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Why Do Dementia Patients Wander

How To Prevent Wandering

Caregiver Training: Wandering | UCLA Alzheimer’s and Dementia Care Program

A person with Alzheimers disease who is restless or has a tendency to wander should never be left alone. And even with another adult in the house, the caregiver should take steps to lessen the danger that the person will exit the house or building.

Steps can include:

Although wandering is one of the most dangerous behaviors associated with Alzheimers disease, there are some ways to prevent or manage the risk. We want to educate and inform caregivers in order to help you remain confident in the face of this difficult disease. For more information about Alzheimers disease, visit www.brightfocus.org/alzheimers.

More Useful Links And Resources

To learn more, download our guide for people living with dementia. This version includes forms and worksheets you can fill in online and print.

To learn more, download our guide for caregivers. This version includes forms and worksheets you can fill in online and print.

Access a print version of the guide for people living with dementia: this can be printed and filled out by hand.

Access a print version of the guide for caregivers: this can be printed and filled out by hand.

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.

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Dementia And Wandering: How To Help Prevent And Reduce The Risks

Six in ten people living with dementia will wander according to the Alzheimers Association®. Worrying over loved ones who have wandered away from home and ended up missing can be scary and nerve-racking for families, care partners, and close friends. Searching for a loved one with dementia who has gone missing can be agonizing.

People unfamiliar with dementia patients wandering away may be taken aback when this happens. Some may wonder how anyone who has lived in the same area for years can get lost and not even remember how to get back home or how a person in the early stages of dementia could be unable to find his or her way home after doing their weekly shopping.

It is common for people with Alzheimer’s disease and other forms of dementia to wander away or become disoriented. In some instances, a person with dementia may not be able to find their way around in their own home. Alzheimer’s disease and other forms of dementia not only impact memory and judgment but can also affect spatial orientation and the persons ability to navigate their surroundings.

Family caregivers can take steps to reduce their loved one’s chances of wandering away by identifying behaviors that increase the risk. Once wandering behaviors are identified, family members and care partners must follow up with measures to help ensure the person’s safety.

Tools For Caregivers: The Wandering Information Sheet

Dementia and Wandering: A Matter of Life and Death

The Wandering Information Sheet was designed to help family members of dementia patients, and local law enforcement, should a loved one or family member wander away from home and become lost.

, fill it in, and keep copies of it handy for law enforcement in the event your loved one wanders away and becomes lost. Additionally, this information sheet is fillable so that caregivers, families, and others can directly fill it out on their computers. It can also be printed off first and filled out if preferred.

All searches begin with an investigative component. During this time you will be asked dozens of questions to aid law enforcement and search teams determine where and how to look. This information is critical to the success of the search. Completion of this form, before an incident, allows the searching to start sooner and aids in collecting more accurate information.

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Lack Of Physical Activity

If a person constantly walks about, it may be because they have energy to spare. They may feel the need to do more regular exercise. If they are able, it could help if they take part in exercise classes or activities such as walking groups. You can also help them to include more exercise in their daily routine without making big lifestyle changes.

Good examples include:

Why Older Adults With Dementia Wander

By Darlene Ortiz 9 am on March 22, 2017

Dementia causes many challenging symptoms for seniors that caregivers must learn to manage and prevent. Out of all of these symptoms, wandering is the most troublesome because no one wants to think about their loved one getting lost. Seniors who wander sometimes wind up injured or ill before they are found, which can make it difficult for family caregivers to care for their senior loved ones.

Caring for a senior loved one can be challenging for families who dont have expertise or professional training in home care, but this challenge doesnt have to be faced alone. Family caregivers can turn to Jefferson County Home Care Assistance for the help they need. We provide high-quality live-in and respite care as well as comprehensive Alzheimers, dementia, stroke, and Parkinsons care.

Knowing the reasons why a senior might wander can help you plan preventative strategies to keep your loved one safe.

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Use The Following Strategies To Prevent Wandering:

  • Identify the most likely times of the day when the person may wander and plan activities to promote relaxation and prevent agitation at that time
  • Provide a routine. Routine provides structure and a sense of security and safety.
  • Ensure the persons basic needs are met and reassure them if they feel lost or disoriented.
  • Pay attention if your loved has difficulties locating rooms inside the house or moves around without the purpose

If your loved one with dementia wanders, search the immediate area as soon as possible and call 911 if you cannot find the person within 15 minutes.

Strategies For Preventing Wandering

Caregiver Training: Refusal to Bathe | UCLA Alzheimer’s and Dementia Care

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.

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Reasons Why People With Dementia Wander

Task Oriented:

Pain, discomfort and agitation: Emotions can be reason to wander. They are not happy in their present situation so if they move to another location maybe those symptoms will not come with them. But in actuality, they are wandering.

Loss of Memory: When people become disoriented due to their present thoughts disappearing, their reality being blurred or seeking places that were once familiar to them, they wander looking to go back to those comforting and safe places. They are searching for their past.

Disorientation: They may wake up at 5 in the morning and not know if it is day going into night or night going into day. They will leave their surroundings to seek the answer.

Everyday Activities Can Lead To Wandering

Seniors with dementia may become disoriented trying to follow old routines and complete daily tasks that were once common for them. Some activities that can lead to wandering include:

  • Following past routines. With Alzheimers and other forms of dementia, people may cognitively revert to times past. Trying to follow familiar routes like driving to work, going on long walks, or returning to an old neighborhood can result in disorientation and dementia wandering.
  • Searching. A senior may be looking for someone or something not in their present environment for example, a childhood friend or a room in a home they used to own.
  • Navigating the home. Sometimes, a trip to the mailbox, restroom, or kitchen can lead to disorientation.
  • Attempting former chores or responsibilities. Responsibilities like caring for a child, cooking dinner for the family, or gardening can lead to wandering. Trying to find a young child or go to the grocery store can put seniors in unfamiliar environments.

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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.

How Can They Be Kept Safe

Dementia Wandering: Causes &  Prevention

If you are concerned about the safety of a loved one who has Alzheimers, here are a few things you can do to help keep them safe should they ever wander.

  • Reducing hazards and installing night lights to help nighttime wanderers.
  • Installing alarms, locks and various devices which can alert you that the patient is on the move.
  • Placing removable curtains over doors or camouflaging doors.
  • Having the patient wear a GPS device or any other tracking device so that you can receive electronic alerts about his or her location.

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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.

How Caregivers Can Address Wandering

Talk with your loved one to understand why they’re wandering, so you can formulate the right care plan. If they have a tendency to forget where they’ve left their belongings, keep their favorite items in a visible place.

If they have difficulty remembering the time, put clocks with large faces throughout their house. To address sleeping problems, help them get more rest by reducing caffeine, avoiding large meals before bed, minimizing alcohol consumption and smoking, and exercising throughout the day.

Since you can’t watch them 24/7, look into in-home caregiver services to give yourself deserved breaks. Make neighbors and local businesses aware of your loved one’s condition, and add personal identification to their clothes, purse or wallet, and phone in case they wander.

If you want help taking care of a loved one with dementia, turn to COMPASS Homecare in Anchorage, AK. These professionals have provided quality in-home care for over 40 years, helping seniors age in place for as long as possible. They’ll provide companionship and handle your relative’s household chores, bathing and dressing needs, and daily errands. Visit the website or call 276-6960 to learn more about their services.

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How To Prevent Dementia Patients From Wandering

Taking preventative measures is an important step in removing the risk of wandering. Ensure that basic needs are met, hazards are reduced, and security features are in place so that if it does occur, youll be alerted or notified.

  • Make sure basic needs are met. Measures include toileting, nutrition and thirst so that the individual isnt searching to satisfy their basic human needs. Clearly label areas and provide a clear, well-lit path to these areas.
  • Safeguard their spaces by reducing common hazards. This includes removing clutter , securing dangerous objects , eliminating tripping hazards and ensuring well-lit areas and signage are available for identification purposes.
  • Secure their area with physical barriers and technology. This will impede the range they are able to roam. A fence outside of the property is a great physical barrier. Additionally, you can install security alarms and safety technologies such as door, driveway and bed sensors to notify you of any movement. Other deterrents include door locks, cupboard latches, and window closures. If your loved one is prone to finding their way through these security features, wearable trackers or GPS devices will help you locate them.

Benefits & Risks Of Wandering

Caregiver Training: Sundowning | UCLA Alzheimer’s and Dementia Care Program

Wandering often indicates an underlying issue. Talking with your loved one and paying attention to what they’re trying to achieve will help you solve their problem and correct their daily regimen. This behavior is also frequently one of the first signs that medical intervention is needed to address any pain, illness, or medication complications.

It can be challenging to leave your wandering relative alone. While around-the-clock caregivers can prevent them from getting lost or injured, it can also make them feel like they’re losing their independence. Listen to their concerns and explain that requiring more support isn’t negative it’s a positive step that will help them retain as much normalcy as possible.

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Use Visual Cues For Reorientation

People who have Alzheimers often forget where they are, even inside their own homes. Visual reminders can provide clues and trigger memories that help reorient dementia patients to their surroundings. For example, post descriptive photos on the doors to various rooms, such as the bathroom and kitchen. Another approach is to post stop signs for dementia patients on doors that they shouldnt open or areas of the home that would be dangerous for them to gain access to.

Risk Factors And Causes Of Wandering In Dementia

Even though wandering is a common clinically recognized behavior, the exact risk factor and cause for wandering in dementia are unknown. Although wanderers do not differ from non-wanderers in dementia by gender, age, and ethnicity, some studies reported it is more prevalent in men younger than other elderly and people of African descent.7,8,9 Furthermore, people with Alzheimers disease and dementia with Lewy bodies are more likely than those with vascular dementia to wander.10 Wandering is linked to the severity of cognitive impairment , including issues with recent and remote memory, time and place orientation, and the ability to react appropriately to a given conversation subject.11,12 Persons with Dementia on antipsychotic treatment or who had comorbid depression, psychosis, or externalizing behaviors like arguing and threatening were more likely to wander.1315

The causes of wandering are elusive, though hypotheses have been proposed ranging from biomedical to biopsychosocial to personenvironment interactions.14 This includes the following:

  • A neuropsychological or biomedical explanation that relates wandering behavior to visuospatial dysfunction, visuo-constructional disability, or poor topographical memory. This theory is supported by imaging studies that report hypoperfusion in the left temporoparietal brain region and reduced glucose utilization in frontotemporal regions.1417
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    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.

  • Provide supervision. In the early stages of dementia, it may be okay for someone to be alone for short periods. As dementia progresses, continuous supervision will likely become necessary. Always stay with your loved one in new or changing environments, including stores, parks, and restaurants. If youre a primary caregiver, consider hiring in-home care for respite to run errands, work, or spend time with family.
  • Obscure doors. Neutral door coverings and floor mats in front of doorways reduce exit-seeking behaviors, according to a 2014 clinical trial by the Department of Veterans Affairs. Use removable curtains, paint, or wallpaper that matches the surrounding walls to obscure entries and exits. Alternatively, you can use posters that say Do Not Enter or Emergency Exit.
  • Hide signs of leaving home. During unsupervised times, keep trigger items out of sight, says Denny. Dont leave car keys by the door, or anything else that might prompt someone to think theyre supposed to go out and do something. Consider keeping keys in hard-to-reach places, or on your person, especially if your aging relative no longer drives.
  • Installing pressure-sensitive alarm mats at doors and bedsides
  • Attaching warning bells to doors
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