Wandering

It is estimated that over 60 percent of Alzheimer’s patients will wander off at some point. Wandering can be a very confusing and scary behavior problem not only for the patient but for the caregiver as well.

Wandering can be caused by different symptoms that an Alzheimer’s patient is experiencing at any given moment. Boredom, restlessness, hunger, thirst, disorientation, confusion, stress, agitation, anxiety, side effects from medication—any or all of these problems can add to the problem of wandering.

There are other reasons why a person with Alzheimer’s may wander off, some of which make no sense to us, but make perfect sense to an Alzheimer’s patient.

For example, a patient will want to “go to work,” even though he or she has been retired for 10 years or more. Or the patient may want to “go home,” and try to return to a childhood home, even if that place exists only in his or her memory. These types of ideas are instilled into the patient’s brain because that is where they are at the moment, somewhere in the past.

Getting Lost

When wandering off, the Alzheimer’s patient often sets out with a specific goal in mind; however, that goal is usually lost at some point. It’s not unusual for patients to forget what that goal was or why they set out to do it in the first place. By the time they get to a certain point they get scared because they don’t know where they are or how to get back home. And being lost is a frightening thought for someone who does not have Alzheimer’s, let alone those who do.

How to Cope With Wandering

Many people with Alzheimer’s wander away from their home or from their caregiver. As the caregiver, you need to know how to limit wandering.

Try to follow these tips before the person with Alzheimer’s wanders:

  • Make sure the person carries some kind of ID or wears a medical bracelet. If the person gets lost and can’t communicate clearly, an ID will let others know about his or her illness. An ID will also show where the person lives.
  • Let neighbors and the local police know that the person with Alzheimer’s tends to wander.
  • Keep a recent photograph or video recording of the person to help police if the person becomes lost.
  • Keep doors locked. Consider a keyed deadbolt, or add another lock placed up high or down low on the door. If the person can open a lock, you may need to get a new latch or lock.
  • Install an “announcing system” that chimes when the door opens.
  • Consider a GPS locating device to find the wandering patient.

Look for the trigger

  • If the behavior is new, determine if there have been any big changes in her life. A recent move or change of caregiver can be stressful, for example, and frustration and anxiety can cause wandering. Take extra measures to calm the patient in stressful times, such as going on fewer outings and following a set routine. A new medication could be causing agitation as a side effect; mention the wandering to the prescribing doctor.
  • Look for a pattern in wandering episodes. If the wandering always happens at night, for example, it could indicate fear or loneliness, and the patient may need extra support after dark. If the wandering tends to happen at mealtimes, the patient may be hungry or thirsty and unable to follow through on these desires. Some people wander at specific times linked to activities from their previous work life or other former routines.
  • Assess whether your patient is busy enough. Sheer boredom is a common cause of wandering. Your patient should ideally have access to a variety of activities (sorting laundry or blocks, making art or crafts, watching nature-type videos, and talking). It’s also good to provide time out of doors with a companion and interaction with other people.

Reduce temptations and stressors

  • Keep keys out of sight. A friend or relative who has Alzheimer’s that’s severe enough to include wandering shouldn’t be driving. But that person may still recognize keys left hanging in a familiar place and drive off — even if you don’t think he or she has memories of driving or still knows how.
  • Avoid crowds. Crowded situations can produce stress that leads to wandering once the patient is back at home. And from a practical standpoint, it’s hard to keep track of someone who wanders when you’re in a shopping mall, fair, or other large public gathering.
  • Don’t let a wanderer go out alone. Even if the person you’re caring for is a longtime walker, he or she shouldn’t venture out unsupervised. The patient could become confused and meander away from her usual turf.
  • Don’t leave the patient in the car. If you leave someone prone to wandering alone in the car while you’re running a quick errand in the bank or drugstore, that person may become frightened or worried and slip out of the vehicle.
  • Make the house safer for walking. If you haven’t done so already, remove throw rugs, arrange furniture so the person has clear pathways to move through, and eliminate clutter and low-to-the-ground hazards such as magazine racks or plants.
  • Install nightlights. Illuminate preferred safe paths, especially in hallways and rooms that are used most.
  • Consider childproof locks for dangerous doors. Doors leading to stairways or the outdoors are the most problematic, so make it hard for an older person to open them. Block sliding glass doors.
  • Try new locks. Any kind of door lock that’s different from what the person always used, especially if it’s a bit challenging, such as a high chain lock or a key lock for a door that once had a button lock, might work because it’s difficult for an Alzheimer’s sufferer to learn new things.
  • Try a “Do Not Enter” sign on an exit door. Some people are deterred by this simple measure.

Try safety tools

  • Look into alarms that signal movement. Bed pads or chair pads with wireless remote alarms. With current technology these sensoring systems are becoming more and more inexpensive, and they offer an immediate alert that a wanderer is getting up. Other devices include floor mats with remote alarms, motion detectors that go off, and conventional door chimes that sound when a door is opened.
  • Disguise dangerous doorways. A gentler alternative to door locks is to lead the person away from certain doors with visual cues that convey that the door is something else. Camouflage possibilities include painting the door to match a surrounding wall or hanging posters, mirrors, or murals  on the door that are specially designed to make it look like a bookshelf or pantry shelf.

Enlist the help of others

  • Tell immediate neighbors about the person’s Alzheimer’s. Ask them to call you if, say, he or she uncharacteristically comes over to visit or is seen walking alone.
  • Use daycare and professional help. If someone with Alzheimer’s begins leaving home when he or she wanders, that person should no longer be left alone even for short periods. If you are the primary caregiver, take advantage of adult daycare programs or a relief caregiver when you must go out.

Be prepared

  • Keep track of clothes. If your friend or relative is a chronic wanderer, some caregivers recommend making sure the person always dressed in bright colors. That way, if the person does slip away, he or she can be more easily identified and found. The caregiver should keep track of what he or she is wearing each day.
  • Keep a recent photo handy. It’s common to avoid photographing an older person who appears greatly changed because of the disease. But an up-to-date shot will help searchers identify your patient if he or she should become lost.

Of all the reasons and solutions we have discussed for a wandering Alzheimer’s patients, none is more important than the caregiver being constantly aware of the habits of your patient.

Only you can know for sure what your patient is capable of, and what his or her needs are.

Being a good caregiver means being aware of almost everything your patient is doing at any given time. The good news is that there are products and services on the market today that will help give you “peace of mind” to help stem the problem of wandering. If you can take advantage of these products or services, wandering might just be one less problem you have to worry about.