Which action is helpful for a person with Alzheimer's disease AD who often wanders?

According to the National Institute on Aging, about 60% of people with Alzheimer's disease will wander, a potentially dangerous behavior that can lead to a person becoming lost or injured. The single most helpful action is to create a multi-layered safety plan that includes securing the environment, using technology, and implementing behavioral strategies to address the root causes of restlessness.

Quick Summary

Creating a comprehensive safety plan is the most effective approach for managing a person with Alzheimer's who wanders. It involves securing exits with alarms, providing tracking devices, establishing calming routines, and notifying neighbors to ensure the individual's safety.

Key Points

• Secure the Exits: Install door and window alarms or keyed locks placed high or low to prevent unsupervised departures and alert caregivers.

• Use Wearable GPS Technology: Utilize GPS tracking devices, often integrated into watches or bracelets, for real-time location monitoring in case the person leaves the home.

• Establish a Consistent Routine: Implement a predictable daily schedule for meals, exercise, and sleep to reduce anxiety, restlessness, and the impulse to wander.

• Register with a Safe Return Program: Enroll the individual in a program like the Alzheimer's Association's Safe Return to ensure 24/7 support and aid from emergency responders.

• Create a Safe Wandering Area: Provide a securely fenced-in yard or garden where the person can walk and get fresh air safely, satisfying their need for movement.

• Provide Clear Identification: Ensure the person always wears a medical ID bracelet or carries identification with their condition and your contact information.

• Inform Your Community: Tell neighbors and local police about the wandering behavior, giving them a recent photo and your contact information to create a community safety net.

Understanding the Causes of Wandering in Alzheimer's

Wandering is not a random act but a behavior with underlying causes that a caregiver can address. By understanding the motivations, it is possible to implement more effective prevention strategies.

Common Triggers for Wandering

• Confusion and Disorientation: The person may feel lost in their own home and search for a familiar place, such as their childhood home or a past workplace.
• Reliving a Past Routine: An individual might be trying to go to a past job, pick up children from school, or run an errand, believing they still need to complete these tasks.
• Boredom or Restlessness: A lack of physical or mental stimulation can lead to a need for movement. Wandering can be a way to alleviate this boredom.
• Anxiety or Fear: The person may be frightened by something in their current environment, like loud noises, and feel the need to escape.
• Basic Unmet Needs: Discomfort from hunger, thirst, or needing to use the bathroom can prompt someone to wander in search of relief.

A Multi-Layered Approach: Securing the Environment

The most helpful action for a person with Alzheimer's disease AD who often wanders is to create a secure, safe living environment. This does not mean creating a prison but rather an environment that offers freedom within safe boundaries. A multi-layered strategy provides different levels of security to prevent a dangerous situation.

Physical Barriers and Alarms

1. Use Door and Window Locks: Install keyed deadbolts on all exterior doors, placing them high or low on the door where the person might not look or be able to reach. Other options include chain locks or slide bolts. Remember to keep the key in a place easily accessible to a caregiver in case of an emergency.
2. Install Door and Window Alarms: Consider alarms that chime or alert a caregiver whenever a door or window is opened. Pressure-sensitive floor mats placed in front of exits can also alert you when the person gets out of bed or approaches a doorway.
3. Camouflage Exits: Discreetly camouflage doors by painting them the same color as the wall or hanging a decorative curtain or poster over them. This visual deception can make exits less obvious to someone with memory impairment.
4. Secure the Yard: For those who need fresh air, a securely fenced-in yard with a locked gate can provide a safe outdoor space for walking.

Comparison of Wandering Prevention Technologies

Feature	GPS Tracking Devices	Door/Window Alarms	Smart Home Sensors	Safe Return Programs
Primary Function	Real-time location tracking	Entry/exit alerts	Movement/activity monitoring	Emergency response network
Wearable	Yes (watch, bracelet, pendant)	No	No	Yes (ID bracelet)
Cost	Subscription fees, device cost	One-time device cost	Device cost, optional hub	Registration fees
Alerts Caregiver	Yes (via app, text)	Yes (local or remote)	Yes (via app)	Yes (24/7 hotline)
Effectiveness	High for locating a lost person	High for preventing exit	Moderate (best with other tech)	High for community coordination
Best Use	When a person leaves the home	As an immediate warning system	For nocturnal wandering or fall risk	For community awareness and ID

Behavioral Strategies and Engagement

Beyond environmental modifications, addressing the person's behavioral needs is a crucial part of prevention. Engaging the individual and managing their daily life can reduce the underlying causes of wandering behavior.

Creating a Calming and Structured Routine

• Establish a Predictable Daily Routine: A consistent schedule for waking up, meals, and bedtime provides a sense of security and reduces anxiety. A structured day is less likely to trigger feelings of restlessness or confusion.
• Schedule Regular Exercise: Planned, supervised physical activity, like a walk in a safe area, can help reduce excess energy and improve sleep, which in turn reduces nighttime wandering.
• Provide Engaging Activities: Keep the person occupied with simple, repetitive tasks that they enjoy. Activities like folding laundry, listening to familiar music, or gardening can be calming and purposeful.
• Minimize Overstimulation: Overly noisy or busy environments can be overwhelming. Provide a quiet, clutter-free space for relaxation to help minimize agitation.

Preparing for the Worst-Case Scenario

Even with the best precautions, wandering can still occur. A solid emergency plan is essential for a person with Alzheimer's disease AD who often wanders.

Essential Emergency Preparedness Steps

1. Register with a Safe Return Program: Programs like the one from the Alzheimer's Association, in partnership with MedicAlert®, provide a 24/7 hotline and emergency response service.
2. Ensure Constant Identification: The person should always carry some form of ID, such as a medical alert bracelet, pendant, or temporary tattoo. This ID should include their name, condition (e.g., "memory loss"), and your contact number.
3. Use GPS Tracking Technology: Wearable GPS devices offer peace of mind by allowing you to track the person's location in real-time if they leave a designated area.
4. Inform Your Community: Make neighbors, local police, and businesses aware of the person's condition and wandering tendency. Provide a recent photo and ask them to contact you immediately if they see the person alone.
5. Create a Wandering Information Sheet: A pre-filled sheet with the person's physical description, typical wandering destinations, and a recent photo can be given to police to speed up the search process.
6. Hide Car and House Keys: Keep all car and house keys, coats, and hats out of sight to prevent the person from having an easy way to leave.

What to Do Immediately If the Person Is Gone

If, despite your best efforts, the person with Alzheimer's has wandered off, a swift and calm response is critical. Time is of the essence, and knowing the right steps can make all the difference.

The First 15 Minutes Are Critical

• Call 911 Immediately: Do not hesitate. Inform the police that a person with Alzheimer's is missing. Provide them with your prepared wandering information sheet.
• Search the Immediate Area: Check all rooms, closets, the garage, basement, and any nearby bushes or sheds. Many people who wander are found within a short distance from where they disappeared.
• Notify Your Network: Call all family, friends, and neighbors who you have previously informed of the situation. Send them the recent photo and description.

By combining proactive prevention measures with a robust emergency plan, caregivers can significantly reduce the risks associated with wandering. A supportive and secure environment, coupled with the right technology, provides the best defense against this common and dangerous behavior in people with Alzheimer's.

For additional support and resources, the Alzheimer's Association offers a wealth of information and a 24/7 helpline.

Conclusion: Prioritizing Proactive Safety

Wandering is a symptom of Alzheimer's that can be unsettling for both the individual and their caregivers. By focusing on preventative actions—primarily creating a secure home environment and establishing calming routines—you can reduce the frequency and risk of wandering. The most helpful approach is a combination of physical security (alarms, locks), technological assistance (GPS trackers), and behavioral management (routines, exercise). A prepared emergency plan with community awareness serves as the final safety net. These proactive measures not only enhance the person's safety but also reduce stress for caregivers, allowing for a more secure and peaceful living situation for everyone involved.

Frequently Asked Questions

What is the very first thing I should do if my loved one with Alzheimer's wanders?

If you discover your loved one is missing, the very first action you should take is to call 911 immediately. Every minute counts. While waiting for authorities, begin searching nearby, including the house, yard, and immediate vicinity.

Are door alarms effective for a person with Alzheimer's who wanders?

Yes, door and window alarms are highly effective tools. They provide a vital alert system that notifies caregivers when an exit is opened, allowing for immediate intervention. Placing pressure-sensitive mats in key locations can also serve this purpose.

What kind of ID is best for a person with Alzheimer's who wanders?

A medical alert bracelet or necklace is often recommended, as it is difficult to misplace. It should state their condition (e.g., 'memory loss') and include your contact number. Some caregivers also use temporary tattoos or sew identification into clothing.

How can I reduce restlessness that causes a person with Alzheimer's to wander?

To reduce restlessness, try establishing a predictable routine, incorporating regular supervised exercise like a walk, and providing engaging activities to keep them occupied. Addressing basic needs like hunger or thirst can also help.

Should I tell my neighbors and local police that my loved one with AD tends to wander?

Yes, informing your neighbors and local law enforcement is a crucial preventative measure. Provide them with a recent photo and ask them to contact you immediately if they see the person alone outside of the home.

How can I safely provide outdoor time for a person with Alzheimer's who wanders?

For safe outdoor time, create a securely fenced-in yard or garden. This allows the person to move freely and get fresh air in a controlled and safe environment. Always ensure the gate is locked.

What are some ways to keep keys and other departure cues out of sight?

Keep car keys, house keys, coats, and purses out of plain view and in a secured location. These items can act as visual cues that trigger the desire to leave the home. A secured cabinet or high shelf can be a good storage solution.