Wandering and looking for a way out is a common tendency for elderly adult mental health patients with dementia, where a patient sees a door, and wants to pass through it by instinct. Elderly patients with cognitive impairments who are admitted to a hospital mental health ward often exhibit behavioural disturbances. According to research, it’s hard to say what in particular might cause a patient to wander while in hospital, though for most patients who spend a prolonged amount of time in hospital, the motivation is often a change of scenery.

Drawing from her previous experience in a Long-Term Care home, Nicole Rodney-Hare had an idea. As the Clinical Manager of Geriatric Psychiatry at #Trillium Health Partners, Nicole knew that installing attractive, professionally drawn murals designed to disguise the exits on the hospital’s Seniors’ Mental Health Unit would remove the stress of exit-seeking for patients, and would instead promote a calming environment with less anxiety, less stress, and ultimately, a better #patient experience. Local painter Susanna Lamy was hired to paint the murals.

“Knowing how culturally diverse the Mississauga community is, I wanted to pick a theme that everyone could relate to. I decided on painting typically Canadian scenery. I chose themes like the Muskoka cottage patio, and the East Coast ocean view, especially because I know how soothing watching water can be. I also felt many people could relate to gardening and nature, and by painting a garden mural, I wanted to bring that back to them so they could imagine they were sitting in their garden. I tried to incorporate physical surroundings in such a way that the murals appeared believable, giving patients the sense that the scenery on the painting was truly a part of their surroundings,” Lamy said. “It’s great to do a mural on a restaurant wall, but it doesn’t have the same impact – here, I could see I was creating something that really impacts someone’s health, recovery and overall patient experience,” Lamy added.

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“Since the murals went up, we no longer have patients standing at the exit doors, waiting for them to open. The area has become more of a conversation rather than a place of high risk behavior,” said Rene Turner, Manager, Seniors’ Mental Health Services, Trillium Health Partners. “The murals have helped us to create a warm, home-like, low-stress environment. This has helped to reduce agitation and exit seeking behaviours, and created a space which promotes wellness and a positive patient experience,” Turner said.

Joan Heck visits her husband at Trillium Health Partners’ Mississauga Hospital every day, where he is currently staying while he waits for a Long-Term Care placement. “I always see patients near the murals, enjoying them, pointing things out. Once, I even saw a lady stop at the garden mural and try to pick a flower. People really connect to the visual experience – they think they are looking at a real place. The exit doors are hidden so well, patients no longer stand there. Without the paintings, my husband would definitely be standing at the doors every day. They make a big difference,” Joan says.

Since the murals were installed within Trillium Health Partners’ Mississauga Hospital Seniors’ Mental Health Unit in June of 2015, there has not been a code white on the unit, and exit seeking has been reduced from daily to ‎almost none. Trillium Health Partners is currently expanding the murals project to other areas of the hospital, including its Mental Health Unit and Intensive Care Unit.