In a high-quality dementia care facility, confused residents who are at risk of unsafe wandering are skillfully redirected away from exit doors by staff members who are trained to provide them with the illusion of freedom while still keeping them in the safety of the care home. A propaganda-addled populace wandering around trying to find an escape from its oppressors is redirected in very much the same way.
If you’ve ever visited a loved one in a locked dementia care facility, especially near sunset, you know how agitated the people who live there can become. The impulse to wander and pace is very common, and depending on where they’re at cognitively they’ll often demand to leave the facility at once so they can go “home”.
When this happens, unskillful staff members will take an openly authoritarian position and tell the resident that they cannot leave and that the facility is their home now. This confrontational approach invariably leads to agitation on the part of the confused resident, because in their mind they really do live somewhere else and are being told they need to remain locked in a strange place that they have no memory of. This can quickly lead to a catastrophic response that is unpleasant for everyone, especially the resident in question.
A more skillful staff member will employ a very different strategy. Rather than engaging in futile attempts to persuade someone with severe dementia that they must stay and that their perception of reality is wrong, they will simply say “Ah yes, right away Mister Smith! Let’s go get you ready to leave.” They’ll take him by the hand, ask him if he wants dinner before he leaves, get him talking about his time in the army, distracting him from the thought of leaving and letting the memory loss do the work for them. In a few minutes Mister Smith is happily chowing down on mechanical soft meat and potatoes without a care in the world.
The fancier facilities won’t even have locked doors that are immediately noticeable, with (as weather and daylight permit) the doors left unlocked to a large, enclosed garden area full of circular walkways which eventually guide a wandering resident back indoors. The actual exit point of the facility is through a building on the far end of this large yard with a staff member at the front desk who can redirect any resident who happens to meander their way through the winding paths.