How can you as the carer prevent wandering?

Did you know that up to 60% of people with dementia may wander at least once, posing a significant safety risk? As the carer, understanding how can you as the carer prevent wandering is crucial for ensuring the safety and well-being of your loved one. This guide explores practical and compassionate approaches to manage and mitigate this challenging behavior, helping you create a secure and calm environment.

Quick Summary

Caregivers can prevent wandering by implementing home safety modifications, establishing consistent routines, managing triggers like "sundowning," and utilizing tracking technology and community support systems.

Key Points

• Secure the exits: Install locks out of sight (high or low) and use door/window alarms to provide alerts when a person attempts to leave.

• Establish a routine: Maintain a consistent daily schedule for meals, sleep, and activities to reduce anxiety and disorientation that can trigger wandering.

• Use tracking technology: Invest in GPS trackers (like smartwatches) or medical ID bracelets to ensure quick location and identification if wandering occurs.

• Identify and manage triggers: Observe and log patterns related to wandering, such as sundowning, boredom, or unmet needs, to address the root cause.

• Engage in meaningful activities: Provide purposeful and stimulating activities, as regular physical and mental engagement can decrease restlessness.

• Build a support network: Inform neighbors and local authorities about wandering tendencies to help ensure a prompt and safe return if the person goes missing.

Understanding Why Wandering Occurs

For a carer, understanding the root causes of wandering is the first step toward effective prevention. People with dementia or other cognitive impairments may wander for many reasons. They might be looking for something, trying to fulfill a past routine, or simply feeling disoriented, restless, or bored. Changes in routine, noisy environments, and the phenomenon of "sundowning"—increased confusion and agitation in the late afternoon and evening—are common triggers. A person might believe they need to go to work or find their former home, driven by confusion rather than a conscious desire to leave.

Creating a Secure Home Environment

Securing the home is a foundational aspect of preventing wandering and ensuring safety. A multi-layered approach provides the best protection, combining low-tech and high-tech solutions.

Implement Physical Deterrents

Physical modifications to the home can make it more difficult for a person to exit unnoticed:

• Install locks out of sight: Consider keyed deadbolts positioned high or low on exterior doors, outside of the person's typical line of sight.
• Use alarms and sensors: Simple bells on doorknobs or more advanced motion sensors can alert you when a door or window is opened. Pressure-sensitive mats near exits can also be effective.
• Camouflage exits: Covering doors with curtains or large decals that look like bookshelves can visually disguise the exit. For people with dementia, this simple trick can significantly reduce their focus on the door.
• Secure the yard: Fencing with locked gates can provide a safe outdoor space for fresh air while preventing unsupervised leaving.

Remove Temptations and Hazards

Items that signal a departure, such as coats, shoes, wallets, and car keys, should be kept out of sight. A person might see their coat and feel the urge to go out, so concealing these items can prevent a wandering episode before it starts. It is also essential to reduce clutter and ensure pathways are clear to prevent trips and falls. Nightlights in hallways, bedrooms, and bathrooms can help with nighttime navigation, reducing disorientation and anxiety.

Establishing Calming Routines and Engagement

Engaging a person's mind and body can help manage restlessness and reduce the impulse to wander.

Structure the Day with Purposeful Activities

A consistent daily schedule provides a sense of predictability and security, especially during times of anxiety or sundowning. Plan a variety of meaningful activities that match the person's abilities, such as folding laundry, listening to music, or going for a supervised walk. Regular physical activity, particularly in the morning, can help reduce nighttime agitation and promote better sleep.

Observe and Address Triggers

Keeping a log of when wandering behavior occurs can help you identify triggers. Look for patterns related to times of day, noise levels, or specific situations. Addressing basic needs—checking if the person is hungry, thirsty, or needs to use the bathroom—can often prevent an episode before it starts.

Utilizing Advanced Technology and Community Support

Technology provides an extra layer of protection, and a strong community network can be a vital resource.

Comparing Wandering Response Technologies

Feature	GPS Tracker (e.g., smartwatch)	Medical ID Bracelet	Wander Alarm System
Function	Tracks location in real-time	Identifies individual if found	Notifies carer when person exits
Effectiveness	High, for finding lost individuals quickly	High, for clear identification	High, for immediate alerts at home
Wearability	Discreet, often worn as a watch	Simple jewelry or sewn into clothing	Integrated into home environment
Cost	Can be higher, with monthly fees	Low, one-time purchase	Varies, from simple to complex systems
Privacy	Raises concerns for some; requires balance with safety	Minimal privacy concerns	Confined to the home environment

Building a Local Support Network

Introduce your loved one to trusted neighbors and explain their condition and wandering tendencies. Provide your contact information and ask them to call you immediately if they see the person alone. It is also wise to inform your local police and fire departments, who can add the person to a vulnerable person registry.

Planning for Emergencies: What to Do If Wandering Occurs

Even with the best precautions, wandering can happen. Being prepared is the best defense.

1. Search the vicinity immediately: Start by checking the home and immediate outdoor area. Look in familiar places, such as previous residences or old workplaces.
2. Call 911: Do not delay in contacting authorities. Provide a recent photo and detailed description of what the person was last wearing.
3. Use your support network: Alert neighbors and friends to assist in the search.
4. Use tracking devices: If the person is wearing a GPS tracker, check their location immediately. Wandering response programs can also assist with searches.

Legal and Ethical Considerations for Caregivers

While safety is paramount, it is important to balance security measures with the individual's dignity and autonomy. For example, while securing doors is necessary, it is ethically problematic and illegal to lock a person in a house and leave them unattended. The goal is to make it difficult to leave unnoticed, not to imprison them. Involving the person in care decisions as much as possible respects their personhood and can reduce agitation. Caregivers can consult resources like the Alzheimer's Association for guidance on handling specific behaviors and creating safe plans of action: Wandering Safety.

Conclusion

Preventing wandering is a significant and stressful part of caregiving, but a proactive, compassionate, and layered approach can mitigate the risks. By focusing on securing the environment, establishing routines, understanding triggers, leveraging technology, and building a community support network, you can ensure your loved one's safety while preserving their dignity. Remembering that wandering is often a symptom of an unmet need or a moment of confusion, rather than a deliberate act, allows you to respond with empathy and effective strategies. The best approach balances security with respect, creating a safe and engaging home where your loved one can thrive.

Frequently Asked Questions

What is 'sundowning,' and how does it relate to wandering?

Sundowning is a state of increased confusion, anxiety, and agitation that occurs in the late afternoon and evening, often associated with dementia. This can increase a person's risk of wandering, as they may become more disoriented and restless during this time. Establishing a calming evening routine and reducing stimulating activities can help.

Are lockable doors safe for someone who wanders?

Yes, but with precautions. While it is important to secure exits, you must never lock a person inside and leave them unattended. Locks should be positioned out of their sightline (high or low) and paired with alarms to alert you if an exit is attempted, allowing for immediate supervision while balancing safety with dignity.

How can I make my backyard or patio safe for a senior who wanders?

Creating a secure outdoor space with a high, locked fence can allow a person to safely enjoy fresh air and exercise. Ensure the gate has a secure, hard-to-open lock and that the path is clear of tripping hazards. Alerting neighbors is also a key safety measure.

What if my loved one refuses to wear a medical ID bracelet?

If they resist wearing a bracelet, there are other options. You can sew a label with their name, condition (e.g., 'memory loss'), and your contact information into their clothes. Temporary tattoos with the same information are also available and can be a good alternative.

What should I do immediately if I realize my loved one is missing?

The most important thing is to act quickly. First, search the immediate area, checking all rooms and the yard. If you cannot find them, call 911 immediately. Have a recent photo and a description of their clothing ready. Notify neighbors and use any tracking devices you have.

Can certain medications increase the risk of wandering?

Yes, some medications can cause confusion or disorientation, which may increase the likelihood of wandering. If you notice changes in behavior, consult with the person's doctor to review their medications and dosages. Never alter medication without medical advice.

Is it possible to disguise exits to prevent a senior from wandering?

Yes, this technique can be very effective. Covering doors with posters, decals that resemble bookshelves, or curtains can reduce the visual cue that it's an exit. Similarly, placing a black mat in front of a doorway can sometimes be perceived as a barrier they cannot cross.