How to stop a dementia patient from wandering?

Over 60% of people with dementia will wander at some point, a behavior that poses significant risk but is often manageable. Learning how to stop a dementia patient from wandering is crucial for ensuring their safety while preserving their dignity and sense of independence.

Quick Summary

Managing dementia-related wandering involves creating a secure home environment, establishing consistent routines, engaging the individual in meaningful activities, and utilizing technology like GPS trackers to ensure safety and provide peace of mind for caregivers and families.

Key Points

• Identify Triggers: Pay close attention to what prompts the wandering, such as boredom, anxiety, or confusion, and note the time of day it most often occurs.

• Secure the Environment: Modify the home by installing out-of-sight locks, camouflaging doors, and using alarms or pressure mats to monitor exits without creating a restrictive atmosphere.

• Establish Routines: Consistent daily schedules for activities, meals, and sleep can reduce confusion and agitation, which are common wandering triggers.

• Engage and Redirect: Provide meaningful activities to occupy the person's time and attention. If they attempt to leave, validate their feelings and gently redirect them to a new task or conversation.

• Utilize Technology: Employ GPS tracking devices, which are available in various forms (watches, shoe inserts), to provide real-time location information and set up safe-zone alerts.

• Have an Emergency Plan: Prepare for the possibility of a wandering incident by having recent photos, a list of known wandering spots, and an immediate plan of action to inform law enforcement.

Understanding the 'Why' Behind Wandering

Before implementing any intervention, understanding the potential triggers and motivations for a person with dementia to wander is essential. The behavior is not random; it is often driven by an underlying need, emotion, or memory. This could be a desire to go home, return to a past job, search for a loved one, or simply a response to boredom, anxiety, or discomfort. Identifying the pattern and time of day a person is most likely to wander—a phenomenon often associated with 'sundowning,' where confusion and agitation increase in the evening—is the first step toward effective prevention. A person-centered approach, focusing on the individual's history and current needs, is far more effective than a one-size-fits-all strategy.

Creating a Secure and Safe Home Environment

Environmental modifications are a cornerstone of preventing wandering. These changes should focus on minimizing risks while allowing for freedom of movement in safe areas.

Securing Exit Points

• Install locks out of sight: Place deadbolts or slide locks either high or low on exterior doors, so they are not within the person's immediate line of sight. Never lock a person inside a home alone.
• Camouflage doorways: Disguise doors by painting them the same color as the walls or covering them with removable curtains or posters. Placing a black doormat in front of a door can sometimes make a person perceive a hole, acting as a visual deterrent.
• Use alarms and monitoring devices: Install door or window alarms that chime or alert a caregiver's phone when opened. Pressure-sensitive mats placed near the bed or at a doorway can also signal movement.
• Hide trigger items: Keep items that might prompt a person to leave, such as coats, keys, wallets, and purses, out of sight.

Creating Safe, Engaging Spaces

• Reduce clutter: Create clear, well-lit pathways free of clutter, throw rugs, or electrical cords that could cause falls.
• Use visual cues: Use large, clear signs or images to label important rooms like the bathroom and bedroom to reduce confusion.
• Secure the yard: A fenced-in yard or patio area with a locked gate allows for safe outdoor time. This provides a secure space for exercise and fresh air, which can reduce restlessness.

Redirecting Behavior and Engaging Activities

Restlessness and boredom are common triggers for wandering. Engaging the individual in meaningful activities can help occupy their time and provide a sense of purpose.

• Structured routines: Establish consistent daily routines for mealtimes, waking, and bedtime. Predictability reduces anxiety and confusion.
• Meaningful activities: Involve them in simple, familiar tasks they once enjoyed, such as folding laundry, watering plants, or listening to music. Tapping into past routines, like an afternoon walk, can satisfy their need to be busy.
• Daily exercise: Regular physical activity, such as a supervised walk, can help channel restlessness and promote better sleep, especially during 'sundowning' hours.
• Validation and redirection: If they insist on leaving, validate their feeling without arguing. For example, if they say they need to go to work, you can say, “I know how much you enjoyed your job. Let's look at some old photos from that time.” Then, gently redirect them to another activity.

Leveraging Tracking Technology for Added Safety

While environmental modifications and behavioral strategies are the first line of defense, technology provides an invaluable safety net. Many modern tracking devices are discreet and offer robust features.

GPS Trackers vs. Medical Alert Systems

Feature	GPS Trackers (e.g., AngelSense, Tranquil Watch)	Medical Alert Systems (e.g., LifeStation)
Tracking Method	Real-time GPS location via smartphone app	Professional monitoring service (some with GPS)
Design	Often discreet (watches, shoe inserts, clip-ons)	Traditionally worn as a button on a pendant or wrist
Primary Goal	Proactively track location and receive geofence alerts	Reactively call for help with an SOS button push
Battery Life	Varies widely, from 1-30 days; some models last longer	Often longer, depending on the model
Communication	Some offer two-way or one-way calling capabilities	Connects directly to a monitoring center
Target User	Individuals with moderate to advanced wandering risks	Individuals at risk of falls or needing immediate help

Other Identification Methods

• Medical ID bracelets: These provide critical information, including the person's name, condition, and emergency contact numbers.
• Enroll in community programs: Services like Project Lifesaver work with local law enforcement to track wandering individuals using specialized equipment.

What to Do If Your Loved One Does Wander

Despite all precautions, wandering can still occur. Having an emergency plan is vital.

1. Search the immediate area first. Check places the person might go, including brush, bodies of water, and familiar routes. Wandering patterns often follow the dominant hand.
2. Act immediately. If they are not found within 15 minutes, call 911. The survival rate of lost dementia patients drops significantly after the first 24 hours. Inform law enforcement that the person has dementia.
3. Provide crucial information. Have a recent photo and a list of familiar places they might go readily available. An unwashed article of clothing can aid search dogs.
4. Enlist help. Contact family, friends, and neighbors to help search. Alerting neighbors in advance that the person has a tendency to wander is a proactive step.

Conclusion

While a single solution does not exist for how to stop a dementia patient from wandering, a layered approach provides the most comprehensive safety. By focusing on understanding the underlying causes, securing the environment, engaging the individual in meaningful activities, and having technology as a backup, caregivers can significantly mitigate the risks associated with wandering. This combination of strategies ensures safety, reduces stress, and allows for a dignified quality of life for both the person with dementia and their caregivers. For further support and resources, the Alzheimer's Association is an invaluable resource for families and caregivers dealing with dementia-related behaviors.

Frequently Asked Questions

Why do dementia patients wander?

Dementia patients wander for many reasons, including confusion, anxiety, boredom, or a desire to follow a past routine like going to work or going 'home.' Often, it is a purposeful action driven by a distorted reality rather than a random behavior.

What is 'sundowning' and how does it relate to wandering?

Sundowning is a phenomenon where confusion and agitation worsen in the late afternoon or evening. This increased restlessness can be a major trigger for wandering and exit-seeking behaviors during these hours.

How can I secure doors without making the person feel trapped?

You can secure doors discreetly by installing slide locks or deadbolts above or below the person's typical line of sight. Another effective method is to camouflage the door using a poster or by painting it the same color as the wall to make it less noticeable.

Are GPS tracking devices for dementia patients reliable?

Yes, modern GPS trackers are highly reliable and offer real-time tracking, often using multiple networks (GPS, Wi-Fi) for better accuracy. They come in discreet forms like watches or shoe inserts and include features like geofencing and SOS buttons.

What should I do immediately if a person with dementia goes missing?

Search the immediate vicinity, including the yard and close-by landscapes, for no more than 15 minutes. If they are not found, call 911 immediately and inform the authorities that the person has dementia. Have a recent photo and details of their condition ready.

How can I redirect a person who is trying to leave?

Instead of arguing, validate their feelings by saying something like, 'I know you're looking for something important.' Then, gently redirect their attention to a new activity or task, such as having a snack or looking at family photo albums.

Can activities and exercise prevent wandering?

Yes, meaningful engagement and daily physical activity are highly effective in reducing wandering. Staying busy and stimulated can prevent the boredom and restlessness that often lead to a person with dementia feeling the need to wander.