Nursing professor utilizes location tracking in wayfinding research at independent and assisted living facilities

Nursing students at computers analyzing wayfinding data.
Nursing students analyze location tracking data.
Image credit - Valerie Hendrickson

After the pandemic caused a 16-month pause in her wayfinding research, Rebecca Davis and her team are back inside independent and assisted living centers to continue their studies.

Davis, professor of nursing and associate dean for research and scholarship in the Kirkhof College of Nursing, received a five-year, $2.2 million grant from the National Institutes of Health in 2018 to study how visual cues (like meaningful artwork and signage) help residents effectively find routes within their facilities.

Davis said independent and assisted living centers commonly have long hallways with neutral-colored walls, confusing intersections, and poor or no signage.

A large picture of the American flag on the wall used as wayfinding design.
Rebecca Davis, professor of nursing, said residents may have better results remembering routes that are marked with bright-colored, simple and meaningful artwork, like these placed by her team in Clark Retirement Community in Grand Rapids.
Image credit - Courtesy photo.
Signs above and by elevators in a hallway used for wayfinding.
Rebecca Davis, professor of nursing, and her team put wayfinding signs near elevators at Clark Retirement Community in Grand Rapids.
Image credit - Courtesy photo.

Her research is taking place in 12 facilities in West Michigan and Cleveland, Ohio. In one of those locations, Sunset Manor in Jenison, Michigan, 13 residents are participating in location tracking. Sensors are placed in common areas and residents wear wristbands, similar to a Fitbit. Davis said as residents move within the facility, their trips are noted within data collection.

“This unique technology offers a rare opportunity,” said Davis. “We are looking to see if there is a difference in how much the residents who are participating get around in the facility and use the public spaces. Ultimately, we want to know if improving wayfinding design helps people use the spaces in their community better.”

The study gives students many opportunities. Graduate students in the Doctor of Nursing Practice program are assisting with data entry and analysis and cognitive assessments of residents; an undergraduate nursing student is helping with location tracking data.

Three nursing students who are helping analyze wayfinding data.
From left: Elizabeth Hill, DNP graduate student, Paige Bekker, DNP graduate student, and Elizabeth Martin, nursing student, are helping analyze location tracking data..
Image credit - Valerie Hendrickson

There is very little scientific research on how the environment affects wayfinding, Davis said.

“There is a move toward making facilities more home-like and less institution-looking, which is important; but signs and visual cues are still needed,” she said. “There is a misconception that residents don’t want signs, but surveys show they want them.”

Davis said many buildings have a complicated design, and some have inaccurate or confusing signs. She said elevators can be especially tricky.

People with cognitive issues and aging eyes may have better results remembering routes that are marked with bright-colored, simple and meaningful artwork, she said.

Davis put together a unique team for the research. She is a nurse and researcher with expertise in caring for people who have dementia, signs of cognitive disorder, and how people perceive the world around them. The architect on the team, Margaret Calkins, has expertise in designing for those with dementia; the speech and language pathologist on the team, Jennifer Brush, has expertise in how people understand language, especially those individuals with a memory impairment.

The study will end in January 2023 and Davis expects results to be published by that summer. Her team will give each participating facility recommendations on where wayfinding design changes would be beneficial and the option to keep the signs and artwork used during the study.

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