For a caregiver, one of the most anxiety-causing side
effects of dementia is wandering. With this diagnosis,
caregivers come to expect severe memory loss and
confusion as to time and place, but usually they are not
prepared for the constant “watch” they must have on
their loved one.
Nearly 60 percent of all people with dementia wander,
especially in the middle stages. There are many facets
to this unpredictable behavior, and the causes are as
numerous as the tactics people have used to curtail
them. In the end, knowing an individual’s personality,
prior lifestyle and triggers which may send them “on the
move” will make all the difference.
Knowledge is Key
If a previous homemaker was accustomed to retrieving her
children from the bus every day at 3:30 p.m., and as a
senior with dementia, she wanders at that time
habitually, it’s time to connect the dots. Her wandering
pattern is the reason people wake up at the same time
each morning without an alarm clock. Those set schedules
become a part of the person. The triggers which initiate
wandering are different for individuals. No two
individuals have identical life experiences and past
daily routines; not even driving or walking habits.
When a man lives in New York City his entire life, and
then is moved to small-town Wisconsin so his daughter
can care for him, it’s understandable he craves some
sense of his former life. Plagued with dementia,
however, he doesn’t understand that his neighbor from
Queens is no longer a short stroll down the sidewalk.
Thus, taking a walk becomes a dangerous wandering risk
when he can’t find his friend’s home.
A loved one’s former work schedule also can be a clue to
wandering patterns. What time did they start? What time
did they arrive back home? Some people believe they are
at work all day and try to leave when the sun sets,
searching for a way home. They may look for a bus stop,
train station, even parking garage. Anxiety might creep
in when they feel unable to leave and care for their
families. Many times a person with dementia says, “Why
are you making me stay here?” For a caregiver, knowing
these seemingly insignificant “life” facts can make a
day less stressful and more predictable.
The Source of Wandering
As the professionals at Mayo Clinic emphasize, many
wanderers are either searching for or escaping from
Often, wandering occurs for no other reason than mere
confusion. When a person with dementia becomes lost and
disoriented after leaving a restroom at a public setting
and cannot place themselves, it is a sign they may need
The challenge for them is an inability to communicate
where they are, who they are with, and where to go next.
Many times a person with dementia may not know their
friends and family by name, but only by sight or even
smell. Living with a degenerative memory disease is
scary. At the onset, the person knows something is
different and “off.” Imagine the fear of being in a room
of people who seem familiar, but you just can’t pinpoint
why. It makes the person with dementia uncomfortable, so
they seek a way out of the situation. Factor in loud
music or congestion of people and these triggers
guarantee a paranoid, very fearful person. This explains
why a person who wanders is not always in search of an
intentional destination, but may be expressing a sign of
distress and the need to escape.
A caregiver on the hunt must consider the physical,
social and geographical factors of the place from where
their loved one left. If it’s from the inside of a quiet
home with which they are familiar, it’s a different
story. They may be bored, looking for their job or going
for the mail.
As a caregiver, it’s also necessary to ensure your loved
one is getting enough exercise. Just as children and
adults need physical stimulation to keep their bodies
healthy, so do people suffering from dementia. Exercise
lessens their anxiety and sense of boredom.
Socialization is also an essential component to
controlling nervousness, and in turn, wandering. No one
likes to be alone.
The desire to fulfill basic living needs such as eating,
drinking and using a restroom are all reasons a person
may wander. Photos on doors can help with direction and
a successful outcome. It is the caregiver’s
responsibility to ensure these needs are met; otherwise,
the person under their care may take off in pursuit of a
bathroom and soon become lost.
A Different Direction
There are many factors a caregiver cannot control, as
hard as they may try. With this illness, brain function
is changing and lessening. A caregiver can have some
influence, however, by guiding their loved one in a
different mental direction.
Understanding why persons with dementia wander is the
key to keeping them safe. A caregiver can pinpoint the
triggers by keeping a journal of the incidents. Also,
the caregiver should look for a pattern, whether it is a
time of day or the location the wanderer is seeking.
Once the “why” is determined, there are several methods
available to slow down someone with dementia.
For the homemaker, meeting her kids at the bus, folding
towels, stirring a pot, or engaging in something else
that reminds her of her past daily routine can keep her
busy. A caregiver can tell her that the children will be
home shortly, and change the discussion topic.
Distraction and redirection are vital in keeping a loved
one calm and feeling in control. How a caregiver
redirects is just as important as the task itself.
It must be done in a way that is supportive of the
person with dementia.
The Journal of Family Practice says this: “Redirection
is the most commonly misused behavioral management
technique. When patients enter restricted areas, attempt
to elope, or engage in problematic interpersonal
exchanges, caregivers may tell them ‘You can’t do that’
and attempt to physically lead them away. Handled this
way, redirection is often an antecedent to agitated or
The journal offers this three-step approach, developed
at Mayo Clinic, to successful redirection.
First, validate the person’s apparent emotional state.
(“You look worried.”) This helps establish rapport.
Secondly, join their behavior. A caregiver might say,
“You’re looking for your children? Well, I’m trying to
find something, too. Let’s look together.”
And finally, establish a common goal. Those with
dementia are easier to distract after being treated as
if they are needed, and part of a team. (“Let’s look
over there where those people are having coffee.”)
Looking for the Lost
Even though redirection is a crucial part in providing
care for a loved one with dementia, there are times the
person simply goes missing.
In the “Caregivers Fact Sheet—Wandering in Dementia” by
Meredeth Rowe, RN, PhD, it states that typically
wanderers are found within five miles of their home. Her
research also concludes that 90 percent walk away, five
percent drive and very few use public transportation.
This seasoned nurse says the first step is to contact
law enforcement as 50 percent of the time this sector is
the first to find a lost loved one with dementia. Then,
conduct a search immediately. The person will NOT return
by themselves. Have a search plan. A friends-and-family
network is an essential tool to have in place, so when
the caregiver is out searching, the police and other
people will have someone by a phone who can inform the
others out looking when news comes in.
“Rapid action is crucial in preventing injuries and
death after you cannot locate your relative,” says Rowe.
“Enlist your family and neighbors to rapidly search the
immediate neighborhood including yards, sheds and cars,
etc. for about 30 minutes. If you haven’t found
the person, call 911 – don’t wait more than 30 minutes
at the most.”
Also, it will not work to predict where they may wander.
As caregivers, knowing why they wander is one thing, but
predicting where they will go is another. At this point,
the person is lost and has no clue where to head next.
“Most persons with dementia will remain in populated
areas walking in neighborhoods, around or in businesses,
or along roads,” Rowe adds. “These people are
easier to find, although it might take awhile. A
small percentage decide to seclude themselves in woods,
natural areas, or abandoned buildings and are very
difficult to find. They hide themselves and don’t
respond to searchers. So even though a searcher is
near them, they remain hidden.”
As a caregiver, first get help searching; and then, get
A caregiver must make sure their loved one has
identification on them at all times. Often, police or
community residents find a wanderer and can easily help
by first establishing identity.
However, people with dementia misplace things very
easily, including license and ID cards, so today’s
technology is aiding caregivers with an extra layer of
security for their loved one. The options are growing
One of these options, GPS tracking, is a top competitor
for wander solutions. Many companies have developed
their version of “person” tracking devices. Some are
bracelets, wristbands, and necklace pendants a loved one
can wear with assurance they will never be completely
out of sight.
According to a GPS Tracking blog
(www.rmtracking.com/blog), GPS tracking works by sending
a signal from the transmitter a loved one is wearing to
a home computer or receiving device. A caregiver can log
on at any time to check on the whereabouts of their
loved one, and even view a report of their activities
throughout the day.
Some devices are also equipped with an alert button so
that if the person with dementia becomes disoriented,
they can press a button which sends a message to their
caregiver via phone or email. Other devices allow
caregivers to establish physical perimeters, alerting
them if their loved one ventures beyond.
The U.S. federal government has even stepped up to offer
assistance for dementia-based location initiatives. The
program works with local law enforcement, establishing
response teams who are notified once a person with
dementia has gone missing. These teams are trained
specifically to help guide the person home, using
state-of-the-art technology and also special
communication skills, knowing how to approach them and
earn their trust.
Other technology solutions involve in-home camera
monitoring and just released, cell phone tracking
devices which are linked to 911 emergency response
systems. Resources are available to caregivers; it is
just a matter of determining which technology is best
suited for their loved one’s lifestyle.
Safety is always a caregiver’s number one priority and
freedom is their loved one’s goal. It may take a village
to raise a child, and many caregivers would agree it
takes the same to keep a loved one with dementia safe.
From doctors prescribing medications to neighbors being
on the look-out, resources are available. Rowe
says a caregiver should not be embarrassed to ask for
help, and that “persons with dementia wander even when
the caregiver has done everything humanly possible to
provide excellent care and prevent this from occurring.
It is not possible to provide 24-hour supervision. ”
The Alzheimer’s Foundation of America and professionals
at Mayo Clinic offer these practical tips to keep a
- First, reduce hazards. Throw rugs and extension cords are
both tripping risks. Gates at stairwells and nightlights
offer fall prevention.
- Having a “safe” zone for walking and
exploration offer a loved one a place for
exercise and also instills a sense of freedom
they may have lost. A fenced backyard or
three-season patio are good options.
- Reduce environmental stimuli like loud music
or overcrowding, which might initiate wandering
- Set a daily routine that includes
- Hide essential items such as coats, keys,
wallets, and shoes that may spark a desire to
- Another consideration to increase safety is
camouflage. A coat of paint, curtains, or some
wallpaper can cover a door and blend it in with
the surrounding wall. A mirror also works to
deter a dementia patient from entering rooms
that are off limits or not safe.
It’s difficult for a caregiver to not feel as if they
are “locking down” their loved one, but the
repercussions can be a lost person, or worse. Wandering
is a serious side effect of dementia, though it may be
minimized with a bit of knowledge and practical safety
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