Understanding Wandering: Dementia & Alzheimer's

Understanding Wandering - Dementia & Alzheimer's

Identifying the early signs of wandering is crucial in helping caregivers take proactive steps to safeguard individuals with dementia. Wandering is a common behaviour observed in people living with dementia and is often rooted in the cognitive and neurological changes caused by the condition. This behaviour can manifest in various forms, each requiring careful observation and understanding to address effectively.

By understanding the underlying causes and triggers of wandering, caregivers can implement preventative strategies such as creating structured routines, using visual cues for orientation, and employing safety measures like secure locks or monitoring devices.

Education and vigilance are key in mitigating risks associated with wandering, ultimately enhancing the quality of life for individuals with dementia while providing caregivers with peace of mind. Below are some valuable insights and suggestions.

 Indicators of Wandering

Understanding these indicators and causes allows caregivers to identify wandering tendencies early and take preventive actions to reduce risk and ensure safety.

Returning Late from Regular Outings or Drives	A person with dementia may begin to take longer than usual to return from places they regularly visit, such as a local park, store, or friend’s home. This delay could be due to confusion about their surroundings or an inability to recall the correct route.
Forgetting Directions to Familiar Locations	Difficulty navigating places that were once second nature, like a favourite coffee shop or a family member’s home, is a common sign. They might start asking for directions to locations they have visited for years or appear lost even in familiar areas.
Unplanned Journeys	The person may leave home unexpectedly without informing anyone, often wandering with no clear destination.
Repeated Attempts to Leave Home	They might express a need to “go somewhere” frequently, such as “going home” (even if they are at home) or visiting someone from their past.
Difficulty Completing Routine Tasks	Disorientation during simple tasks, like walking the dog or running errands, can lead to getting lost or confused about their location.
Sudden Agitation or Restlessness	Restless behaviours, such as pacing or repeatedly opening doors, might indicate an urge to wander.
Confusion and Disorientation	Damage to memory and cognitive functions may cause individuals to forget where they are, why they are there, or how to return home.
Boredom and Inactivity	A lack of stimulation or meaningful activities can result in restlessness, leading them to wander in search of something to do.
Unmet Basic Needs	Hunger, thirst, or the need for a restroom may prompt them to search their surroundings, often resulting in wandering.
Desire for Purpose	Individuals might try to follow a familiar routine, such as “going to work” or visiting a place they once frequented, seeking a sense of normalcy or purpose.
Loneliness or Social Connection	Feelings of isolation can drive them to wander in search of company or past acquaintances.
Memory Triggers	Objects, conversations, or sounds might evoke memories, prompting a person to leave in search of someone or something related to their past.
Escape from Overstimulation	Loud noises, crowded places, or unfamiliar environments can feel overwhelming, causing the person to leave in an attempt to find a calmer space.
Delusions or Misperceptions:	Dementia can cause individuals to misinterpret their surroundings, leading them to believe they are somewhere else and prompting them to act on that false perception.
Physical Discomfort or Pain	They may wander to relieve discomfort or find help if they cannot communicate their needs effectively.
Poor Vision or Spatial Awareness	Visual-spatial impairments caused by dementia make it difficult to navigate even familiar environments, leading to unintentional wandering.
Fear or Anxiety	Situations perceived as threatening, such as unfamiliar caregivers or environments, might cause the individual to wander in an attempt to escape.
Following Environmental Cues	Seeing an open door, for example, might trigger an instinct to walk through it, regardless of destination or intent.

Strategies for Preventing Unsafe Wandering

Engage in Time-based Routines & Meaningful Activities:

• Identify specific times of the day when wandering is most likely to occur, as dementia-related behaviours often follow patterns.

• Plan and implement structured, stimulating activities that match the individual's interests and abilities to help reduce restlessness and redirect their energy.

• Incorporate familiar routines and hobbies, such as gardening, art projects, or listening to favourite music, to provide a sense of purpose.

Provide Emotional Support:

• Acknowledge and validate the individual's feelings if they express a need to "go home" or find a loved one. Avoid correcting them, as this can cause frustration or distress.

• Use empathetic language to explore their emotions and provide comfort. For example, respond with phrases like, “Let’s talk about what’s on your mind,” to ease their anxiety.

• Offer consistent reassurance that they are safe and cared for, especially if they appear confused or disoriented.

  
  

Ensure Basic Needs Are Met:

• Regularly monitor and address fundamental needs, including hunger, thirst, and restroom access, to reduce the likelihood of wandering caused by discomfort or searching for essentials.

• Check for fatigue or physical discomfort signs and provide appropriate rest or care.

  
  

Minimise Overstimulation:

• Avoid taking the individual to crowded or noisy environments, such as large shopping malls or busy restaurants, where they may feel overwhelmed or anxious.

• Create a calm and predictable environment at home by minimizing loud noises, sudden changes, and excessive activity.

• If overstimulation occurs, redirect their attention to soothing activities, such as listening to calming music or engaging in light conversation.

By understanding the triggers and underlying needs associated with wandering, caregivers can take proactive measures to reduce risks and promote a safer, more supportive environment for individuals with dementia.

Safety Measures

Ensure Adequate Supervision:

• Provide continuous oversight, particularly in unfamiliar or changed environments, as these can increase disorientation.

• Accompany the person when outdoors or travelling to prevent wandering in new or unpredictable settings.

• Never leave the individual alone in a vehicle, as this can pose serious safety risks.

  
  

Install Alarms and Secure Locks:

• Use pressure-sensitive alarm mats by exits or beside beds to alert you when movement occurs.

• Install door chimes or alarm systems that notify you when a door is opened.

• Place childproof locks or sliding bolt locks out of the person’s line of sight to prevent access to exits.

  
  

Camouflage Doors and Exits:

• Conceal doors with removable curtains, scenic posters, or other decorative elements to reduce the likelihood of the person recognising them as exits.

• Use signs with clear instructions, such as "Stop" or "Do Not Enter," to discourage attempts to leave.

Secure Items That Encourage Wandering:

• Store car keys, coats, shoes, and other belongings associated with leaving the house out of sight and reach to reduce triggers for wandering behaviour.

Consider a GPS Geofencing Watch or Pendant App

• Modern technology enables the use of personal devices, such as watches or pendants, equipped with geofencing applications. These devices allow caregivers or loved ones to establish predefined boundaries. If the wearer moves beyond the designated area, the system promptly sends a notification, ensuring timely awareness and response.

Ensuring a Safe Return

Notify Key Contacts:

• Inform local police, neighbours, and close family or friends about the individual’s risk of wandering.

• Create a network of people who can assist in searching or alert you if they see the person outside unsupervised.

• Keep an updated list of emergency phone numbers readily accessible for quick use during an incident.

  
  

Maintain Updated Documentation:

• Keep recent photographs or videos of the individual for easy identification.

• Prepare a record of medical details, including any specific conditions or medications.

• Compile a list of places the person may wander to, such as former homes, workplaces, or locations with emotional significance.

Provide Identification:

• Ensure the person carries an ID card with essential contact details or wears a medical identification bracelet or necklace.

• Label their clothing discreetly with your contact information to assist searchers in reuniting them with you.

Utilise Tracking Technology:

• Equip the individual with GPS or other tracking devices to monitor their location in real time.

• Choose devices designed for dementia care, offering alerts if the individual leaves a predefined area.

Action Plan for Wandering Incidents

Conduct an Immediate Search	Begin searching in the surrounding area for up to 15 minutes, focusing on locations the individual is familiar with or may have tried to reach.
Contact Authorities Quickly	Notify local law enforcement and provide detailed information, including a physical description, recent photos, and known destinations. If enrolled in a safe-return program, contact them immediately for additional support.
Act Swiftly and Decisively	Rapid response is crucial to increasing the likelihood of a safe recovery. The sooner the individual is located, the lower the risk of harm.

Personal Safety GPS Location Watch or Pendant

 With GPS technology now integrated into devices such as watches and pendants, locating lost individuals in real time has become significantly more efficient. These tools enable swift identification of the individual’s location, facilitating their safe and timely return to a loved one or aged care facility

By implementing these safety measures and having a clear action plan, caregivers can reduce the risks associated with wandering and respond effectively in emergencies.

GPS LOCATOR & FALL Alert Watch

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For additional insights and advice, we invite you to view our detailed blog post on Caring for Dementia Patients

Disclaimer: The content of this blog has been compiled from a variety of sources, including independent aged care research studies, published papers, professional opinions from occupational therapists, and insights from carers experienced in the daily care of individuals with cognitive and physical challenges. This information is provided strictly for informational and educational purposes.

While A.C.A. management have over 35 years of experience in the aged care and disability sectors, we are not accredited medical professionals. Accordingly, the information presented herein should not be interpreted or relied upon as professional medical advice. For any medical concerns, diagnoses, or treatment options, readers are strongly encouraged to consult directly with a qualified general practitioner or healthcare professional.