Understanding the Causes of Wandering
Wandering is often not a random act, but a behavior with underlying causes. For someone with dementia, it can be triggered by a range of feelings and needs they may no longer be able to express clearly. By identifying these triggers, you can address the root cause and potentially reduce the urge to wander.
- Searching for something or someone: They may be looking for a lost object, a spouse who has passed, or even trying to get to a former job.
- Reverting to old routines: A person may believe they need to go to work, pick up children from school, or run errands, driven by a deeply ingrained daily habit.
- Agitation or anxiety: Feelings of confusion, boredom, or a need for exercise can lead to pacing and a desire to escape their current environment.
- Disorientation (Sundowning): This is a state of confusion and agitation that often occurs in the late afternoon or evening. The fading light can cause distorted perceptions and increase the urge to wander.
- Unmet basic needs: The person might be hungry, thirsty, or need to use the restroom but is unable to communicate this, prompting them to leave in search of a solution.
Home Safety Modifications to Secure the Environment
Creating a secure home is the first line of defense. A safe environment allows you to manage the risk of wandering without resorting to restrictive or distressing measures.
Locking Systems and Alarms
Beyond standard deadbolts, there are several discreet options available.
- Locks placed out of sight: Install additional locks high up or low down on doors, out of the person's immediate line of sight. This makes them less obvious to someone who may have trouble with visual perception.
- Doorknob covers: Child-proof covers for doorknobs can make it difficult for a person with dementia to gain a good grip and turn the handle.
- Door and window alarms: These can be simple, battery-operated chimes or integrated into a full home security system. Pressure-sensitive floor mats placed near exits can also trigger an alarm, alerting you to movement.
- Keyed deadbolts: Using a deadbolt that requires a key to open from the inside can be effective, but only when a caregiver is present to avoid trapping the person in an emergency like a fire.
Visual Deterrents and Camouflage
Some simple visual tricks can make exits less obvious.
- Camouflage doors: Paint exterior doors the same color as the surrounding walls or cover them with removable wallpaper or a curtain. A person with dementia may no longer recognize it as an exit.
- Visual barriers on the floor: A black mat or a strip of black tape placed in front of a doorway can look like a hole or a step to a person with impaired depth perception, acting as a visual deterrent.
Technological Solutions for Monitoring and Tracking
Technology offers powerful tools to both monitor your loved one's location and receive alerts.
- GPS Tracking Devices: These come in many forms, including watches, pendants, shoe inserts, or small clips. They allow caregivers to track a person's location in real-time, which is invaluable if they do wander.
- Smart Home Systems: Modern home security systems can integrate door/window sensors, motion detectors, and even bed/chair occupancy sensors to provide comprehensive monitoring and send alerts to your smartphone.
- MedicAlert + Safe Return: This is an identification program that provides 24/7 emergency support. If a person with a MedicAlert ID is found, the ID links to an emergency contact list and medical information, and a nationwide alert network helps coordinate a safe return.
Behavioral Strategies to Redirect and Calm
While safety modifications are crucial, addressing the behavioral triggers is the most proactive approach.
Establish and Maintain Routines
- Structured days: Create and stick to a predictable daily schedule for meals, activities, and bedtime. This reduces anxiety and gives the person a sense of security.
- Meaningful activities: Engage the person in simple, satisfying activities like folding laundry, watering plants, listening to music, or looking at photo albums. This combats boredom and provides a sense of purpose.
Proactive Distraction
- Engage and divert: When a person expresses a desire to leave, try not to argue or reason with them. Instead, acknowledge their feeling and gently redirect their attention to another activity. If they say they need to 'go to work,' you might reply, 'Oh, you have the day off today, let's have some tea,' and guide them to the kitchen.
- Address Sundowning: Plan stimulating activities earlier in the day and create a calm, quiet evening environment. Use nightlights to prevent disorientation.
Remove Triggers and Provide Safe Outlets
- Hide departure cues: Keep items like coats, keys, wallets, and purses out of sight to avoid triggering the instinct to leave.
- Supervised walks: Plan regular, supervised walks outside or in a fenced garden. This provides safe exercise and satisfies the urge to move around.
Comparison of Wandering Prevention Methods
To help you decide on the best course of action, here's a comparison of common prevention and monitoring methods.
| Feature | Behavioral Strategies | Home Safety Modifications | GPS Tracking Devices |
|---|---|---|---|
| Cost | Low (time investment) | Moderate (one-time purchase) | Moderate to High (device + subscription) |
| Effectiveness | High (for addressing triggers) | High (physical barriers) | High (real-time location) |
| Maintenance | Ongoing caregiver effort | Minimal (installation) | Regular charging, monitoring |
| Example | Routines, redirection | High/low locks, door alarms | Watch, pendant, shoe insert |
| Best For... | Long-term prevention | Immediate physical barriers | Emergency preparedness, peace of mind |
For more detailed guidance on handling wandering and related behaviors, the Alzheimer's Association offers extensive resources and support for caregivers available on their website.
Creating an Emergency Plan
Even with the best precautions, a person may still manage to wander. A prepared emergency plan is critical for a rapid response.
What to Include in Your Plan
- A recent, close-up photograph of the person.
- Their medical information and a list of medications.
- A list of people to contact and their phone numbers.
- Potential places they may wander to (e.g., former home, workplace, park).
- A list of their physical characteristics, habits, and any specific behaviors.
- An unwashed article of clothing stored in a plastic bag for search dogs.
Inform Your Community
Inform neighbors, local business owners, and police about the person's condition and tendency to wander. Provide them with your emergency contact information and a photo. Early awareness from the community can lead to a faster, safer return if they are found wandering alone.
Conclusion
Preventing a person with dementia from leaving the house requires a layered approach, combining environmental safety measures, monitoring technology, and compassionate behavioral strategies. By understanding the reasons behind their actions and proactively managing their environment, you can significantly reduce the risk of wandering. Remember, the goal is not to eliminate their freedom but to ensure their safety and well-being. Keeping a comprehensive emergency plan ready will provide peace of mind and allow for a swift, coordinated response should an incident occur.
