title: Observing wandering-related boundary transgression in people with severe dementia.
abstract: Wandering-related boundary transgression (BT) in long term care (LTC) frequently manifests as intrusion into another resident's bedroom and is associated with adverse outcomes (loss of privacy, resident-to-resident altercations, and becoming lost). This observational study is the first to empirically describe the characteristics of wandering-related BT in LTC residents with severe dementia.
  
  
  
  Using real-time observation, seven independently ambulant residents with severe dementia and a positive history of wandering and BT were observed for a minimum of twelve 30 minute periods randomized over two non-consecutive days (n=92 observation periods). Frequency and duration of locomoting/non-locomoting phases and BT (entry into out of bounds/private space), patterns of ambulation (direct, random, pacing, and lapping), and activities observed during BT were measured during observation periods.
  
  
  
  Across 431 locomoting phases, 58 (13%) resulted in a BT and the bedroom of another resident was most frequently (86%) involved. BT was statistically associated with random ambulation and peak activity periods, and was observed more often in those with more frequent ambulation. Most BT events were unwitnessed by others and occurred when the participant was alone.
  
  
  
  Describing BT has increased understanding of when, where, and how BT occurs and provides background for future intervention research.
authors.affiliation: a School of Nursing , Queensland University of Technology , Brisbane , Australia.
authors.forename: Margaret
authors.initials: M
authors.lastname: MacAndrew
authors.affiliation: a School of Nursing , Queensland University of Technology , Brisbane , Australia.
authors.forename: Elaine
authors.initials: E
authors.lastname: Fielding
authors.affiliation: b School of Nursing and Midwifery , Pennsylvania State University , State College , PA , USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Kolanowski
authors.affiliation: a School of Nursing , Queensland University of Technology , Brisbane , Australia.
authors.forename: Maria
authors.initials: M
authors.lastname: O'Reilly
authors.affiliation: a School of Nursing , Queensland University of Technology , Brisbane , Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Beattie
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000503:physiopathology*; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D007398:Interpersonal Relations; D008134:Long-Term Care; D008297:Male; D012720:Severity of Illness Index; D016138:Walking / Q000502:physiology*
keywords: Dementia; boundary transgression; intrusion; wandering