was used in 50% and “Male” or “Female” was used in 8%. The survey was followed by asking elderly people in an acute medical hospital ward and in an aged care residential complex their preferences for toilet word and symbol labelling There were 21 elderly people with normal cognition, 11 people with mild dementia and 16 people with moderate dementia. The international symbol was preferred by people with normal cognition or mild dementia but a symbol more representative of a toilet was preferred by people with moderate dementia (p < 0.05). “Ladies” or “Gents” was the word most preferred by people with normal cognition. “Toilet” was the word preferred by people with moderate dementia (p < 0.05). We recommend the use of the word “Toilet” accompanied by a picture of a toilet for labelling toilet doors for people with dementia.

Strategies to Inform Innovations in Continence Care for People Living with Dementia in the Acute Hospital Setting: A Mixed Methods Narrative Synthesis Review

“…The non-research material consisted of web pages/web booklets (n = 5) [75][76][77][78][79], guidelines (n = 2) [10,80], reports (n = 2) [81,82], guidelines/guidance (n = 2) [33,83], framework (n = 1) [84], model (n = 1) [85] and information sheets (n = 1) [86]. Seven research studies were conducted in the USA [60,61,65,66,70,72,87], two in Australia [67,73] and one in each of the following countries; UK [69], Japan [63], Taiwan [68],…”

“…There were six quantitative non-randomised studies and of these three ful lled all four quality criteria [60,61,63], for two studies it was not possible to ascertain the response rate for the sample [65,66] and the other did not compare the base line characteristics between those in the control and intervention groups [64]. The remaining three studies were quantitative descriptive, two studies ful lled all four criteria [67,68] and the study that did not, we were unable to ascertain what the response rate was for the sample [69].…”

“…It is therefore important to recognised the nonverbal signals, body language, facial expressions, behaviours and any signs that the PLWD uses to communicate in such instances [78,79,81,87] so that their wishes can be acknowledged [81]. Listening carefully to the words or phrases that PLWD use for describing the toilet [67,77,[79][80][81] as well as being able to recognise familiar gestures [67,80,81] is seen as important. New staff should be trained to recognize the importance of toileting and to how to understand individual behaviours and non-verbal cues in relation to toileting [87].…”

“…Finding the appropriate words and symbols to describe the toilet Wilkinson et al, [67] sought to evaluate the comparative suitability of a range of words or symbols to label a toilet for PLWD. As part of an institutional survey (n = 24) the words that were used to label the toilet were "toilet "(67%), "Male/Female" (11%) and there in some institutions there was no labelling (22%).…”

What do service planners and policy-makers need from research?

“…As Lawton (1987) points out, there is an astonishing range of professionals involved in design and they all have their own approach to research. Architects see research as trying out designs (which appears wholly unscienti®c until you grasp the complexity of a building and the way every aspect is interlinked), behavioural scientists struggle with thē uid and multifactorial nature of living environments, clinicians are deeply cynical of research in this ®eld without experimental studies but rarely try them (a small, honourable exception being Wilkinson et al (1994) in New Zealand, who tested toilet door signs), interior designers are more concerned with user satisfaction than research into ecacy as far as outcomes for people with dementia are concerned. We seem to have had a research stalemate for a number of years, during which time this consensus has developed.…”