A Comprehensive Guide: How to keep dementia patients from leaving the house?

According to the Alzheimer's Association, 6 out of 10 people with dementia will wander at least once, a potentially dangerous behavior. Understanding how to keep dementia patients from leaving the house is critical for their safety and for the peace of mind of their caregivers.

Quick Summary

Preventing wandering in dementia patients involves a multi-faceted approach, including securing the home, using technology for monitoring, establishing a predictable routine, and addressing the underlying causes of their urge to leave the house.

Key Points

• Address Underlying Causes: Identify and respond to the root cause of wandering, whether it's anxiety, boredom, or disorientation, rather than just the behavior itself.

• Secure the Environment: Make your home safe by installing high or low-mounted locks and visual barriers on doors and windows to prevent unobserved exit.

• Leverage Technology: Utilize modern technology like wearable GPS trackers, geo-fencing, and door alarms to provide alerts and help locate a wandering patient.

• Maintain Routine: Establish a consistent daily schedule for activities, meals, and sleep to reduce confusion and anxiety, which can trigger the urge to wander.

• Engage and Distract: Keep the person occupied with purposeful activities and regular physical exercise to reduce restlessness and provide a sense of purpose.

• Create a Safe Space: Ensure the home is free of clutter and filled with familiar, comforting objects to promote a sense of security and reduce stress.

Understanding the Root Causes of Wandering

To effectively prevent a person with dementia from wandering, it's crucial to understand why they might leave the house. Wandering is often not a random act but a behavior driven by a specific need or feeling. Common triggers include:

• Searching for something or someone: The patient may be looking for a past home, a loved one, or trying to go to a familiar place, like an old job.
• Restlessness and anxiety: A feeling of agitation or unease can cause a person to feel a need to walk or move around.
• Boredom or lack of stimulation: A monotonous environment can lead the individual to seek more interesting surroundings.
• Disorientation: Confusion about time and place can cause them to believe they need to be somewhere else.
• Physical discomfort: Pain, hunger, thirst, or the need to use the bathroom can be misinterpreted as a need to leave.

Environmental Modifications for Home Safety

Creating a safe and secure home environment is the first and most critical step in managing wandering behavior. A few simple changes can make a world of difference.

Securing Exits and Windows

• Door Locks: Install complex locks that are difficult to operate, such as chain locks or high-mounted deadbolts. Placing locks higher or lower than eye level can prevent the patient from easily spotting and unlocking them.
• Door Alarms: Utilize simple, inexpensive chimes or alarms on doors and windows. These provide an audible alert whenever an exit is opened.
• Visual Distractions: Camouflage doors by painting them the same color as the surrounding wall or covering them with a curtain or screen. Placing a large, floor-to-ceiling mirror near a door can also make it less apparent.

Creating a Safe, Familiar Environment

• Reduce Clutter: A home free of clutter and obstacles reduces the risk of falls and makes navigating easier.
• Keep Familiar Objects: Surround the patient with familiar, comforting objects like family photos or favorite items. This helps create a sense of safety and recognition.

Behavioral and Routine Strategies

Addressing the patient's routine and behavior can often preempt the desire to wander.

Establishing a Consistent Daily Routine

• Structure is Key: A consistent daily schedule for meals, activities, and sleep reduces confusion and anxiety. Predictability helps minimize feelings of disorientation.
• Calm Transitions: Plan transitions between activities carefully. Abrupt changes can cause distress and trigger wandering behavior.

Engaging the Patient

• Purposeful Activities: Give the person meaningful tasks or activities. This could be simple chores, folding laundry, or engaging in a favorite hobby. Having a sense of purpose can reduce restlessness.
• Planned Exercise: Regular, supervised physical activity, such as walking in a safe area, can help burn off excess energy and improve sleep, both of which can decrease wandering.
• Supervision: Never leave the person unsupervised, especially during times when wandering is most likely, such as late afternoons or evenings.

Leveraging Technology for Monitoring and Safety

Technology can provide an additional layer of security and peace of mind for caregivers.

Wearable GPS Devices

• GPS Trackers: Wearable GPS devices, often in the form of a wristband or pendant, allow caregivers to track the patient's location in real-time if they do leave the house. These can be life-saving tools.
• Geo-Fencing: Many GPS devices offer a geo-fencing feature that sends an alert to the caregiver's phone if the patient exits a predefined safe area.

Door and Window Alarms

• Pressure-Sensitive Mats: Placing a pressure-sensitive mat in front of an exit can trigger an alarm when stepped on, alerting the caregiver.
• Motion Sensors: Motion sensors can be placed strategically to alert caregivers if the person approaches a forbidden area, like a door.

Home Monitoring Systems

• Video Cameras: Small, non-intrusive cameras can be used to monitor common areas of the house, allowing a caregiver to check on the patient remotely.

Emergency Preparedness

Despite all precautions, wandering can still occur. Having an emergency plan is essential. Consider enrolling the patient in a program like the Alzheimer's Association's MedicAlert + Safe Return program, which provides ID bracelets and a national database to help locate missing individuals with dementia.

Comparison of Wandering Prevention Strategies

Strategy	Pros	Cons
Environmental Modifications	Cost-effective, immediate impact, non-intrusive.	Not a complete solution, patient can adapt to changes.
Behavioral Strategies	Addresses root cause, improves quality of life.	Requires consistent effort, results may take time.
GPS Technology	Real-time tracking, immediate alerts, high success rate.	Can be expensive, patient may dislike wearing device.
Door/Window Alarms	Inexpensive, provides immediate alert.	Can be triggered accidentally, may be startling to patient.

Conclusion

Implementing a multi-pronged approach that combines environmental modifications, behavioral strategies, and technology offers the best chance of success for how to keep dementia patients from leaving the house. The safety and well-being of the patient are the top priority. By creating a secure, predictable, and engaging environment, and by preparing for potential emergencies, caregivers can effectively mitigate the risks associated with wandering while maintaining a high quality of life for their loved one.

Frequently Asked Questions

What is the best way to prevent a dementia patient from wandering?

The most effective approach is a combination of strategies, including securing exits with locks and alarms, establishing a predictable daily routine, using GPS tracking technology, and ensuring the patient feels safe and engaged.

How can I secure my house for a person with dementia?

To secure your house, install high-mounted or child-proof locks on doors, use window alarms, conceal exit points with curtains or paint, and remove potential hazards like rugs or clutter that could cause falls. Consider a geo-fenced GPS tracker for added security.

What is wandering in dementia?

Wandering in dementia refers to the unsafe movement or leaving of a safe area by a person with dementia. It is a common symptom often triggered by disorientation, restlessness, or the search for something familiar, posing a significant risk to the individual's safety.

Are there special locks for dementia patients?

Yes, there are special locks designed to deter dementia patients. These include high-mounted deadbolts, keyless entry locks with complex codes, and locks with alarms. The goal is to use locks that are less obvious or more difficult for a confused person to operate.

What should I do if a dementia patient has wandered off?

If a dementia patient has wandered off, immediately call 911 and activate your emergency plan. Provide law enforcement with a recent photo, a description of their clothing, and details about common places they might go. Programs like Safe Return can also assist.

How can daily routine help prevent wandering?

A consistent daily routine helps prevent wandering by reducing confusion and anxiety. Predictable schedules for meals, activities, and rest create a sense of order and safety, minimizing the disorientation that can lead a person to seek to leave the house.

Is it safe to let a dementia patient wander outside?

It is generally not safe to let a dementia patient wander unsupervised, as they can become disoriented, lost, or fall. While planned, supervised walks are beneficial, unsupervised wandering puts them at risk of injury, exposure, and getting lost.