Alzheimer’s disease and other forms of dementia are associated with a greater propensity for wandering, frequently placing people in dangerous situations. In addition, there are an increasing number of possible risks associated with the prolonged period of intense cold in winter.
According to the Alzheimer’s Association, people with Alzheimer’s and other forms of dementia experience wandering as a common symptom, impacting six out of every 10 of those diagnosed. Although it is one of the most disturbing behavioral changes typical of someone with the disease, family caregivers are frequently taken aback by it.
Most people who wander because of dementia do so with intent and are trying to reach a certain destination. However, people with Alzheimer’s disease often exhibit impairments in their judgment and direction, which can cause them to wander during any stage of the disease, including the early, middle, and late stages.
Wandering can take place if the individual is still driving or if they have access to the keys to the vehicle. For example, they might get in their car and drive away, but then they would be lost and unable to find their way back.
Any person with memory problems who is physically capable of walking is in danger of wandering, regardless of whether or not they have left the facility. Wandering is a common symptom of dementia that can strike at any stage of the disease and any hour of the day. From my experience, I have found that this mostly occurs in the middle stages of dementia.
Even though they can maintain a comfortable lifestyle in their own homes, some people who are adults and have dementia nonetheless express a desire to “go home.” It’s possible that you’re wandering because you’re under a lot of pressure, in a lot of pain, feeling lost and confused, not getting enough sleep, or because you have unmet needs like being lonely, bored, or hungry, or seeking comfort and want to feel safe.
A loved one who wanders is among the most important concerns for caretakers, but it is possible to avoid wandering by putting the appropriate protections and training into place.
Continue reading as I explain what leads someone with dementia to move away from familiar settings mistakenly. I also discuss techniques to decrease wandering behavior and keep elders safe even when they do wander.
Reasons For Wandering
It might be challenging to determine why a person with dementia goes off when they are alone. Every person who lives with dementia is different; nevertheless, some reasons are universal to all cases of dementia:
1. Confusion And a Lack of Orientation
The confusion and disorientation that people with dementia, such as Alzheimer’s disease, are prone to encounter can help to explain a significant portion of the wandering behavior. For example, they could become disoriented and believe they should be somewhere else or even forget where they are.
They can become unaware of the passage of time or their location altogether. This may result in the individual continuing to walk or drive in an attempt to reorient themselves, which might lead to additional confusion rather than answers. Confusion and disorientation can also be made worse by being in an overly stimulating or unpleasant atmosphere.
2. They Have The Misconception That They Have to “Go Home”
It is not uncommon for people who have dementia to assume that they are not at home, although they may, in reality, be there. Because of this idea, they can become disoriented and wander off in pursuit of the location they consider their home.
It’s possible that the desire to remain at home or find “comfort” has a part in this behavior.
3. Behavior That is Either Repetitive or Agitated
People with dementia may have an overwhelming need to move around or engage in activities requiring them to repeat themselves frequently. Because of this, they could get the impression that they have to be somewhere else or that they have to keep walking or moving for no purpose at all.
Sometimes a person’s inability to verbally communicate a requirement or discomfort, such as pain, side effects of medicine, hunger, or the urgent need to use the restroom, might be the root cause of an urge to move. The need might be so difficult to resist that it almost compels them to go in search of it.
4. Need For Routine And Other Internal Drives
If your loved one has dementia, it may be difficult for them to remember changes in their environment or their daily routine, such as the fact that their old job is no longer available. They may also be unable to recall whether or not they’ve done routine everyday activities like eating, napping, or going to the bathroom.
However, the need to carry out routines, especially those that have been practiced for a long time, such as going to work, eating, or going to a specific location, persists. As a result, people with dementia who have had this experience may feel compelled to depart at a specific time of day or to move around more frequently.
A good example of this is if you see your loved one attempting to leave the house around the time they used to go to work in the morning. To get food or the bathroom, to look for something they’ve been thinking about, and find something they’ve seen or heard may also cause them to roam. They may also roam as a result of being bored.
5. Delusions
A delusion is known as a false belief. It is common for individuals to get disoriented and confused about what is happening around them.
Delusions is more common in those with dementia. In dementia care, the person living with dementia will believe this false belief is real. For example, the person living with dementia thinking that someone they know is trying to poison them. Those living with dementia who have never wandered before should be checked out by a medical professional if they suddenly begin exhibiting uncertainty, disorientation, and wandering symptoms.
Ways to Prevent Wandering
For those who can’t always watch their loved one, there are ways to identify the causes of wandering and create environmental changes that will help decrease the episodes of wandering.
1. Behavior Management Approach
Behavior management techniques, like the DICE approach, enable loved ones to take on the role of a “scientist” in order to better understand the causes of wandering.
As an example, might the conduct be a result of variables such as pain and suffering that they are unable to verbally express? Does their wandering coincide with when they used to go to work or go out? Are they putting up any kind of effort to keep themselves busy and productive when they’re on the job? As part of the DICE model, you’d
- D: Describe what takes place.
- I: Investigate possible reasons.
- C: Create a plan.
- E: Evaluate it.
In this and other approaches to behavior management, the focus is less on altering the person who has limited insight into their behaviors (assuming that they have dementia) and more on modifying any physiological, environmental, or medical variables.
For instance, if you see that roaming typically takes place shortly after getting up in the morning, you can speculate that the want to eat or the desire to participate in daily rituals has a role in the behavior. You may next devise a plan to involve the person with dementia in the preparation of meals, to engage in reminiscence about previous work responsibilities, or to have them participate in one or two activities that would remind them of their previous responsibilities.
After putting the strategy to the test, you would next determine whether or not there has been a reduction in wandering.
2. Establish a Routine
Routine and structure are provided by creating a daily schedule. Keeping a checklist of tasks that must be completed at a specific time and location can assist keep people from becoming lost. Making a list even more meaningful should contain items that the person personally appreciates or has previously found meaningful.
There are a variety of different sensory reminders that may be beneficial in reminding the person that this timetable does exist. Some examples of these include alarms, lighting, or writing a timetable on a whiteboard or a daily planner in large font.
3. Plan Your Activities to Coincide With Periods of Restlessness or Agitation
People with dementia who are agitated, restless, or bored are more prone to get lost. The likelihood of wandering can be lessened if you can identify these periods and plan activities around them, perhaps using the behaviour management or DICE strategy mentioned above. It is also possible to use items such as music or art as a sensory distraction or to soothe to help you relax.
4. Locks And Alarms on Windows And Doors
Whenever the person with dementia wanders, we need to think about home safety recommendations to put into place. An Occupational Therapist can help with this! Ask your doctor about a referral.
The external door should have a deadbolt lock installed. Install it higher or lower than usual so that it isn’t in your line of vision. This is to ensure that a person with dementia is not left alone in their home in the event of a crisis. Also, install alarms on all windows and doors of their room and the living room (alarms that will notify you, but not the person with dementia).
Everybody in the house should be made aware of the importance of fire safety. To ensure the safety of people with cognitive disabilities, ensure that all locks are easily reachable. When there is an emergency, the doors should be able to be opened in a matter of seconds. Check out my post here on 5 door locks.
5. Avoid Crowded Places
Even for those with Alzheimer’s, navigating crowded places like shopping malls can be difficult for those with dementia. Excessively stimulating environments can result in wandering and other behavioral problems. Visiting these spots at off-peak times will help to keep the crowds at bay.
6. Make Use of Visual Cues or Distractions
You may have noticed that your loved one has trouble remembering environmental and life events shifts due to dementia. Dementia affects the ability to recall details about these changes, but it has less of an impact on the ability to recall previously practiced visual or procedural concepts.
Put a stop sign at your front entrance, for example, to let your loved one know that they need to stop or leave the doorway. A door can also be painted to fit the room’s colour scheme or represent something special to the person, like a flower, sport, or place.
7. GPS Devices
If your loved one is always wearing a GPS tracking device, you may feel more secure. Most of these wearable GPS devices like a a bracelet or watch have a build in GPS locator incase they wander out of the house.
Investing in a GPS or similar wearable monitoring equipment that allows you to keep track of a person’s whereabouts and locate the person living with dementia. If your elderly loved one won’t wear a wearable tracker, you can buy shoes, bracelets, necklaces, and anklets from vendor websites that contain these devices. Here is a post I wrote on 5 best GPS trackers to check out!
Decisions on electronic tracking devices should be made with the permission of those with dementia wherever possible.
8. Register With a Safe Return Program
For peace of mind in case they do wander away from home, enrol them in a service such as the Alzheimer’s Association’s Medic Alert Safe Return. This option does not provide GPS tracking, but provides the personal ID number and other relevant information.
When your elderly loved one is enrolled, they will receive a wearable ID that can be used to recognize your loved one and call you. Calling a toll-free hotline is another option if you need to report your elderly loved one missing.
Silver Alert or similar programs to help families identify missing elderly individuals may also be available through local law enforcement authorities.
9. Involve The Neighborhood
Have a neighbour call you if they spot your aging loved one wandering around the neighbourhood and introduce them to your loved one. Wear an ID bracelet or pendant or sew identity tags onto clothing to ensure your loved one is always identified.
10. Camouflage The Doors
Another way to keep your elderly loved one from opening outside doors is to disguise them.
People with dementia often have difficulty finding or opening doors that have been covered up or marked with prominent signs.
For example, if you want a curtain hanging above the entrance, you may attach a curtain rod. Make sure your senior does not notice your opening and closing the curtain.
Large placards reading “Stop” or “No Entry” could also be placed on the door to deter people from entering. It’s not uncommon for someone with dementia who exhibits such symptoms to refuse to open a door at all.
11. Exercise
Anxiety and depression appear to be reduced by physical activity, as do agitation and disorientation. Additionally, it may help you sleep better and longer. Behavioural and psychological symptoms of dementia may be reduced by exercising for at least half an hour, many times a week, although the exact type, duration, and frequency of the exercise remain unknown (including wandering).
Summary
People with dementia, including Alzheimer’s, may begin to wander at some point, but this may not endure indefinitely. I typically see wandering in the middle stages of dementia. Managing this behavior can be difficult because there is no one-size-fits-all pattern. The most important objective is to keep the person who is at risk of wandering safe.
A safe and monitored area in the home or yard should be provided for seniors to walk or pace rather than keeping them from roaming. Walking together throughout the day may also help prevent dementia patients from attempting to elope in the evening when many suffer from symptoms of sundowner’s syndrome.
In addition to aiding in mobility, this will also assist seniors in burning off surplus energy and feeling more in control of their motions.
Alzheimer’s patients often show no signs of wandering before they actually start. What course of action would you take if someone you cared about wandered away from home despite your best efforts to keep them safe? You should also consider using the anti-wandering goods and tactics mentioned above, including a recent photo and a comprehensive physical profile of your care recipient in their emergency medical file, as well as any relevant information regarding their vehicle.
References
- https://dailycaring.com/8-ways-to-prevent-alzheimers-wandering/
- https://www.verywellhealth.com/prevent-wandering-dementia-causes-97639
- https://www.hebrewseniorlife.org/blog/why-do-people-dementia-wander
- https://www.rightathome.net/blog/alzheimers-understanding-preventing-wandering-behavior
- https://www.seniorliving.org/health/wandering/
- https://www.brightfocus.org/alzheimers/article/how-prevent-wandering-alzheimers-patients
