Reducing Wandering Through Improved Waiting Room Design: Page 2 of 2

January 17, 2013

Many useful recommendations are made in Geriatric Care by Design: A Clinician’s Handbook to Meet the Needs of Older Adults Through Environmental and Practice Redesign, which was published in 2011 by the American Medical Association.4 While these are general recommendations for practices caring for all older adults (≥65 years), they can be particularly beneficial for practices caring for persons with dementia, who have a greater number of sensory deficits to contend with and are more sensitive to environmental issues than cognitively intact persons. What follows are just a few of the recommendations that are outlined in the Handbook with regard to waiting rooms4:

• Ensure the reception desk is accessible to patients in wheelchairs (countertop area should be 30 inches high and at least 36 inches wide).

• Use light to medium floor colors with no or simple patterns with low color contrast to improve perception.

• If using carpets, use low-pile types to improve mobility.

• Have sturdy furniture that can’t be tipped and that has rounded corners to prevent injuries when bumped into. Avoid glass tabletops. 

• Reduce background noise by using sound-absorbing materials, such as drapes, carpeting, and wall and ceiling panels.

• Offer a variety of seating areas that use firm or medium-firm cushions, ensuring comfort and easing repositioning and the ability to move between seating and other areas. 

• Use glare-free lighting and ensure that all light sources are shaded, including lamps and windows.

• Use light to medium wall colors in warm rich tones, such as yellows and blue/greens. 

• Ensure that the foreground is always distinct from the background. For example, patients should be able to distinguish the couch from the floor, door handles from the door, and walls from the floor intersection.

• Signage should be easy to read and placed at appropriate intervals to prevent patients from getting lost. 

waiting room designIn designing interprofessional faculty. These individuals designed the new space, and if you look at the Figure, which provides a glimpse of our office, you’ll see many of the recommendations outlined in Geriatric Care by Design put into practice. We have multiple seating areas, low-pile carpeting, shaded lamps, white trim to delineate the walls from the floor, soft yellow paint, and rounded corners on our furniture. our new office space, we benefitted from more than 30 years of practical experience among our

Take-Home Message

Geriatricians recognize that optimal care must involve a partnership between an individual patient, their family support system, and the healthcare provider. This care philosophy, known as
patient- and family-centered care, emphasizes a dignified, mutually beneficial partnership of shared medical decision-making.5 The current healthcare debate has renewed societal interest in improving the care of older adults. An office environment that increases safety and fosters a sense of dignity among  cognitively impaired older adults through familiar environments enables improved partnerships and outcomes. 


1. Lester PE, Garite A, Kohen I. Wandering and elopement in nursing homes. Annals of Long-Term Care: Clinical Care and Aging. 2012;20(3):32-36.

2. Inouye SK. Delirium in older persons. N Engl J Med. 2006;354(11):1157-1165.

3. Alzheimer’s Association. 2012 Alzheimer’s Disease Facts and Figures. documents_custom/2012_facts_figures_fact_sheet.pdf. Published March 2012. Accessed December 13, 2012.

4. Bakker R. Environmental design. In: Geriatric Care by Design: A Clinician’s Handbook to Meet the Needs of Older Adults Through Environmental and Practice Redesign. Chicago, IL: American Medical Association; 2011:1-14.

5. Johnson B, Abraham M. Partnering with Patients, Residents, and Families: A Resource for Leaders of Hospitals, Ambulatory Care Settings, and Long-Term Care Communities. Bethesda, MD: Institute for Patientand Family-Centered Care; 2012:4-11, 26-39. 


The author reports no relevant financial relationships.  


Address correspondence to:

Jeffrey D. Schlaudecker, MD

2123 Auburn Ave, #340

Cincinnati, OH 45219