Wandering and Dementia

Dr. Sharafsaleh


In this post, I will review the reasons why a person with dementia wanders and strategies to keep your loved one safe. The Alzheimer's Association estimates that 6 out of 10 people with dementia will wander. Wandering can happen at any stage of the disease; consider reading my blog post on stages of dementia. Wandering can be extremely dangerous due to risk of injury or death. One study found that most patients found dead after wandering were only within one mile of their home.


Why do people with Dementia Wander?


We are not exactly sure why people with dementia wander, but some reasons could include:

  1. Searching for something, a loved one, sometimes even a deceased loved one like a spouse.

  2. Fear or feeling stressed because they do not recognize where they are.

  3. Looking for a place that they remember, like their home (even if they are at home)

  4. Being Restless, agitated, or bored.

  5. Responding to an external stimulus, such as something they see or hear

  6. They have lost the ability to follow instructions. A loved one may ask them to wait someplace, and they may not remember the instruction.

  7. Having a need, such as looking for food or a bathroom.

  8. Following old routines such as wanting to go to work or run errands.

Is your loved one at risk for wandering?


Could your loved one be at risk for wandering? For example, is your loved one with dementia making statements like "I need to get to work, I have to go shopping, this isn't my house"? If so they may be at risk. Your loved one may be at risk if they do not remember coming back into the house after going outside. Or no longer remembering the task they are involved with or forgetting what they are doing in the middle of an activity.


Ways to prevent wandering


First, you should always make sure that your loved one with dementia has adequate supervision. I often advise caregivers to start monitoring patients more closely and have 24-hour care when wandering behavior begins. Consider an ID bracelet in case wandering does occur, or sewing identification into their clothing. Asking neighbors and local businesses to contact you if they see your loved one alone without you.


Create a safe environment

1. Install door and window locks

  • Add childproof doorknob covers that make it difficult to open doors.

  • Try installing a lock so that your loved one does not see or has difficulty reaching it.

2. Install alarms

  • Door and window alarms to alert you if doors have been opened

  • Pressure-sensitive alarm mats next to a loved one's bed can alert you if they get out of bed at night.

3. Secure car keys in a safe place and out of sight.

  • Never leave a loved one who wanders alone in a car.

4. Consider a GPS location tracker.


5. Camouflage doors that lead to the outside

  • Try using a curtain rod above the door and hanging a dark curtain, maybe a decorative shower curtain that looks like a picture, or mural, a bookshelf.

  • Place a small black carpet in front of the door. Because of visuospatial changes that people with dementia experience, they may think there is a hole in the ground and avoid the area.

  • Try putting a prominent "STOP" sign on the door; sometimes, patients with dementia will not open a door with a large sign on it.

  • Place pictures on doors to show what an entryway is. For example, place a picture of a bathroom or bedroom in front of those rooms. Sometimes people with dementia get lost in their own homes; reorienting them this way can prevent walking out of the house.

Address behaviors

What are some of the reasons that your loved one is wandering? How is your loved one feeling, are they restless, is there a pattern to the wandering? For example, does your loved one tend to wander more in the evening, or are bored or hungry?

1. Reassure your loved one, you may need to tell a lie.

  • If your loved one is looking for a deceased spouse, and cannot remember that their spouse passed away, tell them that they will be home soon. Telling a person that their loved one has died, knowing that they will likely forget, can only cause more restlessness and harm. Imagine the first time you learn of a person's death; how tragic is that news? But after a while, the news is no longer as sad to hear. People suffering from dementia may experience the same trauma because every time they hear the news can be the first time.

2. Address restlessness and boredom

  • Go on a walk with your loved ones and make sure they are getting plenty of exercise.

  • Keep your loved one busy and distract the:

  1. A baby doll or an animated pet can help calm someone upset, serve as an attention-getter, provide social interaction, regenerate warm, nurturing feelings.

  2. Create a busy box- for example, if your loved one played golf, fill a shoebox with pictures, golf balls, anything related to golf that your loved one can go through.

  3. Make a rummage drawer. Fill a kitchen drawer with odds and ends that are safe to go through (think of your kitchen junk drawer); keep this drawer slightly open so that as your loved one passes, it may catch their attention. It may help to keep them busy and forget about wanting to leave the house.

3. Ensure your loved one has adequate sleep and a daily routine.

  • Make sure mealtimes are set, ensure your loved one has adequate fluids and access to food.

  • Avoid daily naps and try to keep bedtime consistent. Naps can cause more wandering and agitation in the evening. You may need to help with a natural sleep aid. Ask your loved one's doctor if a small dose of Melatonin may be appropriate.

Conclusion

I hope you found this post helpful. If your loved one wanders off, contact the police immediately, many states have a silver alert for missing older adults. Also, as mentioned, ensure neighbors and local business owners are aware and able to contact you if they find your loved one wandering. People are less likely to get help when they see an adult wandering but will do so if they know the situation. You don't have to give details; you can just ask them to call you if they see your loved one walking around.


Consider reading other blog posts on dementia from GeriAcademy including, Could This Be Dementia, Types of Dementia, Stages of Dementia, A Memory Clinic Evaluation, Medications to Treat Dementia, and Tips to Better Communicate With a Loved One Who Has Dementia.