The Doorway Effect: Why Moving Can Be Especially Challenging for Those with Dementia

Q. The other day, I was watching TV when a commercial came on and I went to change channels, but the remote was nowhere to be found. I called my wife in the other room, and she told me that she thought she saw the remote in the kitchen.

I headed through the arch opening into the kitchen, but then I couldn’t remember why I came to the kitchen. After trying to recall what it was that brought me into the kitchen, I gave up and headed back to the TV. Of course, at the next commercial, I remembered why I had wanted to go to the kitchen.

This type of thing is happening more and more. Do you know if this is a normal sign of aging, or whether this is potentially a sign of dementia? I am only 65, but I’m worried that this may be an early sign of dementia, especially because both of my parents had Alzheimer’s in their later years, and my sister is in the early stages. In fact, my sister’s family is considering moving to be closer to us, which will hopefully be good because we can all have a built-in support group.  Thanks for any help or guidance you can provide.

A. Forgetting what we should do as soon as we enter a room happens to most of us at some point, and it can be incredibly frustrating. Equally frustrating is the fact that this psychological phenomenon occurs in people of all ages, including people with dementia. There is actually a name for this phenomenon. It’s called the “Doorway Effect,” first shown by psychologists Gabriel Radvansky and David E. Copeland, who performed the first studies in 2006, showing that a person’s memory declines more when passing through a doorway or moving from one location to another than if they had remained in the same place. Originally, they called this psychological event the “location updating effect,” but it later became known as the “doorway effect.”

What is the Doorway Effect?

The Doorway Effect happens when we enter a room and have absolutely no idea what we are doing there.

To study the Doorway Effect, Drs. Radvansky and Copeland organized three experiments in real and virtual environments and the subjects (all of whom were college students) performed memory tasks while going through doorways.

In the first experiment, subjects used a virtual environment and moved from one room to another, selecting one object from a table and switching it with another object from another table, and they then did the same thing, but in the same room – without passing through a doorway. The study found that subjects forgot more after walking through a doorway than after walking the same distance without the doorway.

The second experiment took place in a real environment and the results of this experiment were totally consistent with the results of the virtual experiment.

The final experiment demonstrated that doorways actually served as “event boundaries” and are linked with the ability to remember. The results of these and many more recent studies show that the act of passing through a doorway apparently serves as a trigger for the brain to file away memories, making it more difficult for the brain to retrieve these memories after passing through a doorway.

Why This Might Happen

According to the research, human memories are episodic, which means that they are segmented and strongly depend on the person who makes them. For example, the way one person remembers something will most likely differ from the way another person remembers exactly the same thing.

In addition, if memories are episodic, walking through a doorway is thought to reset memory to make room for the emergence of a new episode.

The good news is that experiencing such episodes after entering another room does not tell you anything about your memory, intelligence, or cognitive abilities. So when you enter a room and suddenly forget why you are there, you should not think that Alzheimer’s disease is creeping up on you! But what if you already have Alzheimer’s or another form of dementia?

How Walking Through Doors Might Affect People with Dementia

In an article published in the Quarterly Journal of Experimental Psychology, Dr. Radvansky explained what was described above saying, “(e)ntering or exiting through a doorway serves as an ‘event boundary’ in the mind, which separates episodes of activity and files them away. Recalling the decision or activity that was made in a different room is difficult because it has been compartmentalized.”

Katya De Luisa, author of Journey Through the Infinite Mind: The Science and Spirituality of Dementia, was the subject of a recent series on my blog. Read Part 1 and Part 2. She also discusses the Doorway Effect, which she refers to as Event Boundary Effect, saying, “(b)asically, passing through a doorway separates one set of thoughts and memories from the next. This might also apply to changing environments.” When it comes to moving with dementia, she explains that a “(p)erson with dementia experiences confusion moving from one place to another, as well, whether moving through the rooms in their home, traveling to a grocery store, or taking a trip. When caring for a person with dementia at home, take a momentary pause before entering a different room and ask the person to look around. This might help reduce their anxiety and confusion by bringing their conscious awareness to the new environment. Actually, this is something we could all practice. It’s just a moment to bring ourselves back to the present. It’s like a reboot for our brain.”

Moving with Early-Stage Dementia

People with early-stage dementia often move, perhaps from a multilevel home to a single-level home or from a private home to a retirement community. These moves are often a beneficial way of addressing what are likely to be important accessibility issues in the future. Traveling and tourism may also be beneficial for people with early-stage dementia. Please see today’s Critter Corner article for further information on this topic.

Moving Someone with Moderate to Severe Dementia

Because of the Doorway Effect, moving someone who has moderate- to late-stage dementia can cause more rapid cognitive decline. But, if that person is living at home and needs to move to a nursing home, for instance, for safety or more care than can be provided at home, leaving the individual in an environment where they are no longer safe or comfortable can cause an equally swift decline. Once your loved one settles into a new home or facility, the person should stabilize again, but there is no way of knowing for sure how the person will respond to a new environment ahead of time. Luckily, staff in nursing homes and assisted living memory care facilities are trained to watch for certain cognitive issues and understand specific situations that often arise after a move. They also know how to make someone with dementia feel comfortable and safe.

Plan in Advance for Your Loved One with Dementia

The Farr Law Firm is dedicated to easing the financial and emotional burden on those suffering from dementia and their loved ones. We help protect your family’s hard-earned assets while maintaining your loved one’s comfort, dignity, and quality of life by ensuring eligibility for critical government benefits such as Medicaid and Veterans Aid and Attendance. If you have a loved one who has been diagnosed with Alzheimer’s or another form of dementia, please call the Farr Law Firm as soon as possible to make an appointment for a no-cost initial consultation:

Medicaid Planning Fairfax: 703-691-1888

Medicaid Planning Fredericksburg: 540-479-1435

Medicaid Planning Rockville: 301-519-8041

Medicaid Planning DC: 202-587-2797

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About Evan H Farr, CELA, CAP

Evan H. Farr is a 4-time Best-Selling author in the field of Elder Law and Estate Planning. In addition to being one of approximately 500 Certified Elder Law Attorneys in the Country, Evan is one of approximately 100 members of the Council of Advanced Practitioners of the National Academy of Elder Law Attorneys and is a Charter Member of the Academy of Special Needs Planners.

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