Dementia – Practical Tips to Prevent Wandering
How the Alzheimer’s Caregiver Can Create a Safer Environment
Aug 1, 2009
More than 60% of people with Alzheimer’s will wander at some time. Years ago, many people with Alzheimer’s were restrained in long term care facilities and at home if they began to wander. Learn how to keep a wanderer safe while maintaining his dignity and optimizing his freedom.
Is the Person with Dementia Getting Enough Exercise?
Those with dementia may wander because of their need for physical activity. The American Heart Association recommends 30-40 minutes of moderate daily activities unless otherwise directed by a healthcare provider. Examples of moderate activities include:
- Walking
- Playing shuffleboard
- Gardening
- Housework
- Dancing
Behaviors That Often Precede Wandering
Two behaviors that typically occur before wandering are pacing and disorientation. If a person with dementia has a need, he is often unable to verbalize that need and will exhibit a sudden change in behavior instead. Check for clues that may indicate an unmet need.
- Ensure that appropriate fluids are offered at regular intervals throughout the day.
- She may be hungry if a mealtime is near.
- He may pull at clothing if needing to use the toilet.
- Check to see that clothing is suitable for the environmental temperature.
- Consider pain medication if appropriate.
- Providing a calm, predictable, and relaxed atmosphere may decrease anxiety.
- Sudden increased disorientation, or delirium, may indicate an infection or medication reaction, so notify the healthcare provider if the change in behavior persists or is cyclic.
Watch for Patterns of Wandering in People with Alzheimer’s
Many people with Alzheimer’s disease have a pattern to their behaviors. By watching for patterns, caregivers may be able to distract the person with specific activities at those times. Watch for triggers in addition to physical needs above, such as the time of day and environmental changes. Many people with dementia tend to become increasingly agitated in the transition between daylight and darkness, a condition known as Sundowners syndrome. A new or change in a familiar environment may result in increased agitation – it is helpful to introduce changes slowly if possible. For example, brief visits to a future home or with a new caregiver may be helpful to help prepare for the change. If the behavior seems to be related to medications, immediately notify her healthcare provider.
Make the Home Environment Safe for Someone with Dementia
Providing an environment that fosters free movement can help reduce stress for the caregiver while providing increased safety for the person with dementia. If the person with Alzheimer’s tends to explore areas, the caregiver may install child-safety devices. Try providing activities that involve the hands, such as:
- folding clothes
- washing vegetables
- exploring a rummaging drawer with a variety of objects
- providing recreational activities, such as music and animal-assisted therapy
Safety Suggestions for Those Who Tend to Wander Away From Home
Fewer than 4% of people with dementia can find their way home unassisted. This presents a major safety challenge, especially during weather extremes because a person with dementia may be inadequately dressed for environmental conditions. People with Alzheimer’s may be quite lucid at times and may be able to disarm many safety devices, so always ensure that the person with dementia is properly supervised.
- Place a large sign on exit doors saying “Stop” or “Do Not Enter.".
- Hide doorknobs with a color-matched cloth or a curtain.
- Place a mirror near doorways because seeing her face may stop her from leaving the building.
- Wall murals depicting an outdoor scene may make the person with dementia feel as if he is outside.
- Keep temptations, such as keys, out of sight.
- Install motion sensors or a device that will alarm if an exit door is opened.
- Provide reassurance and redirect conversations if he appears anxious or insists on “going home” or “going to work," or attempts to fulfill former responsibilities.
- Keep a recent photo and detailed physical description of the person readily available.
- Know identifying information of all vehicles at the home.
- Notify neighbors and police of the person’s tendency to wander and provide contact information as well as obtaining their contact information.
- Utilize programs designed to help track someone who is lost, such as MedicAlert+SafeReturn and Project Lifesaver International.
Planning Ahead to Protect Someone Who May Wander
Although no plan is foolproof, taking practical steps such as those listed above may help protect the dignity and health of someone with dementia or Alzheimers.
The information in this article is not intended to be medical advice. Contact your healthcare provider with specific concerns related to wandering, Alzheimer’s Disease, and dementia.
Web Site Sources:
Alzheimer's Association "Wandering"
American Heart Association “Exercise (Physical Activity) for Older People and Those With Disabilities”
A Place for Mom “Sundowners Syndrome”
Everyday Health “Strategies to Deal With an Alzheimer’s Patient Who Wanders” by Dennis Thompson, Jr.
Real Mental Health “Responding to Unusual Behavior: Understanding and Responding to Challenging Behaviors in Alzheimer’s Disease”
WebMD “Animal Assisted Therapy: The Purr-fect Therapy” by Michele Bloomquest
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