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Preventing Wandering in Persons with Alzheimer’s and Dementia

Last Updated: October 04, 2019

 

 Dad was watching TV while I made us lunch. I couldn’t see him, and I never heard the front door open. I brought his sandwich into the living room, where the TV was on but his favorite chair was empty. The dread that came over me was like diving into icy water. He’d wandered away.

 

Defining Wandering

One of the scarier symptoms of Alzheimer’s disease and related dementias is wandering, when someone will forget how to get to a certain place, or where they just came from, and become lost, confused, and possibly frightened. Caregivers can find this behavior extremely distressing, because a loved one will disappear and get lost, even in populated areas, and have no means of getting home. According to the Alzheimer’s Association, 60 percent of people with Alzheimer’s will wander away and become lost at some point.

Why would someone wander? Reasons include:
– Boredom
– Excess energy
– Trying to walk off discomfort
– Trying to find something
– Confusion, like believing incorrectly that there’s somewhere important to be
– Sundowning (click here)

 

 

Understanding Why Wandering Happens

Alzheimer’s disease and other dementias kill brain cells, slowly destroying a person’s memory. Immediate recall, or the most recent memories, are the first to go. This means the last thing you were doing is easiest to forget, which makes it easy to stand and start moving with the intention of doing something, and then forget your intention. Even people in the earliest stages of dementia can be prone to wandering.

Someone with dementia is easily disoriented, and crowded or unfamiliar settings can cause confusion and a strong desire to get away. As soon as your loved one starts walking, though, it’s possible to forget what just happened and become suddenly lost. The urge to go home can be strong, even for someone who is already home!

This problem, fortunately, can be managed by mindful caregiving. What follows are tips and tools for how to keep your loved one from wandering away.

 

 You want to find your wandering loved one as fast as possible. The survival rate for people who wander depends on how long it takes to find them. Ninety-three percent of people lost for 12 hours survive (meaning one out of 14 do not); only 12 percent of people lost for 72 hours survive.

 

Solutions to Prevent Wandering

Imagine the sensation of suddenly realizing you’ve lost your loved one. This is what it’s like to be caregiver to someone who wanders. The way you counteract it is by holding to a routine, which establishes normalcy, and planning. If you understand what wandering is, and the steps toward preventing it, you can drastically lower the potential for your loved one to wander, and you can have a plan of action if they do.

 

Behavioral Solutions

Check the Basics
Wandering may be caused by some essential need, like having to go to the bathroom, or being thirsty or hungry. Keeping your loved one comfortable can make a big difference.

See the Doc
Wandering may be caused by side-effects from medications, or delusions and hallucinations that come with dementia. See the doctor to rule these causes out, or for help addressing them.

Study Behavior
If your loved one wanders, try to understand when and why. Look for patterns, and adjust accordingly. For example, if your loved one wanders because of restlessness, try going on more walks together. If it happens in the afternoon, fill that time with an activity.

Mind Surroundings
Know your neighborhood, and where your loved one might wander to. Identify dangerous areas like stairwells, construction sites, bodies of water, and busy streets.

Know the Spots
Keep a list of familiar places your loved one might seek out, including church, favorite restaurants, friends’ homes, and former jobs.

Community Help
Tell neighbors and local police that your loved one tends to wander, and ask they notify you immediately if they see your loved one out alone.

Updated Picture
Keep a recent photo of your loved one, shot from about medium distance, to show authorities and others if necessary.

For the Dogs
Keep an article of your loved one’s clothes, unwashed, in a plastic bag, for use by police dogs to know the scent in the event of becoming so lost that dogs are necessary.

Fill the Time
Your loved one may wander at particular times of day. If you notice this, then try to fill those same times with activities like watching a favorite show or listening to music.

Smart Accessories
Have your loved one wear some sort of dementia identification at all times. ID jewelry (bracelets or necklaces) are best, because something like a card is easily lost. On the ID, include your loved one’s name, address, your phone number, and important medical information. You could also sew identification into clothing. (For more high-tech solutions, like GPS monitoring watches, see below.)

Don’t Wait
If you can’t find your loved one after 15 minutes, call 911. Tell police that a person with dementia is lost, and follow their instructions. First responders are trained for this situation.

High-Tech Solutions

MedicAlert + Safe Return Program
The MedicAlert and Alzheimer’s Association Safe Return program is an emergency response service available nationwide. If a loved one with dementia wanders and can’t be found, caregivers call an 800 emergency response number, available 24/7. A photo of the missing person and any critical information is given to emergency responders, and if anyone else finds your loved one they need only call the number on the ID jewelry and MedicAlert + Safe Return will contact the caregiver.

GPS Tracking
Global Position System tracking devices can quickly locate someone with dementia who has wandered. Tiny GPS monitors fit in jewelry, watches, shoe insoles (for instance GPS Smartsoles) or attached to clothing. The AngelSense GPS device attaches to clothing or can be worn as a belt, and allows caregivers to monitor their loved ones from an app. If a loved one wanders into an “unknown location” an alert is sent to the caregiver. AngelSense also includes an alarm to help locate a wandering person, and the capability to call that person and speak through the device. Other options are smartphone GPS apps like Senior Safety App, though these are only useful if your loved one carries a smartphone.

Project Lifesaver
“At risk” people, including those with dementia, wear a device that transmits a frequency signal. The transmitter is connected to a band, and the device (about the size of a wristwatch) is worn on the wrist or ankle. When a loved one wanders off, Project Lifesaver is notified, and specially trained emergency personnel find the individual via the frequency.

Alarm Devices
Alzheimer’s door alarms use sensors that sound an alarm if certain doors are opened. The devices can also be used on windows and cabinet doors. There are also bed alarms that beep and alert caregivers if a person with dementia is getting out of bed or a chair. In addition, there are floor mats with alarms that are triggered when a person walks on them.

Medical Alert Systems
Medical alert systems, or Personal Emergency Response Systems (PERS), are commonly thought of as devices used in the even of a fall, but they also track movements in the home and include GPS tracking in case of wandering. For more information about PERS, click here.

 

Low-Tech Solutions

Lock It Up
Consider installing locks on external doors that are flush to the doorframe or are near its top or bottom, out of sight for your loved one. This might prevent escape in an emergency, so consider the benefits and risks of locks (and consider the high-tech door alarms explained above).

Fake Knobs
Attach door knob covers to doors that access the outdoors. These will turn without actually opening the door.

Signs Up
Place signs on important doors that say things like STOP and DO NOT ENTER.

Ring Ring
If you can’t afford door alarms, something as simple as a bell hung high can help you know if your loved one is wandering outside.

Light Up
Regular night lights can help someone who has a tendency to wander at night. Night lights reduce disorientation and help prevent falls and accidents. Consider motion-sensor lights.

Wandering Zone
Consider providing a safe location for your loved one to wander, like a fenced-in yard.

Notify Authorities
Keep recent photos of your loved one available for the police or friends and family who would help you search for your loved one in the event of wandering and becoming lost.

Memory Care Units

When dementia advances into the late stages of the disease, caregiving may become unfeasible for you. The simple fact of Alzheimer’s and related dementias is that keeping your loved one safe can become too difficult. Fortunately, there are professionals trained to provide specialized healthcare in long-term living environments called memory care units, special care units (SCUs), Alzheimer’s care units, or dementia care facilities. Supervision is round-the-clock, with assistance for daily living activities, and activities that promote body and brain health. These facilities are specially built to account for wandering; residents who go for a walk, for instance, are led through circular hallways rather than encounting a stopping point at a wall that might cause aggravation. SCUs may be stand-alone residences or a wing of an assisted living facility or nursing home. Learn more about choosing a dementia care residence.