How To Prevent Alzheimer’s Patients From Wandering

How To Prevent A Loved One With Dementia From Wandering

Bayshore | Tuesday, March 13, 2018 6:44 PM EST | Dementia

Wandering is a common behaviour associated with dementia, especially in the middle to late stages of the disease. It is not only a potential safety risk for the person with dementia, it is also very stressful if you are the caregiver. There are a number of strategies that can help reduce the risk of wandering even if you cant prevent it. However, there is no one size fits all solution. Consider your loved ones unique situation and try to make his or her independence and freedom a priority for as long as possible.

Identify The Underlying Cause

Dementia can cause the elderly to become confused with their surroundings, even in familiar settings like their own home. In many cases, theres an explanation for why a senior may get up and wander from home. Some common reasons include:

• Waking up in the middle of the night hungry or thirsty
• Looking for the bathroom and getting lost
• New medications with side-effects causing confusion
• Feeling too hot or cold in a room and looking for somewhere more comfortable
• Similarly, if theres too much noise in an area, a senior may wander to a quieter location
• If occurring at nighttime, sundown syndrome may be a factor.

Identifying the cause of the behavior makes it easier to find a solution.

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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What Causes Dementia Wandering

Alzheimers disease and other types of dementia affect cells in the part of the brain that controls memory. Recent memories and spatial recall or the ability to remember different locations or where something is in relation to something else are two of the first things seniors with cognitive decline lose, according to the National Institute on Aging. These challenges make it harder to remember a destination, determine directions, or recall the reason for leaving in the first place.

Seniors with dementia may want to escape a situation because theyre confused or disoriented. But as they depart, they can forget what happened, become unexpectedly lost, and begin to wander. Emotional distress, medical conditions, and a perceived need to complete tasks can all cause dementia wandering.

Ways To Prevent Seniors With Dementia From Wandering

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Your neighbor just found your senior dad wandering alone outside. Unfortunately, this type of behavior is common in people who have memory problems or dementia. The Alzheimer’s Association says that 60 percent of people with dementia will wander. It affects everyone, as family members live in fear that their loved one will wander off and get lost or hurt, especially in the middle of the night.

Why Do Alzheimers and Dementia Patients Wander?

Memory care

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Use Visual Cues Or Distractions

As mentioned earlier, in dementia, it can be difficult for your loved one to remember environmental and life changes. Although one’s memory of these changes is impacted, certain over-rehearsed visual or procedural concepts are not as affected by dementia. For instance, placing a stop sign at your front door may be a useful way to cue your loved one to stop or to walk away from the door. You can also paint a door to match the walls’ colors or have the door represent something else of importance to the person .

Dress Them In Bright Clothing

This is a simple tip, but it can make a big difference: If wandering occurs at night, the risk of injury is exacerbated, especially if the elderly person ends up near a busy street. To increase their visibility, ensure that theyre wearing bright colours. This will also be helpful if they get lost during the day, as more vibrant clothing will make them stand out in a crowd and render them easier to spot.

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Enlist The Help Of Others

• Tell immediate neighbors about the persons Alzheimers. Ask them to call you if, say, he or she uncharacteristically comes over to visit or is seen walking alone.
• Use daycare and professional help. If someone with Alzheimers begins leaving home when he or she wanders, that person should no longer be left alone even for short periods. If you are the primary caregiver, take advantage of adult daycare programs or a relief caregiver when you must go out.

Try To Follow These Tips Before The Person With Alzheimers Wanders:

• Make sure the person carries some kind of ID or wears a medical bracelet. If the person gets lost and cant communicate clearly, an ID will let others know about his or her illness. An ID will also show where the person lives.
• Let neighbors and the local police know that the person with Alzheimers tends to wander.
• Keep a recent photograph or video recording of the person to help police if the person becomes lost.
• Keep doors locked. Consider a keyed deadbolt, or add another lock placed up high or down low on the door. If the person can open a lock, you may need to get a new latch or lock.
• Install an announcing system that chimes when the door opens.
• Consider a GPS locating device to find the wandering patient.

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If A Person With Dementia Goes Missing

Look For A Pattern Or Underlying Cause

• Keep a diary of when and where your loved one tends to wander. This may give you clues as to what is triggering the behaviour. If they wander at night, perhaps they are hungry or thirsty. Leaving a glass of water or a few crackers by their bed might help.
• Anticipate the times your loved one may wander, or has wandered before. If they tend to wander at the same time every day or when they are bored, plan meaningful activities to keep them better engaged. If they are searching for a spouse or child, leave a note stating that he or she will be visiting soon to provide reassurance and reduce wandering.

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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.

Are they:

• 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.

How To Keep Alzheimers Patients From Wandering

When caring for a senior with Alzheimers at home, it is very challenging to completely prevent wandering. Fortunately, there are steps that dementia caregivers can take to minimize the risk of elopement. Explore the following wandering prevention products and strategies to keep a dementia patient safe at home.

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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.

Install Door Locks For Dementia Patients

Specialized locks and escape prevention devices can be installed on doors, windows and gates. These products require complex maneuvers to open entrances/exits, making it difficult for seniors with moderate to severe cognitive impairment to leave. Keyless electronic locks can also be used in this manner. Be aware that dementia presents differently in each person. Some individuals, especially those in the early stages, may still be able to reason well enough to unlock some of the dementia-proof devices on the market.

Another option is to install sliding bolt locks out of a seniors line of sighteither up high or down low on door frames. These can be used on their own or in conjunction with other locks to serve as a back-up method for securing doors.

Never lock a person with dementia in the home by themselves. Proper supervision is required to ensure their safety, and doors should only be secured when another person is present. Otherwise, the dementia patient could be trapped in the event of an emergency, such as a fire or urgent medical issue.

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Make Sure They Can Be Identified

Be sure your loved ones have some form of identification on them. Multiple forms of identification, emergency contact numbers and disclosure of their medical diagnosis of dementia are a good idea, in case one form is removed or lost. You might get an ID bracelet or pendant, or one that laces into shoelaces or attaches to a watchband, as well as identification inside their clothing and in their wallet. My boyfriend suggested a very simple Road ID bracelet with a comfortable wristband like the one he wore when he went running. I purchased one for my dad, and he wore it for eight years, never trying to remove it. Be sure you have recent photos in case they are needed for identification in a search effort to locate an older adult who is missing.

Dementia And Wandering: Causes Prevention And Tips You Should Know

Three in five people with Alzheimers disease or another type of dementia will wander, according to the Administration on Aging. This potentially dangerous result of cognitive decline may occur when a senior with dementia is trying to find someone or something. It can also be the result of discomfort, anxiety, or fear.

If a person is confused because of memory changes, and the environment becomes uncomfortable, they may attempt to leave the situation to get away from the discomfort, says Andrea Denny, outreach, recruitment and engagement core leader for the Knight Alzheimer Disease Research Center in St. Louis, Missouri. This desire to escape the overwhelming stimuli may cause what we call wandering. While people with dementia often leave with a goal or destination in mind, they may forget directions, encounter an obstacle in their planned route, or realize the place theyre trying to reach is imaginary or inaccessible.

Wandering sometimes called elopement can be dangerous. Nearly 50% of seniors who wander will suffer a fall, fracture, injury, or some type of elemental exposure, according to a 2016 assessment of wandering behaviors in the International Journal of Geriatric Psychiatry. Fortunately, research suggests certain strategies and technologies can help decrease dementia wandering. Learn whos at risk of elopement, potential causes, 12 tips to reduce wandering, and how to be prepared if dementia wandering occurs.

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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.

How To Reduce Dementia Wandering At Night

Dementia wandering at night is a common problem, especially in conjunction with sundown syndrome. Denny suggests taking these steps to reduce the likelihood and hazards of nighttime wandering:

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The Danger Of Alzheimers Wandering And How To Prevent It

Every six out of 10 people with dementia wander at some point in their lives. This is why, as a caregiver, you play a crucial part in ensuring your loved ones health and safety. It can be difficult to accept that your less physically able family members could walk off into unknown territory. This is why its necessary to keep a lookout for your loved ones, ensuring that they remain within arms reach at all times. Get to know four different ways to prevent Alzheimers wandering.

What To Do If Your Loved One Wanders Away

Time is of the essence. It is extremely important to not delay action. Several immediate steps you can take are:

• Notify police immediately. Call 911.
• Have a safety plan in place, and a phone tree to alert friends and family.
• Alert local businesses and neighbors prior to an occurrence of wandering to increase awareness of your loved ones condition and tendencies.
• Use social media when applicable.
• Some states have Silver Alerts.
• In Pennsylvania, the State Police administer the Missing and Endangered Person Advisory System. Contact your local state police barracks as soon as possible.

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