Wandering is one of the greatest challenges faced by family caregivers whose loved one has Alzheimer’s or other memory loss. Over 60 percent of Alzheimer’s patients will become lost at some time. Most are gone only briefly, though long enough to frighten their loved ones. Others may be lost for an extended period of time, and unfortunately, there are news reports each year of missing Alzheimer’s patients who are never located. It is a sobering fact that if a person with dementia is lost for over 24 hours, he or she is likely to suffer a fall or other serious injury, or even death from injury or exposure. Reports one family caregiver, “The thought that Dad would climb onto a bus at the corner and we would never find him again keeps me awake at night, even on nights when he is getting a good night’s sleep.”
Why do people with dementia wander?
For people with Alzheimer’s or other memory loss, confusion and disorientation make it increasingly difficult to recognize familiar faces and places, even a spouse or child, or a lifetime home. Geriatricians point out that the term “wandering” is something of a misnomer, because many times, in the person’s mind, his or her activity is not purposeless. She may be looking for the bathroom but be unable to find it. He may think it is time to leave for work, even if he retired years before. A great-grandmother might be searching for her children, in the belief that they are still small and in need of her care.
Other factors that contribute to wandering include restlessness, agitation and stress; boredom and lack of a sense of purpose; sleep disorders; physical pain; and the side effects of medications.
Keeping loved ones safe
When a loved one with dementia wanders, family often decide that a nursing home or other residential memory care is the best choice for the person. However, many patients fare much better at home, in familiar surroundings. How can families keep their loved one safe at home, for as long as possible? Here are some strategies recommended by professionals:
Observe your loved one’s patterns. The first step is to understand as best you can the reason for your loved one’s wandering. What are his “triggers”? Where does he usually try to go? During what time of day is he most restless? Does he seem to be looking for something, someone, or someplace?
Adapt the home to keep your loved one safe. Beyond the usual “aging in place” home modifications, you can add special locks to doors, safety gates to prevent exit, and an alarm that will sound if the front door is open. See the resources at the end of this article for information about other home modifications.
Be sure your loved one always carries ID, and a medical alert to tell others he has memory loss. If he doesn’t consistently carry a wallet, try a bracelet, pendant, or clothing labels. Contact your local Alzheimer’s Association office to learn about their Safe Return program. In addition, more and more families are also using a GPS or other tracking device to help locate loved ones quickly.
Notify neighbors and local merchants about your loved one’s condition. Ask them to contact you if they see your loved one alone when he shouldn’t be. Having this conversation with you makes it more likely that others will recognize the problem and feel comfortable getting involved.
Find out if your state has a “Silver Alert” program, similar to the “Amber Alert” for missing children. As law enforcement agencies recognize the needs of growing numbers of adults with dementia, more states are implementing this broadcast notification system.
Try “behavior modification” strategies. If your loved one expresses feelings of being lost or abandoned, reassure him he is safe. Redirect him to safe activities that fill his need for a sense of purpose. If “sundowning” (restlessness at night) is a problem, limit daytime naps. Dementia-care professionals have found that “correcting” a dementia patient frequently can increase agitation. “Don’t correct—redirect” is their guideline.
Have your loved one’s medications reviewed. A person with Alzheimer’s may take medications for the disease itself, for mood or other behavior changes, and for other medical conditions they might have. It is important to take medicines correctly, and it is just as important to be alert for side effects that might increase wandering and other difficult behaviors.
Provide appropriate activities to reduce boredom and isolation. Boredom is stressful for people with dementia, and increases wandering. Art activities, crafts, household tasks, singing, cooking simple foods and socializing all promote well-being and a sense of purpose, which makes it less likely that your loved one will wander.
Get the help of professionals. Family caregivers need a break to renew their energy and take care of other responsibilities. In the earlier stages of the disease, home care or an adult day center can be a good choice. As the disease progresses, a residential care community specializing in care for residents with memory loss is often the safest choice, providing condition-appropriate activities, socialization and supervision for people with Alzheimer’s and related conditions.