How Do You Prevent Wandering in Vulnerable Individuals?

According to the Alzheimer's Association, six in ten people with dementia will wander at least once. Effectively managing and preventing this behavior is crucial for safety and peace of mind. Here's how do you prevent wandering by implementing a combination of security measures, behavioral strategies, and technology.

Quick Summary

This guide provides caregivers with a comprehensive overview of strategies to manage and prevent wandering in vulnerable individuals, including those with dementia and children with autism. It covers home safety modifications, the use of tracking devices, identifying triggers for wandering, and implementing routines.

Key Points

• Identify Triggers: Recognize the specific reasons for wandering, such as boredom, confusion, or anxiety, to address the underlying cause.

• Secure the Home: Install locks and alarms on doors and windows, and consider camouflaging exits to make them less noticeable.

• Establish a Routine: Create a structured daily schedule with engaging activities to minimize restlessness and anxiety, especially during peak wandering times.

• Utilize Tracking Devices: Equip the individual with a GPS tracker or a radio frequency device for real-time location monitoring and faster recovery.

• Maintain Identification: Ensure the person always carries identification, such as a medical alert bracelet or labels sewn into clothing.

• Inform Your Community: Alert neighbors and local authorities about the person's wandering tendency and have a clear, recent photo available.

• Address Basic Needs: Check for unmet needs like hunger, thirst, or needing the restroom, as these can be triggers for wandering behavior.

Understanding the Causes of Wandering

Wandering, also known as elopement, is a common and dangerous behavior among individuals with cognitive impairment, developmental disabilities, and even pets. The triggers can vary widely, and understanding the root cause is the first step toward effective prevention.

• Cognitive Impairment (Dementia/Alzheimer's): Individuals may wander due to confusion, disorientation, boredom, or a desire to return to a perceived past time or location, such as a childhood home or a former workplace. Disrupted sleep cycles, known as sundowning, can also increase nighttime wandering.
• Developmental Disabilities (Autism Spectrum Disorder): For children with ASD, wandering may be triggered by sensory sensitivities, a search for a preferred item or place, or a desire to escape an overstimulating environment. A strong attraction to water is also a significant risk factor.
• Restlessness and Anxiety: Feelings of agitation, fear, or boredom can prompt someone to walk aimlessly to relieve that energy. Ensuring a person's basic needs—such as thirst, hunger, or needing to use the restroom—are met can sometimes prevent this.

Enhancing Home Security to Prevent Wandering

Creating a secure home environment is the most fundamental step in preventing elopement. This involves a multi-layered approach to make exits less accessible and less appealing.

Practical Home Modifications

• Install Locks Strategically: Add deadbolts or sliding bolts to all exterior doors, placing them high or low to be out of the direct line of sight. Some caregivers use keyed locks on both sides to prevent easy opening, but the key must be readily accessible in an emergency.
• Camouflage Exits: Paint doors the same color as the surrounding walls or cover them with removable curtains or screens to make them blend in. A dark-colored mat in front of a door can also serve as a visual barrier, as some individuals with dementia may perceive it as a hole.
• Use Door and Window Alarms: Inexpensive, battery-operated alarms can be placed on doors and windows to alert you when they are opened. A more advanced home security system can signal every time an exit is used.
• Secure the Yard: If possible, enclose the yard with a fence and a locked gate to provide a safe, outdoor space for supervised activity. Check regularly for gaps or weak points.

Implementing Behavioral and Routine-Based Strategies

Addressing the behavioral triggers for wandering is key to reducing its frequency. A consistent routine and engaging activities can help alleviate anxiety and boredom.

Comparison Table: Reactive vs. Proactive Wandering Prevention

Strategy	Reactive Approach	Proactive Approach
Environment	Chasing after the person once they leave.	Installing alarms, locks, and camouflaging exits beforehand.
Activities	Scrambling to find a diversion during agitation.	Planning structured, engaging activities to fill the day and prevent boredom.
Triggers	Ignoring or correcting a desire to "go home."	Validating feelings and redirecting the individual's attention to a different activity.
Identification	Realizing the person has no ID after they are missing.	Ensuring a medical ID bracelet or clothing labels are always in place.
Supervision	Leaving the person unsupervised for short periods.	Maintaining constant supervision, especially during peak wandering times.
Technology	Searching without tracking devices.	Using GPS or radio frequency trackers for peace of mind and faster location.

Leveraging Tracking and Identification Technology

For an extra layer of safety, several technologies and identification methods can help locate a person who has wandered.

Devices and Identification Methods

• Wearable GPS Trackers: These come in the form of watches, shoe inserts, or clip-on devices. They allow caregivers to monitor a person's location in real-time via a smartphone app. Some can even create geofenced safety zones.
• Radio Frequency (RF) Tracking: Services like Project Lifesaver work with local law enforcement to provide wrist or ankle bracelets that emit a radio frequency signal. Responders use a specialized receiver to track the individual.
• Medical ID Jewelry: A simple, non-removable medical ID bracelet or pendant should clearly state the person's name, condition (e.g., "memory loss"), and a contact number.
• Temporary Tattoos or Labels: If the person tends to remove jewelry, temporary tattoos with contact information or discreetly sewing labels into clothing can provide vital identification.

Creating a Comprehensive Emergency Plan

Even with the best preventative measures, wandering can still occur. Having a detailed plan in place is crucial for a quick and safe response.

Steps for Emergency Preparedness

1. Inform Your Network: Tell trusted neighbors, family members, and friends about the person's wandering tendency and provide them with a recent photo. Give them a number to call immediately if they see the individual alone.
2. Alert Local Authorities: Inform your local police and fire departments about the person and their condition. Some communities have registries, like Silver Alerts, for vulnerable missing individuals.
3. Prepare a Wandering Information Sheet: Create a document with a recent photo, physical description, medical details, and a list of familiar places the person might go (e.g., former home, workplace). Keep this document ready to provide to emergency services.

Conclusion: A Multi-Faceted Approach to Safety

Preventing wandering requires more than a single solution; it demands a multi-faceted approach centered on understanding, security, and preparedness. By addressing the root causes of wandering through structured routines and engagement, securing the living environment with locks and alarms, utilizing modern tracking technology, and establishing a clear emergency plan, caregivers can significantly reduce risk. For many, integrating these strategies offers the best chance of ensuring the safety and well-being of a loved one, providing a protective net that honors their dignity while minimizing the potential for danger. Consistent vigilance and a compassionate, person-centered approach are always the most critical tools.

Frequently Asked Questions

What is the best type of lock to prevent a person with dementia from wandering?

For individuals with dementia, keyed deadbolts placed high or low on exterior doors are effective, as they are less likely to notice or be able to operate them. You can also use child-proof doorknob covers or install alarms that chime when a door is opened.

How can I prevent a child with autism from wandering?

To prevent a child with autism from wandering, secure all doors and windows with locks and alarms. Consider a tracking device, teach the child basic safety skills, and create a family emergency plan. Informing neighbors and local first responders about your child's condition is also highly recommended.

Are GPS trackers effective for preventing wandering?

GPS trackers are highly effective for locating an individual if they do wander. They can be worn as a watch or attached to clothing, providing real-time location data via a smartphone app. Some systems can even alert you when the person leaves a designated safe zone.

What should I do if a loved one with dementia has already wandered off?

If a loved one with dementia wanders off, immediately call 911. Search the immediate vicinity for 15 minutes, but do not delay alerting authorities. Provide them with a recent photo and a list of common places the person might go.

How do I deal with someone who wants to 'go home' even if they are already there?

Rather than correcting the individual, validate their feelings and gently redirect their attention. You can say something like, "This isn't the right time, but we can have a snack here instead," and offer a distracting, engaging activity.

Can routine and exercise help prevent wandering?

Yes, establishing a consistent daily routine and ensuring regular physical exercise can significantly reduce restlessness and boredom, which are common triggers for wandering. Engaging activities can provide mental stimulation and reduce agitation.

Is it safe to use a fence to contain a person who wanders?

Using a fence to secure a backyard or patio area is a safe way to provide a supervised outdoor space for a person who wanders. It allows them to get fresh air and exercise without being at risk of leaving the property.