Understanding the Risk: Is anyone who has memory problems and is able to walk is at risk for wandering?

Over 60% of individuals with dementia will wander at least once. The answer to 'Is anyone who has memory problems and is able to walk is at risk for wandering?' is a definitive yes, as mobility is a key component of this common and dangerous behavior.

Quick Summary

Yes, any person with memory impairment who is mobile is at risk. Wandering is a complex behavior tied to confusion and unmet needs, not just the ability to walk.

Key Points

• Direct Risk: Any individual with memory problems who is mobile is at significant risk for wandering.

• Beyond Memory: Wandering is often triggered by unmet needs, stress, pain, or attempts to follow old routines, not just memory loss.

• Home Safety is Key: Simple modifications like door alarms, disguised exits, and secure locks are crucial first steps in prevention.

• Routine Reduces Restlessness: A structured day with physical activity and engaging tasks can minimize the urge to wander.

• Technology Provides a Safety Net: GPS devices and monitoring services are essential tools for quickly locating a missing person.

• Emergency Plan is Non-Negotiable: Having a ready-to-go action plan, including a recent photo and calling 911 immediately, is vital.

The Unsettling Truth About Memory Loss and Wandering

Wandering is one of the most stressful and dangerous challenges caregivers face. It's a behavior intrinsically linked to cognitive decline, seen in conditions like Alzheimer's disease and other forms of dementia. When a person has memory problems, their ability to recognize familiar places, recall their address, or even understand why they’ve left home becomes compromised. If this cognitive impairment is paired with physical mobility, the risk of wandering becomes significant. They may leave home with a purpose in mind—like going to a former job or visiting a childhood home—but are unable to navigate the journey or find their way back. This isn't aimless walking; it's often a goal-directed action rooted in a distant memory or a present need.

Key Factors That Increase Wandering Risk

While memory problems and mobility are the primary prerequisites, several other factors can trigger a wandering episode. Understanding these can help caregivers anticipate and mitigate the risk.

• Unmet Needs: The person may be looking for a bathroom, feeling hungry or thirsty, or experiencing pain. Their cognitive impairment prevents them from communicating this need, so they begin searching for a solution.
• Stress and Agitation: A noisy, crowded, or unfamiliar environment can cause anxiety. Leaving the area is a coping mechanism to escape the sensory overload.
• Changes in Routine: People with dementia often thrive on predictability. A disruption to their daily schedule can cause confusion and a desire to return to a more familiar setting or routine.
• Sundowning: Many individuals experience increased confusion, anxiety, and agitation in the late afternoon and evening. This phenomenon, known as sundowning, is a common trigger for wandering.
• Past Routines: The person might attempt to follow an old routine, such as leaving for work in the morning or picking up children from school, even if they have been retired for years.

Proactive Strategies for Wandering Prevention

Preventing wandering requires a multi-layered approach that addresses home safety, daily routines, and caregiver awareness. The goal is to create a safe environment that reduces the impulse to leave while ensuring a rapid response if an incident occurs.

Securing the Home Environment

Creating physical barriers is the first line of defense. These should be subtle enough to not feel like a prison but effective enough to prevent unsupervised exits.

1. Door and Window Alarms: Install simple alarms that chime when a door or window is opened. This alerts you to a potential exit.
2. Disguise Exits: Place a curtain or a mural over the door to make it less recognizable as an exit. You can also place a black mat in front of the door, as some individuals with dementia may perceive it as a hole and avoid it.
3. Use Complex Locks: Install locks that are difficult for someone with cognitive impairment to operate, such as a deadbolt placed high or low on the door, or a slide-bolt.
4. Secure the Yard: If you have a yard, ensure gates are locked and the perimeter is secure to provide a safe outdoor space.

The Power of Routine and Engagement

A structured and engaging day can significantly reduce the urge to wander. Boredom and inactivity are major contributors to agitation.

• Establish a Daily Schedule: Regular times for meals, activities, and rest can provide a sense of security and purpose.
• Incorporate Physical Activity: Regular walks (supervised), gardening, or light exercise can help reduce restlessness and improve sleep.
• Provide Meaningful Activities: Engage the person in simple, enjoyable tasks like folding laundry, looking at photo albums, or listening to music. This helps reduce anxiety and boredom.

Technology as a Safety Net: A Comparison

Technology offers a crucial safety net if a person does wander. Various devices are available, each with its own pros and cons.

Technology Type	How It Works	Pros	Cons
GPS Watches/Pendants	Uses satellite signals to provide real-time location.	Accurate outdoors; some have fall detection.	Requires regular charging; can be removed by user.
GPS Shoe Insoles	A GPS tracker is embedded inside a shoe insole.	Discreet and unlikely to be removed.	Location updates may be less frequent; needs charging.
Bluetooth Tags	Small tags that connect to a smartphone app.	Inexpensive; long battery life.	Very limited range (100-300 ft); relies on phone proximity.
Managed Services	Professional monitoring services (e.g., Project Lifesaver).	High success rate; coordinated with law enforcement.	Monthly fee; requires enrollment and specific equipment.

Creating an Emergency Action Plan

Despite the best prevention efforts, wandering can still happen. Having a plan in place is essential for a quick and safe recovery.

1. Act Immediately: Do not wait. Most individuals are found within a 1.5-mile radius of where they went missing. Begin searching the immediate vicinity, checking common areas and hiding spots.
2. Call 911: Inform the operator that a vulnerable adult with memory impairment is missing. Provide a recent photo, a description of their clothing, and any medical conditions.
3. Alert Your Network: Contact neighbors, friends, and family who live nearby. If you are part of a program like MedicAlert or Project Lifesaver, contact them immediately.
4. Keep a File Ready: Maintain a file with a recent, clear photo, a list of medical conditions, medications, and contact information for doctors and family. This can be handed to law enforcement to save critical time.

Conclusion: Vigilance and Compassion

The risk of wandering for anyone with memory problems and the ability to walk is real and demands serious attention. It is not a sign of poor care but a symptom of the disease. By understanding the triggers, implementing preventative strategies, leveraging technology, and having a clear emergency plan, caregivers can create a safer environment. This proactive approach not only protects the individual but also provides peace of mind for those who care for them. For more resources and support, consider reaching out to organizations like the Alzheimer's Association.

Frequently Asked Questions

What is the difference between wandering and elopement?

Wandering typically refers to moving about within a confined space with no clear direction, while elopement is the act of leaving a safe area, such as a house or care facility, without supervision, which poses a much higher risk.

Does wandering only happen in the later stages of dementia?

No, wandering can occur at any stage of dementia. It is a common behavior, with studies showing that 6 in 10 people with dementia will wander at least once. It can even be an early sign of the disease.

Are there specific times of day when wandering is more common?

Yes, wandering can be more frequent in the late afternoon and early evening. This is often associated with 'sundowning,' a state of increased confusion and agitation that occurs as daylight begins to fade.

Is there a medication to stop wandering?

There is no specific medication to stop wandering. While some medications may be prescribed to manage anxiety or agitation that can trigger wandering, the primary approach is non-pharmacological, focusing on behavioral and environmental strategies.

What is Project Lifesaver?

Project Lifesaver is a community-based program that uses radio frequency technology to track individuals with cognitive conditions who are prone to wandering. Participants wear a transmitter, and if they go missing, a trained emergency team can track the signal.

How can I make my home safer for someone who wanders?

Start by installing alarms on doors and windows, using child-proof doorknob covers or placing locks high or low on doors. Also, reduce clutter to prevent falls and ensure all areas are well-lit.

Should I get a medical alert bracelet for my loved one?

Absolutely. A medical alert bracelet or necklace that identifies the person and notes their memory condition can be life-saving. It should include an emergency contact number or refer to a service that stores their information.