Wandering is a common behavior that arises in the later stages of dementia or Alzheimer’s disease. This behavior is fraught with possible danger. It’s one of the most potentially hazardous of all problems generated by dementia because it involves the risk of
Getting lost
Being run over
Becoming a target for muggers
Developing hypothermia or becoming dehydrated as a result of wearing inappropriate clothing
Of course, none of these things may happen, and the wanderer may just have a lovely stroll. However, plenty of caregivers have been driven to their wits’ end by this behavior as the police return their relative after a night-time sojourn to the park in his pajamas or a jaywalking expedition along the main road.
Understanding the causes of wandering
A whopping 60 percent of people with dementia are believed to wander. But they don’t do it to get on their caregiver’s nerves; an underlying reason for this behavior always exists. In fact, rather than being labeled as “wandering,” this behavior should really be seen as walking with purpose. It’s just that family members and caregivers are often in the dark about what that purpose is. Some suggested causes are
Searching for something or someone: This may be an object the person thought he left somewhere and can’t find, a person he desperately wants to see, or if he’s in new and unfamiliar surroundings, he may simply be on the hunt for something to eat or drink or for a bathroom. And he may be searching for home, often somewhere he lived in the past.
Getting away from something: Stressful or worrying situations may prompt the person with dementia to just get up and go; maybe he finds the current environment too noisy and is trying to find some peace and quiet.
Sticking to previous routines: Apparently, old habits die hard, and this can certainly be the case when someone goes wandering. He may set off for work at a particular time or make his way to the local football stadium to support a team disbanded years ago.
Responding to memory lapses: Someone with dementia may become stuck or side-tracked halfway through a task and set off to get the “something” he’s convinced he needs to finish off the job.
Dealing with a combination of excess energy and boredom: Simply because someone has dementia doesn’t mean that he can’t get bored or wants a change of scenery and some exercise.
Obviously, personality differences mean this list isn’t exhaustive. It does, however, cover most bases.
Smart strategies to try
Caregivers’ stress levels can go through the roof when they’re looking after someone who wanders. As a result, wandering can be a very frustrating and frightening behavior to deal with. However, knowing why a person may wander means that the caregiver can take steps to control it. Here are a few tips:
Signposting: Make things less confusing in the house or care home by sticking labels (with words or pictures) on all the doors to say which rooms are behind them and putting up small posters with arrows directing the person with dementia or Alzheimer’s disease to the kitchen, bathroom, dining room, and so on.
Camouflaging exits: Making a front door look less like a front door means it won’t prove such an obvious escape route. Hang a curtain across the back of the door or paint it the same color as the wall. Or put up a poster that disguises the door as a window or a painting. Also avoid leaving front door or car keys in sight.
Ensuring that needs are met: Avoid the need for people with dementia to wander off to the bathroom, kitchen, or away from a noisy environment by anticipating their needs. Ask whether they’re hungry and thirsty or need to use the bathroom; turn down the television or music if they find such sounds agitating.
Offering stimulation: Boredom is frustrating at the best of times and can be particularly so if you rely on others for your care and entertainment. Keep the person you care for occupied. If he’s able, encourage him to continue with his hobbies, get him to help around the house with chores, and take him out to get some exercise and thereby create some natural tiredness too.
Providing easy identification: This can best be achieved by giving people small ID cards to carry in their pockets, bags, wallets, or purses. These can inform people on one side that the holder has dementia and may need help, and on the other list contact details. Also consider buying some medical ID jewelry — either a pendant for a necklace or a bracelet, such as from MedicAlert, which not only provides identification information but also a 24-hour emergency number.
Alerting the community: It’s always useful to let neighbors and local shopkeepers know of people who are prone to wandering so they can keep an eye out for them and give you a call if they spot them out unsupervised.
Avoiding leaving them home alone: Leaving someone who can wander either indoors unsupervised or locked in the car while you step out is asking for trouble.
Using a GPS tracking device: Radio tracking devices are available, along with back-up support, from organizations such as Project Lifesaver. Cellphone apps, such as iWander, can also pinpoint someone who’s missing.
Facing the worst-case scenario
If someone with dementia does go missing, you need a plan for tracking him down as quickly as possible. Having notified friends and local shop owners, you’ll have a ready supply of lookouts to contact for help. Developing a good knowledge of your local area is also advisable so you’re familiar with paths, parks, rivers and streams, bus stops, and spots where people could fall and remain out of sight.
As soon as you realize that the person you’re responsible for is missing, spend 15 minutes or so checking these local spots and asking neighbors and shopkeepers whether they’ve seen him. It is also worth considering that he may have gone to see relatives or to visit an old address. After that, if you’ve had no luck, call the police.
Always keep a recent photo of the person with you to show to the police and others if he does go missing.