How do you control wandering dementia? Comprehensive strategies and safety tips

An estimated 6 in 10 people with Alzheimer's disease will wander at some point, leading to high stress for caregivers and dangerous situations for the individual. Understanding the underlying triggers is the first step in learning how do you control wandering dementia and implementing effective safety protocols to protect your loved one.

Quick Summary

This guide provides practical strategies for managing dementia-related wandering by addressing triggers, modifying the home environment, using safety technology, and handling emergency situations.

Key Points

• Identify Triggers: Observe what prompts wandering, such as restlessness, boredom, or physical discomfort, to address the underlying cause proactively.

• Secure the Environment: Use high or low-mounted locks, door alarms, and camouflage techniques to prevent a person with dementia from exiting the home unsupervised.

• Maintain Routine and Redirect: Establish a consistent daily schedule and gently redirect a person who is wandering with a calming activity, rather than confronting them directly.

• Use Tracking Technology: Wearable GPS devices offer an effective way to track a person's location if they do manage to leave the house, providing a critical safety net.

• Create an Emergency Plan: Have a detailed plan that includes a recent photo, a network of neighbors, and instructions to call 911 immediately if your loved one is missing.

• Enhance Communication: Inform neighbors and local police about your loved one's condition and tendency to wander so they can assist in an emergency.

• Provide Engaging Activities: Offer meaningful activities and regular exercise to reduce agitation and boredom, which are common causes of wandering.

Understanding the Reasons Behind Wandering

Wandering is often not a random act but a behavior driven by confusion, unmet needs, or attempts to follow old routines. Caregivers can more effectively address and prevent wandering by identifying and understanding these root causes. Possible triggers include:

• Reliving past routines: A person may feel an urge to go to work, pick up children, or go home, even if they are already there or those events happened long ago.
• Anxiety and stress: Overstimulation from noise or a change in environment can cause restlessness and agitation.
• Physical discomfort: Feelings of hunger, thirst, or needing to use the bathroom can prompt someone to get up and wander in search of a toilet or food.
• Boredom: A lack of physical or mental stimulation can lead to restlessness and wandering.
• Searching: Some individuals may wander while looking for a lost person or item, or they may be searching for comfort and reassurance.
• Sundowning: Increased confusion and anxiety during the late afternoon or evening hours can be a significant trigger for wandering.

Behavioral and Engagement Strategies

Instead of restricting movement, which can increase agitation, focus on proactive, person-centered interventions.

• Create and maintain a consistent routine: A predictable schedule for meals, activities, and bedtime reduces confusion and anxiety.
• Address unmet needs: Check for hunger, thirst, pain, or the need to use the restroom before they become triggers.
• Provide engaging activities: Involve the person in meaningful, simple tasks, like folding laundry, watering plants, or listening to music they enjoy.
• Redirect, don't correct: If they express a desire to go home or to work, validate their feelings and gently redirect them to a different, soothing activity. For example, suggest a cup of tea or looking at a photo album.
• Provide a safe walking area: A secure, enclosed patio or backyard can allow for safe physical exercise and fresh air, which can reduce restlessness.

Environmental and Safety Modifications

Modifying the living space is crucial for preventing wandering and ensuring safety. Start with a home safety checklist to identify and mitigate risks.

• Secure doors and windows: Install locks that are difficult to operate, such as those placed high or low on the door, out of the line of sight. Window stops can prevent them from being opened fully.
• Camouflage exits: Make doors less obvious by covering them with curtains, posters, or paint that blends into the wall. Placing a black doormat in front of a door can also create a visual barrier, as some individuals with dementia may perceive it as a hole.
• Reduce clutter: Keep pathways clear of tripping hazards like loose rugs, furniture, or extension cords.
• Enhance lighting: Use nightlights throughout the home, especially in hallways and bathrooms, to reduce disorientation and falls during the night.
• Hide departure cues: Keep items that signal leaving, such as coats, keys, and purses, out of sight.

Technology for Advanced Protection

Various technologies offer an additional layer of security for caregivers, though they should not replace supervision.

Comparison of Wandering Safety Technologies

Feature	GPS Tracking Devices	Door/Bed Alarms	Motion Sensors
Function	Tracks exact location in real-time.	Alerts caregivers when a door or window is opened or when the person gets out of bed.	Detects movement in a specific area, triggering an alert.
Wearable	Yes, available as bracelets, pendants, or embedded in shoes.	No, they are installed on doors or windows.	No, they are installed in hallways or rooms.
Cost	Typically higher initial cost and may involve monthly fees.	Generally lower one-time cost.	Relatively low cost.
Use Case	Best for tracking location once a person has left the home.	Ideal for alerting a caregiver when a person is attempting to exit.	Effective for monitoring movement within the house, especially at night.
Pros	Provides location data in an emergency, offering peace of mind.	Can prevent an exit by alerting the caregiver immediately.	Can monitor specific areas without being intrusive.
Cons	Privacy concerns and potential for the person to remove it.	Can be easily disarmed or ignored if the person understands how they work.	May cause false alarms and does not provide real-time location tracking.

Creating an Emergency Plan

Despite all preventive measures, wandering may still occur. A well-prepared emergency plan is critical for a fast and safe response.

Emergency checklist if your loved one is missing:

• Call 911 immediately and inform the authorities that the missing person has dementia.
• Call a pre-established network of neighbors, family, and friends to help with the search.
• Provide a recent photo and description to the police and search party.
• Search nearby areas first, especially places they have wandered to before, as most people are found within 1.5 miles of where they went missing.
• Check areas of interest, such as nearby bus stops, former homes, or places of worship.

Consider enrolling your loved one in a wandering response service like MedicAlert® + Alzheimer's Association Safe Return®. This program provides an identification bracelet and a 24/7 emergency response service to help locate and return individuals who wander.

Conclusion

Effectively managing and controlling dementia-related wandering requires a multi-faceted approach. By combining an understanding of triggers with careful home modifications, implementing helpful technology, and establishing a robust emergency plan, caregivers can significantly enhance the safety and well-being of their loved one. Remember, the goal is not to restrict freedom but to create a secure environment that accommodates the need for movement while minimizing risk. A proactive and compassionate approach can provide peace of mind and a safer living situation for everyone involved.

What to do if your loved one starts wandering?

• Stay calm and redirect: If you find them wandering inside, stay calm, reassure them, and redirect their attention with a simple, pleasant activity.
• Use the emergency plan: If they are gone for more than 15 minutes, initiate your emergency plan by calling 911.
• Search nearby first: Start your immediate search in the vicinity, including dense foliage or fence lines, as many people with dementia are found close to home.

Here is a link to the Alzheimer's Association for more information on wandering.

Conclusion

Effectively managing and controlling dementia-related wandering requires a multi-faceted approach. By combining an understanding of triggers with careful home modifications, implementing helpful technology, and establishing a robust emergency plan, caregivers can significantly enhance the safety and well-being of their loved one. Remember, the goal is not to restrict freedom but to create a secure environment that accommodates the need for movement while minimizing risk. A proactive and compassionate approach can provide peace of mind and a safer living situation for everyone involved.

Frequently Asked Questions

What are common triggers for dementia wandering?

Wandering in dementia can be triggered by confusion, anxiety, boredom, unmet needs (like hunger or thirst), or the urge to follow old routines (like going to work).

How can I make the home safer to prevent wandering?

To make a home safer, install locks on exterior doors that are high or low out of sight, use door and window alarms, remove clutter, and ensure paths are well-lit, especially at night.

What is the best way to handle a person who insists on 'going home' when they are already home?

Validate their feelings of wanting to go home by saying, 'We're safe here,' and then redirect their attention to another activity, such as looking at family photos or having a snack.

Are GPS trackers helpful for dementia wandering?

Yes, GPS tracking devices can be very helpful by providing real-time location data if a person wanders away, offering an important safety net for caregivers.

What should I do immediately if my loved one with dementia goes missing?

If your loved one goes missing, call 911 immediately and inform them that the person has dementia. Begin a search of the immediate area and follow your pre-established emergency plan.

Can regular exercise help reduce wandering?

Yes, regular physical exercise and engaging activities during the day can help reduce restlessness and anxiety, which can decrease the likelihood of nighttime wandering or restlessness.

How do I deal with 'sundowning' behaviors that cause nighttime wandering?

To address sundowning, try to limit daytime napping, provide plenty of light exposure during the day, and schedule a calming activity for the early evening to reduce anxiety.