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.
Wandering Causes Prevention Safety Tips & Statistics
One of the most dangerous behaviors associated with dementia and Alzheimers Disease is wandering. Taking the steps to prevent wandering can keep your loved one safe and ensure that they arent at risk outside of their home. Alzheimers wandering creates a hazard for those who have it and others as they can become lost, confused, disoriented, or injured from exposure to harsh weather or other safety risks.
Ways To Prevent A Dementia Patient From Wandering
6 Ways To Prevent A Dementia Patient From Wandering Taking care of a dementia patient is not easy, especially since they tend to wander sometimes. This can become extremely overwhelming for a caregiver. Every noise at night is a worry to them, in case the patient has gone wandering off somewhere. Taking the patient out is also terrifying. If the caregiver does not keep an eye on the patient all the time, there is always a chance that he/she could get lost, or wander off somewhere and get hurt. Knowing how to prevent a dementia patient from wandering can prevent a lot of anxiety for the caregiver, and will do a lot to keep the patient safe at all times.
Its impossible for a caregiver to keep an eye on a dementia patient every second of the day, however, since they are only human, and there will be times when they simply cant stop the person from wandering.
The following are 6 ways to prevent a dementia patient from wandering, not only to keep him/her safe, but to boost the confidence of the caregiver, and reduce their stress levels as well.
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Emotional Causes Of Dementia Wandering
Wandering is a common response to overstimulation and overwhelming situations. Fear, agitation, and confusion commonly lead to dementia wandering outdoors or in public environments. Some emotional cues that can cause wandering include:
Stress or fear. Unfamiliar or crowded locations, like busy restaurants, sidewalks, or even family gatherings, may lead to confusion or fear in people with dementia this could cause them to wander.
Overstimulation. Loud noises and quick movements can lead to anxiety. Brain changes may cause them to interpret these stimuli differently than you and I might, says Denny. While someone without dementia may tune out the conflicting sounds of television, conversation, and outdoor sirens, these noises may cause a person with dementia confusion and fear. The overstimulation may make seniors want to escape a situation in favor of a quieter, calmer place.
Frustration. Inability to communicate can lead to frustration. When someone cant remember or ask for the things they need, theyre more likely to try to complete tasks by themselves.
Products And Strategies For Managing Dementia Wandering
Memory loss associated with Alzheimers disease and other types of dementia often causes seniors to become disoriented, confused and afraid. These conditions can erase memories of once familiar people and places and may result in dementia patients wandering away from home. In fact, the Alzheimers Association estimates that 60 percent of Alzheimers patients will wander at some point. The unpredictability of this dangerous dementia-related behavior can weigh heavily on caregivers and family members.
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My Dad Has Dementia And Is Moving Into Residential Care Are There Any Care Homes With Dementia Units
Yes, there are. These residential units will allow your dad to live in a home environment with the benefit of trained staff on hand to help care for him. It may also be worth considering finding a care home in the right location to enable friends and family to visit regularly. This may be more fitting for your dad and ease the transition.
If your parent/partner suffers from restless leg syndrome they move or twitch their legs uncontrollably, especially during the evenings and night-time. They may also experience tingling, burning and fizzing sensations in their legs too. Symptoms can be relieved by rubbing and stretching legs – but it can be so bad that it wakes the person up. If you discover that your parent/partner has either of these medical conditions, its wise to see a GP and ask for help.
Disguise Entrances And Exits
It may seem like an odd approach, but camouflaging doors and windows can sometimes prevent a senior with dementia from finding a way out of their home. Studies have shown that conditions of the brain, such as Alzheimers disease and other forms of dementia, can have a pronounced effect on eyesight. While most people only think of the brain and spinal cord as the components of the central nervous system , it also includes the retinas and optic nerves. It isnt yet known exactly how Alzheimers disease and the sense of sight are related, but damage to brain cells seems to interfere with the way the eyes receive stimuli, how information is communicated to the brain and how it is processed there. Furthermore, Alzheimers disease mainly affects older adults who are prone to age-related eye diseases like macular degeneration, cataracts and glaucoma.
Caregivers might consider painting doors and doorframes the same color as walls or hanging curtains on windows that match the color of the walls. This will help exits blend in with surroundings and make them less visible to loved ones living with dementia. Another optical trick that some dementia caregivers have used is placing a dark, solid colored doormat in front of doors leading outside. Something about the visual effects of dementia may cause care recipients to perceive the mat as a hole in the floor, thereby deterring them from using the door.
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They Wake Up A Lot During The Night To Use The Loo And I’m Worried They May Get Lost Or Confused Should I Wake Up Too To Help Them
It is normal that older people will need to use the loo more often during the night. This can be difficult if a person also has dementia as they might forget why they’re up, where the toilet is or that they should go back to bed. Start by looking at your parents drinking and eating habits. If they are eating and drinking large amounts in the evening this will increase the need for them to visit the toilet. Limit their intake from late afternoon and enjoy a main meal at lunch. Next make the route to and from the toilet as clear as possible by using signs and plug-in nightlights. Try using pictures if it helps. It might also help to make the lights in the bathroom motion activated for when they get there. If you are still worried or you find they still get lost, it may be that you will have to help them. A monitor or bed-exit sensor will help you to wake up when you need to.
Alzheimer’s Research On Wandering Behavior
Koester’s research provides more insight into wandering in Alzheimer’s patients. Those with Alzheimer’s disease leave their own residence or nursing home and usually start to wander along roads. Eighty-nine percent of wandering patients are usually found within one mile from the point last seen. If the patient is not wandering along the road , they are usually in a creek or drainage , or caught in bushes or shrubberies . But, the Alzheimer’s patient is frequently found wandering a short distance from a road. Unfortunately there are some wanderers who eventually give in to the environment and develop hypothermia or dehydration , or are found deceased .
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Contemplate The Underlying Causes
Think about your loved one and ask yourself what could be causing them to wander. A persons lifelong routines, the onset of new symptoms and even basic personal needs could be triggering their behaviors. The following questions might help:
- Was your loved one always very active?
- Is there a specific activity that they used to do during the day that coincides with the timing or actions of your loved ones wandering?
- Is your loved one at the stage of dementia where they are confusing the past and present?
- Do they recognize familiar surroundings?
- Does your loved one have any unmet needs, such as needing to use the bathroom, wanting food or water, pain that is not being well managed, or desiring comfort?
- Does your loved one seem worried, anxious or bored?
- Have any new medications been added to or removed from your loved ones regimen? What about dosage changes?
- Has their environment changed at all recently?
Only after you have precisely defined the problem by completing these three steps can you start thinking about whether an intervention is needed and what that might entail.
Ways To Prevent Alzheimers Wandering
Simple home safety modifications can make it tough for them to open doors to the outside, including:
- Adding childproof door knob covers make it more difficult to open doors
- Installing an additional lock higher up on the door so theyre out of your older adults line of sight because people with dementia often dont look above eye level try this for regular doors and this for sliding patio doors
- Installing door and window alarms to alert you if theyre opened
- Using pressure-sensitive alarm mats next to their bed to alert you if they get up at night
- Using an alarm like SafeWander that can be triggered when a specific threshold is crossed
Important: Be aware of fire safety needs for everyone in the house. Make sure all locks are easily accessible to people without cognitive impairment. Doors should still be able to be opened quickly in case of emergency.
2. Camouflage doors that lead outsideAnother way to discourage your older adult from opening doors that lead outside is to camouflage them.
Often, people with dementia wont be able to find the door if you cover it up or wont open it if you place large signs on it.
You could also place large signs saying DO NOT ENTER or STOP on the door. Many people with dementia wont open a door with those types of signs.
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If A Person With Dementia Goes Missing
Create And Maintain A Routine
Creating a daily schedule provides routine and structure. Having a list of things that need to be done at a particular time or place may help prevent someone from wandering off. It’s even better if the list includes things the person enjoys or has found meaningful in the past. Using various sensory cues to remind the person that this schedule exists may be useful, including alarms, lights, or having a schedule on a large print daily planner or a whiteboard.
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Understanding Why Dementia Patients Wander
To prevent a loved one from wandering and promote safe walking, you first need to define what they are trying to achieve or where they want to go. It may seem directionless and irrational to outsiders who still have their faculties, but dont assume a wanderer is literally just wandering. This behavior is very individualized and a full description of their actions is essential.
Of course, thats easier said than done. I know family caregivers and the staff at elder care settings are very busy, but it is important to take the time to observe the nuances of a wandering dementia patients behavior. Sometimes it is as simple as asking your loved one what they are doing, but often you will need to step back and closely watch what is happening to discover the purpose behind their behavior. This may take time and require multiple observations. Just remember that, if you cannot define, measure and explain these behaviors, how can you or dementia care experts develop wandering interventions?
Wandering is complex, and there is no one-size-fits-all solution for this symptom of dementia. In my line of work, I use the following three-step approach when troubleshooting these behaviors.
What To Do If Your Loved One Is Missing
Despite your best efforts, there is a high likelihood that your loved one could wander away. Three out of five people with dementia will wander. Heres what to do:
- Search the area where the person was last seen for no more than 15 minutes.
- Alert friends and neighbours to the situation.
- Have someone stay at home in case the person returns.
The sooner you ask for help, the sooner your loved one is likely to be found.
If you need extra help to care for a loved one with dementia, we are here for you. Our caregivers are trained and certified in dementia care.
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How To Keep A Wanderer Safe And Indoors
When it comes to keeping someone from wandering outside , you can lock the doors to the house as long as you are home in the event of an emergency. It is not cruel to lock the doors. You are also saving the neighbors and police some worry. If the police are summoned frequently, they may insist that you find some way to keep your loved one inside and supervised so they will be safe. JessieBelle
Get deadbolt door locks, take the keys out of them at night, and keep the keys on a chain around your neck, that way if your loved one is wandering at night, they cannot get out of the house. If there is a fire, you do not have to look for the keys in the middle of a crisis, because they are right there around your neck. If all the deadbolts are keyed the same, you only need to wear one key. LyricaLady
Child locks and alarms work well and are reasonably priced. Also, try installing a lock at the bottom of the door or at the top. Your loved one may not think to look in those places to unlock the door. jycaregiver
I finally secured the doors to the point that my mom could not open them on her own. I covered our doorknobs with plastic covers designed to keep toddlers from opening doors. Eventually, I had to secure those with duct tape wrapped around and around, as she could get the knob covers off when she was really intent on leaving. I also had to add internal hardware, like sliding locks and chained door guards, and these had to be installed above her reach. Catjohn22
Medicalert + Alzheimer’s Association Safe Return $55
Offered by the Alzheimers Association, this option doesnt use GPS but its worth a mention because of its affordability. Heres how it works: your loved one will receive a personalized member ID tag, wallet card, personal health record, and MedicAlert + Safe Returns 24-hour emergency toll-free number. If they are reported missing, caregivers can call the emergency response line, and local Alzheimer’s Association chapters will coordinate with law enforcement to find your missing loved one. With this system, emergency responders will immediately find out any critical medical information about the missing person and if anyone finds them, theyll know how to get back in touch with you using the information on the member ID tags.
Losing track of your loved one is scary, but these personal tracking devices for people are designed to keep them safe.
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Provide A Safe Space For Wandering
Flexibility is key in Alzheimers care. Dementia-related behaviors are the product of a broken brain, which cannot be fixed. Confusion and disorientation can make seniors with dementia scared, anxious, angry and even aggressive. If your attempts to thwart wandering fail to address a loved ones restless behavior and compulsion to move about, you may need to adjust your approach.
Instead of preventing a senior from wandering, provide a safe and supervised place in the home or yard for walking or pacing. Going for walks together during the day may also help curb the impulse in the evenings when many dementia patients experience symptoms of sundowners syndrome and try to elope. Not only will this help a senior maintain their mobility but it will also help them work off excess energy and feel more control over their movements.