Causes Of Dementia Wandering At Night
As dementia progresses, people often spend more time sleeping during the day and awake or restless at night. Sleep itself is often a major stressor for caregivers, and when you add wandering, its really a challenge, says Denny. No one is happy or able to provide their best care when theyre waking up multiple times a night especially when theyre fearful that their loved one getting up will wander. Some causes of dementia wandering at night may include:
Physical discomfort. Someone may wake because of a physical need, like hunger, thirst, or a bathroom trip. While searching for a solution, they may become disoriented and leave the room.
Being too hot or cold. Alzheimers patients bodies may regulate temperature differently, according to a study in the American Journal of Geriatric Psychiatry. This is because the frontal and temporal lobes the parts of the brain where people process temperature and pain sensations have begun to deteriorate. A natural drop in body temperature also occurs with age. Someone could leave bed to find blankets and become lost, or be unable to fall asleep due to extreme heat.
Perceived obligations. Someone may wake up and think they need to get to work or complete some other imagined duty, says Denny. When they try to fulfill the task, they may leave the bed and become disoriented.
Tip #: Prioritize Diet Exercise And Sleep
Mulder pointed out that a healthy diet and exercise can help your loved ones internal clock stay accurate. Sleep quality and wandering are often linked. Reducing daytime napping can help, as can eliminating caffeinated drinks. Things like a supervised walk around the block near dinnertime can help reduce nighttime agitation/restlessness.
Late night wandering can often have other basic causes, like your loved one being hungry or thirsty when they wake up. Simply leaving some water or a snack by their bed may do the trick.
Tips To Prevent Wandering In Elderly Patients
The possibility of dementia wandering can be frightening, not only for the patient but also for their family, friends, and caregivers. There are some steps that everyone can take to help keep a dementia sufferer safe.
One helpful tip for managing wandering dementia patients is to develop an emergency plan so that you are prepared in the event that a person does wander. That plan can include drafting a list of people you can call for help, having an updated photo of the person and their medical information so you can pass it over to the police, as well as getting to know the neighborhood the dementia sufferer lives in and noting dangerous areas such as construction sites, creeks, open stairwells, and tunnels. It is also a good idea to find out if the person is right- or left-handed. As it turns out, wandering normally follows the direction of the dominant hand. A plan should also include a list of places the dementia sufferer may go to, including former homes, church, restaurants, or a past work place. Many people who have relatives with dementia enroll the person in Medic Alert Alzheimers Association Safe Return program.Here are some practical ways to prevent wandering in the first place:
Develop a daily routine. Dementia sufferers are less likely to wander when they have activities planned that can distract and entertain them.
Reassure the person. Talk with the dementia sufferer frequently to make sure they feel safe and are free from anxiety.
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Strategies For Preventing Wandering
There are several strategies caregivers can try to reduce the risk of wandering.
First, try to determine the reason for wandering. Wandering may be an attempt to get something such as food, drink, security, physical activity, or something familiar or lost. The person may need to use the toilet or may feel restless.
Ask the person often what they want to find or do because those with dementia usually wander for a reason. Make frequent checks during the day to see if they have any unmet needs and try to address them before they start wandering. Offer drinks and snacks throughout the day and ask about toileting needs. The elderly often become cold even in warm environments, so see if the person wants a sweater or blanket.
Try to identify possible sources of stress that may be triggering the wandering. For example, the room may be too noisy, too cold, or too hot. The person may be upset about something that happened during the day or something that was on the TV or news. The person may be seeking safety from a hallucination, delusion, or nightmare.
Lastly, if the individual is taking medications, consult a physician about the possibility that a medication may be causing restlessness. Discuss the possibility of changing the medication regimen to decrease the risk of wandering.
Professional Help With Dementia Sleep Issues
Dementia is a disease that commonly affects an elderly adults sleep cycle. Experts still dont know precisely why dementia patients dont sleep but believe its linked to brain alterations. Other dementia sleep issues like sleep apnea or restless leg syndrome can also make it difficult for loved ones with dementia to fall asleep or stay asleep at night.
If your loved one with dementia struggles with sleep and youre wondering how to keep dementia patients in bed at night, you may want to try:
- Keeping them on a consistent schedule
- Ensuring they exercise regularly
- Creating a calming nighttime routine
Theres also overnight dementia care for family caregivers looking for professional, hands-on assistance.
Stowell Associates in Wisconsin is a premier in-home dementia care provider. We train and equip both our Care Managers and Caregivers to handle the demands of dementia care. With our 24-hour care service, your loved one will receive the best care during the day and nighttime hours. It will also provide you with peace of mind knowing your loved one is receiving the care they need.
Contact us today to talk with a Care Advisor. Theyll help you better understand all the benefits of full-time dementia care.
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Information & Reminders In A Common Place
Create a single place for any notes or reminders that can easily be accessed and read by a person with dementia. This can be a cork bulletin board or a dry erase board. Using a single location simplifies the process and provides for an organized system, preventing the need for a senior to walk around looking for information.
Memory Care Communities Combat Dementia Wandering
As cognitive decline increases, it may become unsafe for your relative with dementia to live at home especially if theyre at risk of wandering. Memory care provides housing and 24-hour care for seniors with Alzheimers and other forms of dementia. These communities offer stimulating activities and therapies to reduce the likelihood of dementia wandering, and also provide a protected environment for seniors who do wander.
Some memory care amenities to keep protect against wandering risks include:
- Specially designed memory care hallways and neighborhoods to allow unrestricted walking and pacing
- Outdoor wandering gardens for secure exploration
- Color-coded walls and signs
- Concealed doorways to reduce agitation
- Alarmed entry and exit doors to alert staff of dangerous situations
- Well-labeled rooms, furniture, and areas
- 24/7 supervision to assist with dementia wandering at night
To learn more about memory care communities near you, reach out to our local Senior Living Advisors.
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Describe What You Are Seeing
I believe the term wandering is vague and misleading. We often fall into the trap of slapping labels on things we dont fully understand or lumping a group of unrelated behaviors together, but dementia and its symptoms are unique to each person. To find a workable solution, you must try to understand your loved ones feelings and motivations during these episodes. Below is a list of questions about common wandering behaviors that can help you begin analyzing their actions.
- Trying to escape and leave the building?
- Frequently or continuously moving from place to place with no perceived direction or destination?
- Walking in a goal-oriented manner?
- Waking up in the middle of the night and acting disoriented?
- Getting lost or unintentionally leaving the premises?
- Anxiously pacing or fretfully walking?
- Having trouble locating/recognizing significant landmarks/belongings in a familiar setting?
- Following behind or shadowing another persons movements?
- Feeling paranoid or in danger?
For example, these questions may help you differentiate between whether dementia wandering at night is due to disruptions in a seniors sleep/wake cycle, scary visual hallucinations before falling asleep or disorientation after getting up to go to the bathroom. Remember, though, a person with dementia may exhibit multiple types of wandering behavior that can fluctuate in frequency and severity.
What Should You Do If A Loved One With Dementia Wanders Away
- Act immediately and dont wait to start your search.
- Can you identify what the person was wearing?
- Where was the person seen last?
- Check inside and outside the home, in neighboring areas, parks, and waterways, and in all areas the person may have wandered to before.
- If you are unable to find the person within 15 minutes,
We hope the information presented in this blog, along with tips on preventing and reducing the risks of wandering, helps you and your family.
Should you or a family member need assistance in providing care for a loved one with dementia,
Senior Helpers Orlando Team Member
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What Is The Best Way To Handle Wandering Patients
You may come to find that your loved ones wandering behaviors are merely annoying and do not pose any harm. This is a good thing because it does not generally require intervention beyond basic safety measures. Walking provides many health benefits and can be a good activity for seniors. However, if a person with dementia is walking to the point of exhaustion, losing weight, falling, getting lost or escaping into unsafe areas , then interventions are necessary.
I have found that family, paid caregivers and health care providers tend to want to control or stop troubling dementia behaviors through medications or physical restraints. However, there are no FDA-approved medications for wandering behaviors, and the medications many doctors recommend can cause sedation and contribute to falls. Additionally, the use of physical restraints can be detrimental to an elders physical and mental health, enhancing the risk of poor circulation, pressure ulcers, weakness, incontinence, increased dependence, depression, agitation, fear and isolation.
Repetitive Speech Or Actions
People with dementia will often repeat a word, statement, question, or activity over and over. While this type of behavior is usually harmless for the person with dementia, it can be annoying and stressful to caregivers. Sometimes the behavior is triggered by anxiety, boredom, fear, or environmental factors.
- Provide plenty of reassurance and comfort, both in words and in touch.
- Try distracting with a snack or activity.
- Avoid reminding them that they just asked the same question. Try ignoring the behavior or question, and instead try refocusing the person into an activity such as singing or âhelpingâ you with a chore.
- Donât discuss plans with a confused person until immediately prior to an event.
- You may want to try placing a sign on the kitchen table, such as, âDinner is at 6:30â or âLois comes home at 5:00â to remove anxiety and uncertainty about anticipated events.
- Learn to recognize certain behaviors. An agitated state or pulling at clothing, for example, could indicate a need to use the bathroom.
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Clothing And Personal Id
- Have your loved one wear bright clothing to make it easier for them to be seen from a distance and easier to spot in a crowd.
- Make sure your loved one always carry ID. Medical ID jewellry such as a pendant or bracelet is less likely to get misplaced or forgotten. Consider sewing identification into their clothing.
Sleep Issues And Alzheimers Disease
Sleeping through the night can be difficult for people with Alzheimers disease and other dementias. As dementia progresses, affected individuals spend more of their nights awake and daytime hours sleeping. Although they spend more of their time sleeping, the sleep is often light and with frequent awakenings.
Many people wake up during the night to wander. They can wake up confused, disoriented, frightened, or feeling alone. They may also suffer from delusions and/or hallucinations that disrupt sleep patterns.
Poor sleep can seriously affect those with dementia, as it can contribute to agitated behavior, delirium, decline in thinking and functioning, falls and injuries, and increased mortality.
This program will provide a general understanding of some sleep issues and offer practical tips to help improve the quality and quantity of sleep for those with dementia and their caregivers.
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Sleep Aids For Dementia Patients
Sleep inducing medications can cause negative side effects in dementia patients. These include worsened cognition and an increased risk of falling. Therefore, recommended sleep aids for people living with dementia are non-drug based and aim to improve sleep routine and the sleeping environment. You can find a full list of dementia products on our dementia products page.
Working With Hospital Staff
Remember that not everyone in the hospital knows the same basic facts about memory loss, Alzheimers disease, and related dementias. You may need to help teach hospital staff what approach works best with the person with Alzheimers, what distresses or upsets him or her, and ways to reduce this distress.
You can help the staff by providing them with a personal information sheet that includes the persons normal routine, how he or she prefers to be addressed , personal habits, likes and dislikes, possible behaviors , and nonverbal signs of pain or discomfort.
Help staff understand what the persons baseline is to help differentiate between dementia and acute confusion or delirium.
For more information on dealing with dementia and hospitalization, see the University of California, San Francisco, Memory and Aging Centers Tips for Hospitalization.
Emergencies: What To Do If Your Loved One Wanders
If your efforts to prevent wandering havenât worked and your loved one has gone off, what should you do? Your natural reaction will probably be to run outside and frantically search in any direction.
But experts say the first thing you should do is call 911 to alert authorities. If your loved one is registered with organizations like Project Lifesaver or the Alzheimerâs Association Safe Return program, you can call them, too. Once youâve done that, you can start looking yourself.
Geraldine Dawson, PhD, chief science officer, Autism Speaks research professor, Department of Psychiatry, University of North Carolina at Chapel Hill.
Beth Kallmyer, director of client services for the national office, Alzheimer’s Association, Chicago.
Alzheimerâs Association: âMedicAlert and Safe Return,â âWandering.â
AlzOnline: âWandering and Dementia.â
Down Syndrome Association of Queensland Inc: âStrategies for Children with Down Syndrome Who Wander.â
National Sleep Foundation: âSleep and Alzheimerâs Disease.â
Pathfinders for Autism: âPlan Your Response to an Autism Emergency.â
Project Lifesaver International: âHow it works.â
Ways To Prevent Dementia Wandering
Dementia wandering isnt entirely preventable but you can reduce the severity and danger of wandering patterns through behavioral changes, preparation, and technology-based solutions. Follow these 12 guidelines to help avoid dementia wandering.
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Create A Calm And Soothing Environment
The environment and atmosphere you create while caregiving can play a large part in helping an Alzheimers or dementia patient feel calm and safe.
Modify the environment to reduce potential stressors that can create agitation and disorientation. These include loud or unidentifiable noises, shadowy lighting, mirrors or other reflecting surfaces, garish colors, and patterned wallpaper.
Maintain calm within yourself. Getting anxious or upset in response to problem behavior can increase the patients stress. Respond to the emotion being communicated by the behavior, not the behavior itself. Try to remain flexible, patient, and relaxed. If you find yourself becoming anxious or losing control, take time out to cool down.
Could I Use Sleeping Tablets For A Limited Time Just To Help The Person I Care For With Dementia Get Back Into A Routine Of Sleeping Throughout The Night
However tempting this may be, the use of sleeping pills for dementia patients can be just too dangerous as they are at risk of falling. The morning hangover effect that sleeping medication leaves a person with can exacerbate the dementia patient’s symptoms of confusion, anger and irritability. Try promoting better sleep strategies and sleep aids for dementia instead. If the person with dementia constantly wakes and gets up, and is at high risk of falling, then a doctor may decide that sleeping pills for a dementia patient can be used for short period of time. Always talk to a GP first as they are used to being asked how to get dementia patients to sleep at night.
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