How can hospitals and care homes protect less able-bodied individuals from doorways?

Managers of healthcare buildings, hospitals, and care homes need to look deeper into how to protect and aid vulnerable and less able-bodied groups around doorways, says Simon Osborne, Commercial Leader of Allegion in UK and Ireland.

However, for the less able-bodied people, such as the elderly, young, injured or disabled, a door can represent a number of problems. It can be an obstacle approached with trepidation, a cause of anxiety and it may have an impact on one’s dignity.It would be fair to say that able-bodied people probably wouldn’t think twice about opening a door. It would quite simply be a natural choice of push or pull and pass through.

In some cases, a difficult door can lead to unfortunate loss of life. One tragic incident occurred in October of 2011 when a 73-year-old pensioner was trapped in revolving doors at South Tyneside District Hospital. The man fell and fractured his hip, later passing away at the hospital.

A door is also expected to offer a safe exit for building occupants. For those of sound mind, again this is not a problem – they know where they are going and how to return safely. However, for the groups who are mentally vulnerable, doors leading out can be dangerous and even life-threatening.

If we look at dementia as an example, which one million people in the UK are predicted to live with by 2025, the Alzheimer’s Society says that a main side effect is wandering. This means a person with dementia may feel the need to walk about for a variety of reasons, whether it is to relieve boredom or stress, respond to anxiety or if they are feeling lost in new environments.

For those suffering from dementia and who live or are based near main roads, we can start to see how the doorway becomes vital to that person’s safety.

For facilities managers and building owners of healthcare-related buildings, our advice would be to look through the eyes of these groups, see how they use doors and interact with their furniture in order to better serve their needs and protect them from unwanted harm.

Adjust door closers to suit your occupants

One of the common problems we see within buildings is that the force of a door closer is not considered for the occupants within.

In hospitals, there are a variety of people who may not be able to pass through a doorway before the door closes on them. This can prove difficult and dangerous for elderly, children, disabled or people who may be injured or have lesser upper body strength.

For these situations, using the right door closer adjusted to the right strength for the weight and size of a door is crucial. Not only will the door close at a speed optimum for users to pass through safely, it will also make the door easier to operate itself, requiring less strength and force from users.

Doors should also be tested in different air pressure scenarios, as during the winter when more doors and windows are likely to be kept shut to lock heat in. This can mean that doors become more difficult to open and require more force, which some people may not have.

Monitor doors and their activities using technology

One of the major continuing developments in the door hardware industry is electromechanical convergence, where we are merging mechanical hardware with electronics and digital systems.

The major advantage of doing so is the ability to monitor doors and their usage, keeping an audit trail and activity log for future refinement.

Doors can now be controlled and monitored via apps or central control systems, while latchbolt monitors can inform whether a door is closed fully or not.

One such event where monitored doors in a hospital could potentially have made a difference was in 2009. A 53-year-old patient, who was potentially suffering from mental health problems, managed to wander into an empty outpatients ward through staff doors at Colchester General Hospital. The patient was then unable to make his way back out due to a set of locked doors in the department. Tragically, the patient passed away in the night due to chronic obstructive pulmonary disease.

Ease of use and convenience

Consider how easy it is for patients and residents to use the doors and door furniture in your building, and the convenience for your own staff and resources.

For patients who find it difficult to operate doors and require assistance, it can become a question of dignity if each and every time they need to open a door they need to ask for help. On the flip side, it can put a strain on your staff and resources if they need to attend to lots of these situations.

Modern door hardware can now make it easy to mitigate these scenarios. Electromagnetic hold open closers can now hold open doors, but close automatically in the event of a fire by being linked to fire alarm systems.

While electronics can help door operation, there should be care and assessment for the users before going ahead with installation. One stark revelation made in the 2016 report by Alzheimer’s Society, ‘Fix Dementia Care, Hospitals’, revealed that in a poll of more than 570 carers, families and friends of people with dementia, 90 percent said that they felt the person with dementia became more confused while in a hospital.

We can only hazard a guess as to whether doors contributed to that confusion by being unfamiliar in design or operation.

Attention should also be given to the door hardware’s ease of operation. Arthritis is commonly prevalent in the elderly, meaning gripping traditional door handles and turning them could be a difficult and painful exercise. A universally understood exit mechanism that can overcome these challenges is the age-old panic bar.

Mechanical panic bars are installed to comply with European standards EN 1125 for panic applications or EN 179 for emergency applications to aid exit from a building.  However, traditionally installing a panic bar could mean that security and functionality is compromised. This is where the door hardware industry has been developing most, and products have now been introduced that can serve all these requirements.  Innovations like the Briton 571 EL electromechanical touch bar device can be integrated with access control systems.

While it is a normal panic bar from the inside, the Briton 571 EL uses an electric motor to operate the latch from the exterior, meaning you don’t have to compromise the security or access control aspect you may need for the entrance point. The push action also gives it a much easier operation for groups like children, elderly and disabled.

Never rest on your laurels

Many who pass through healthcare buildings year in and year out will not be challenged by the doorways or find them difficult to navigate.

However, it is the groups that do have difficulties that we need to give due consideration to, so that we don’t let them down at crucial times of their lives.

In the door hardware industry, we challenge ourselves every day to develop products that can better serve the needs of building occupants, whether it is for the majority or minority. We urge everyone within the chain of facilities and building management to do the same – and never rest on your laurels of keeping people safe and secure.

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