How to Keep Dementia Patients from Wandering: Proven Safety Strategies

According to the Alzheimer's Association, 6 in 10 people with dementia will wander at least once, representing a significant safety risk. Understanding how to keep dementia patients from wandering is crucial for caregivers to protect their loved ones from potential harm and reduce the immense stress associated with this behavior.

Quick Summary

You can prevent a dementia patient from wandering by securing their home, establishing a consistent routine, addressing their underlying needs, and using tracking technology for safety. These proactive measures create a supportive environment and reduce the urge to leave.

Key Points

• Understand the 'Why': Identify the root causes of wandering, which can include searching for a lost routine or a familiar place, to address the underlying need.

• Secure the Environment: Install inconspicuous locks, door alarms, and camouflage exit points to make leaving the home more difficult and alert caregivers.

• Establish a Routine: Create and maintain a consistent daily schedule with meaningful, engaging activities to reduce boredom and restlessness.

• Leverage Technology: Utilize GPS trackers, pressure-sensitive mats, and other monitoring devices for an extra layer of security and a swift response in emergencies.

• Redirect with Calmness: Never confront or argue with a wandering person. Instead, use reassurance, positive distraction, and validation to safely guide them back.

• Prepare for Emergencies: Equip the person with identification, inform your community, and have an emergency plan ready, including a 'wandering kit' for authorities.

Understanding the 'Why' Behind Wandering

To effectively prevent wandering, it is important to understand the motivations behind it. Wandering is often not a random act but a purposeful behavior driven by confusion, anxiety, and a deep-seated need to accomplish a forgotten task. Common triggers include:

• Searching for a familiar place: The person may be trying to 'go home,' even if they are already there, or trying to find a former place of employment.
• Following a past routine: They might feel compelled to walk the dog, pick up children from school, or go to work at a time they used to.
• Restlessness or boredom: A lack of physical or mental activity can lead to a restless urge to move and explore.
• Responding to an unmet need: Wandering can be a non-verbal way of communicating hunger, thirst, or the need to use the bathroom.
• Overstimulation: A noisy or chaotic environment can cause anxiety, prompting the person to seek a quieter, calmer space.

Creating a Secure and Safe Home Environment

Environmental modifications are the first line of defense against wandering. By making the home safer and more difficult to exit unnoticed, caregivers can significantly reduce risk.

Secure Entrances and Exits

• Install locks out of sight: Place deadbolts or sliding bolt locks high or low on exterior doors, outside of the patient's typical line of sight. Some patients can easily figure out standard locks.
• Use door alarms: Install motion-activated sensors or door alarms that chime or alert a caregiver when an exit is opened. These can be discreet and wireless.
• Camouflage doors: Cover doors that lead outside with curtains or wallpaper that matches the surrounding walls to make them less visible. Placing a dark-colored mat in front of a door can also act as a visual deterrent.
• Hide departure cues: Keep items like car keys, coats, and purses out of sight to avoid triggering the urge to leave.

Optimize the Home's Layout

• Clear pathways: Remove loose rugs, clutter, and excess furniture to create clear, unobstructed walkways and prevent falls.
• Use visual cues: Add labels with simple words or pictures to identify rooms like the bathroom or kitchen. High-contrast colors can also help distinguish doorways and objects.
• Secure the yard: If outdoor access is desired, ensure the yard is secured with a fence and a locked gate to allow for safe, supervised outdoor time.

Implementing Effective Routine and Activity Management

A structured and engaging routine can reduce boredom, anxiety, and the compulsion to wander. Addressing the person's needs proactively can prevent the wandering behavior from starting.

• Create a daily routine: A consistent schedule for meals, activities, and sleep provides a sense of security and predictability. Identify times when wandering is most likely and plan stimulating activities for those periods.
• Offer meaningful activities: Engage the person in activities that provide a sense of purpose, such as folding laundry, rocking in a chair, or working on a simple puzzle.
• Encourage physical activity: Regular, supervised exercise, such as a walk in the yard, can help release restless energy and improve sleep quality.
• Meet basic needs: Regularly check if the person is hungry, thirsty, or needs to use the bathroom. Addressing these needs can preempt wandering episodes.
• Manage sleep patterns: Limit daytime naps and reduce fluid intake before bed, especially if night wandering is a problem.

Leveraging Technology for Enhanced Safety

Modern technology provides advanced tools for both prevention and emergency response. Combining these with other strategies offers an extra layer of security.

Comparison of Tracking Devices

Feature	Tranquil GPS Watch	AngelSense GPS Tracker	GPS Smart Sole	PocketFinder Smart Tracker
Wearable Style	Classic analog watch	Clip-on to clothing	Insert in shoe	Small, slips in bag/pocket
Security Feature	Locking strap (special key)	Locking pins (special tool)	In-shoe, hidden	Can be misplaced
Battery Life	Up to 1 week	~24 hours	Varies by usage	Up to 1 week
Alert System	Quiet Bluetooth alerts, geofencing	Loud alerts, Runner Mode	Geofencing	Geofencing
Special Features	Auto-answer call, waterproof	AI learning, fall detection	Fits in most shoes	SOS button

Other Useful Technologies

• Pressure-sensitive mats: Place these mats by the bed or near an exit to trigger an alarm when stepped on.
• Camera monitoring: Use cameras to monitor areas of the home, providing a live feed and recording capabilities.
• Medical alert systems: Many systems now include GPS tracking and geofencing capabilities, alerting caregivers when a person exits a designated safe zone.

Redirecting and De-escalating Wandering Behavior

If a person begins to wander, the immediate goal is to safely redirect them without causing agitation. Shouting or correcting them can increase confusion and distress.

• Stay calm and reassuring: Approach the person calmly and speak in a gentle, reassuring tone.
• Join their reality: Do not argue or correct them if they are convinced they need to go somewhere. Instead, validate their feelings. For instance, if they want to 'go home,' say, 'It sounds like you miss home. Tell me about it.'
• Use positive distraction: Redirect their attention to a favorite activity, a familiar song, or a snack. A simple question can break their focus: 'Would you like some tea?'.
• Reminisce together: Engage them in a conversation about a positive memory related to their destination, which can satisfy the emotional trigger without requiring the physical journey.

Legal Considerations and Emergency Preparedness

It is vital to be prepared for the worst-case scenario. Creating an emergency plan can save precious time in a crisis.

• Never lock them alone: Securing doors should only be done when a caregiver is present. Locking a person with dementia inside alone is dangerous and can trap them in an emergency.
• Provide identification: Ensure the person carries some form of identification at all times, such as a medical alert bracelet, and label their clothes with their name and phone number.
• Build a support network: Inform neighbors, friends, and local police that you care for someone who may wander. Provide them with a recent photo and description. The Alzheimer's Association offers programs like MedicAlert® + Alzheimer's Association Safe Return®, which can assist with emergency response.
• Create a wandering kit: Keep a folder with recent photos, medical information, and a list of common places they might wander to. This saves time when reporting to authorities.
• Know when to call 911: If the person is missing, search the immediate area for no more than 15 minutes before calling 911. Be prepared to inform dispatch that a 'vulnerable adult with dementia' is missing.

Conclusion: A Multi-Faceted Approach to Safety

Addressing the complex issue of wandering in dementia requires a layered, compassionate strategy. By combining thoughtful home modifications, a structured and engaging routine, and the use of modern technology, caregivers can create a safer, more predictable environment. Redirecting behavior with validation and calm reassurance, while having a robust emergency plan in place, offers the best protection. The goal is to maximize safety while preserving the dignity and quality of life for the person living with dementia. For more information and resources on dementia care, visit the Alzheimer's Association website.

Frequently Asked Questions

Why do dementia patients wander?

Dementia patients often wander because they are confused and disoriented. They may be trying to find a former home, going to a past job, or seeking a specific person or object. It can also be caused by restlessness, boredom, or a need to fulfill a basic need like hunger or using the restroom.

What are some low-tech ways to prevent wandering?

Effective low-tech methods include placing locks out of the line of sight (high or low), using camouflage posters or curtains to disguise exit doors, and hiding objects associated with leaving, such as keys, coats, and purses.

Can I use a GPS tracker to keep track of a dementia patient?

Yes, GPS trackers are a valuable tool for monitoring location and can be worn as a watch, shoe insert, or attached to clothing. They often come with features like geofencing, which alerts you when the person leaves a designated 'safe zone'.

What should I do if a dementia patient goes missing?

If a person with dementia goes missing, search the immediate area for up to 15 minutes. If they are not found, call 911 immediately and inform them that a 'vulnerable adult with dementia' is missing. Provide a recent photo and description to authorities and your neighbors.

Are door alarms helpful for preventing wandering?

Yes, door alarms can be very helpful. They provide an alert when an exit is opened, giving caregivers a chance to intervene quickly. There are various types, including pressure-sensitive mats and motion detectors, that can be customized to your home.

Should I correct a dementia patient who says they want to 'go home'?

No, correcting them can increase their anxiety and agitation. It's better to validate their feelings and then use distraction and redirection. For example, 'It sounds like you miss home. Let's look at some old photos and have a snack together'.

How can a routine help with wandering behavior?

A consistent, predictable routine helps reduce confusion and provides a sense of security. Scheduling meals, activities, and rest at the same time each day can reduce restlessness and the impulse to wander, particularly during 'sundowning' hours.