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Alzheimer’s and dementia: The wandering problem

Why do people with Alzheimer’s and dementia wander?

Alzheimer’s and dementia: The wandering problem

Six in 10 people with Alzheimer’s or another form of dementia will wander away from their care settings, according to the Alzheimer’s Association. Disorientation begins in the early stages of dementia, causing people to get lost. They may not remember their name or address and can easily become disoriented in their own neighborhood. As the disease progress, people with Alzheimer’s or dementia may set off on a journey but be too cognitively impaired to get to their destination, much less find their way home, which presents a substantial safety risk for themselves and motorists they may encounter.

Caregivers may frequently find themselves calling the police to track down a missing loved one, and thankfully, law enforcement officials are for the most part knowledgeable about dementia and handle such situations with sensitivity.

Anyone with a memory impairment is at risk of wandering. This might occur for several reasons, including:

  • Confusion. People with Alzheimer’s or dementia might become confused about where they are, even if they are in their own house or their own senior community or nursing home. This confusion can peak at nighttime due to sundown syndrome, a symptom of Alzheimer’s and dementia.
  • Stress or fear. People with Alzheimer’s or dementia might feel the need to wander off as a reaction to a loud and disrupting noise, a stimulating environment or a situation that seems confusing or stressful. This might even include seeing news on TV of a fire or a violent scene in a movie which they think is happening in their immediate environment.
  • Old habits. People with Alzheimer’s or dementia might think they are “trying to go home,” even when they are at their current home already. Sometimes, they might think they are late for work and need to get there as soon as possible. 
  • Basic needs. People with Alzheimer’s or dementia might simply think the back door is the bathroom door, and can easily become sidetracked and disoriented looking for familiar things and accidentally wander away.
  • Boredom. People with dementia might feel the itch to wander away purposefully due to basic boredom with their current activities.

What caregivers can do to prevent wandering

According to the Alzheimer’s Association, here are various strategies to help caregivers prevent loved ones from wandering:

  • Carry out daily activities. Providing a person with Alzheimer’s or dementia with a structured routine is key to establishing stability and preventing disorientation that often precipitates wandering.
  • Keep track of times your loved one is most likely to wander. If your loved one is most likely to wander off right after dinner, plan activities for that time, like exercise or an enjoyable hobby. This can help prevent anxiety, agitation and stress.
  • Reassure the person if they become stressed, confused, or disoriented. If your loved one expresses the need to follow old routines (like “going home” or “going to work,” avoid blatantly correcting the problem and instead communicate in a validating way. The Alzheimer’s Association suggests saying something such as, “We are staying here tonight. We are safe and I’ll be with you. We can go home in the morning after a good night’s rest.”
  • Ensure all basic needs are met. Keeping your loved one’s basic needs satisfied (like not feeling hungry or not needing to go to the bathroom) can help prevent them wandering off to do such activities.
  • Avoid busy, chaotic places that might trigger disorientation. Places such as  grocery stores, malls and concerts can easily cause stress and disorientation, prompting your loved one to wander to a calmer environment.
  • Hide locks out of sight, and use a device that signals when a door or window is opened. This can help prevent a loved one from leaving and can alert caregivers the moment they might potentially start to wander.
  • Always supervise. Don’t leave a loved one alone in new or unfamiliar environments.
  • Keep car safety in mind. Never lock a loved one alone in a car. Also make sure to hide car keys — a loved one might forget that they cannot drive anymore (if that’s the case). 

What should caregivers do if their loved one wanders off?

While it can be terrifying to discover that a loved one with Alzheimer’s or dementia has wandered away, there are ways to prepare and actions to take:

  • Keep a list of neighbors and their phone numbers nearby to enlist their help.
  • Have extra copies of a photo of your loved one to give to neighbors, police officers or other first responders. Keep track of what clothes he or she wears each day in case you need to describe the outfit.
  • Keep in mind that people with Alzheimer’s tend to follow the direction of their dominant hand, so know what hand they write with.
  • Consider enrolling your loved one in the Alzheimer Association’s wandering prevention program, MedicAlert/Safe Return. For $62 (plus a $35 membership renewal fee each year), your loved one will receive an identification bracelet and access to 24-hour emergency support.
  • Caregivers can also buy a GPS tracking device for their loved ones. The GPS SmartSole is a shoe insert that fits inside most shoes and allows caregivers to track their loved one from any smartphone, tablet, or computer with real-time location reports, while the iTraq is a tracking device that can be clipped onto a coat or purse to monitor the location of a loved one.