Understanding the Triggers Behind Wandering
Wandering is often a purposeful, not random, behavior. A person with dementia may be trying to fulfill a past need or habit, such as going to work, finding a loved one, or simply feeling restless. Key triggers often include a change in routine, disorientation, anxiety, and a feeling of being lost or abandoned. Caregivers should try to identify the specific triggers for their loved one to develop targeted prevention strategies.
Creating a Secure and Safe Home Environment
The first line of defense against wandering is to make the home a secure and safe space. This involves both physical barriers and visual deterrents.
Physical Barriers and Technology
- Secure Doors and Windows: Install keyed deadbolts on exterior doors that are placed either high or low, out of the line of sight. Consider safety devices on all windows to limit how far they can be opened. Door alarms that chime or use motion sensors can alert caregivers when a door is opened.
- Camouflage Exits: Sometimes, simple visual tricks can prevent wandering. Covering doors with curtains or painting them the same color as the walls can make them less obvious as an exit. Placing a black mat in front of a doorway can create a visual barrier that some people with dementia may perceive as an obstacle.
- Use of Technology: A wide range of assistive technologies can help. This includes motion sensors, bed occupancy sensors, and wireless home security systems. For individuals with a higher risk, GPS tracking devices built into watches, shoes, or pendants are available and can be crucial for locating a person quickly.
Removing Departure Cues and Hazards
- Hide Valuables and Triggers: Keep items that can act as a trigger for leaving, such as car keys, coats, wallets, or purses, out of sight. A person may see a coat and immediately feel the urge to go outside.
- Clear Clutter: A clear and organized environment reduces confusion. Remove clutter, throw rugs, and extension cords that can be tripping hazards. Ensure pathways are well-lit, especially at night.
Implementing Effective Behavioral Strategies
Beyond environmental changes, managing the individual's behavior and routine can significantly reduce the likelihood of wandering.
Maintaining Routine and Engagement
- Establish a Consistent Daily Routine: A structured day provides predictability and a sense of purpose, which can reduce anxiety and restlessness. This routine should include regular times for meals, activities, and sleep.
- Plan Engaging Activities: Keep the person occupied with meaningful activities, especially during times when they are most likely to wander. Activities could include folding laundry, sweeping, listening to music, or doing simple puzzles.
- Address Basic Needs: Sometimes, wandering is a search for something basic. Ensure the person's needs for food, water, and toileting are met regularly. A sudden urge to find the bathroom, for instance, can lead to wandering.
Redirecting and Reassuring
- Use Redirection, Not Correction: If the person expresses a desire to go “home” or to “work,” avoid correcting them. Instead, use redirection. Acknowledge their feeling and then distract them with a different activity. For example, “Let’s sit down and have a cup of tea first,” or “I have a project here I could use your help with”.
- Provide Reassurance: If they feel lost or abandoned, reassure them that they are safe and cared for. This can help alleviate the anxiety that fuels the need to leave.
Emergency Preparedness and Communication
Even with the best preventative measures, wandering can still occur. Having a plan in place is essential for a quick and safe resolution.
The Importance of Identification
- Medical ID and Clothing Labels: Ensure the person wears a medical ID bracelet that includes their name, condition, and an emergency contact number. For those who remove jewelry, consider sewing identification labels into their clothing.
- Wearable GPS: A GPS tracker is an invaluable tool for emergencies. It allows you to monitor their location and quickly find them if they do wander.
Community and Emergency Services
- Alerting Neighbors and Local Services: Inform neighbors, local police, and first responders that the person has a tendency to wander. Provide them with a recent photo and details about the person's condition. Many communities have registries or alert systems for missing persons with dementia, such as the Silver Alert.
- Have an Emergency Plan: Create a detailed plan that outlines the first steps to take if the person goes missing. This should include who to call and a list of places the person might wander to, such as former homes or workplaces.
Comparison of Prevention Methods
| Method | Cost | Pros | Cons |
|---|---|---|---|
| Home Safety Modifications | Low to Moderate (Locks, alarms) | Effective physical deterrents, one-time setup, provides a sense of security. | May be overcome by determined individuals; requires regular maintenance. |
| Wearable GPS Devices | Moderate to High (Monthly fee possible) | Highly effective for tracking location, provides immediate alerts, peace of mind. | Can be removed or forgotten, device battery life, potential privacy concerns. |
| Consistent Daily Routine | Low (Time and effort) | Reduces restlessness and anxiety, provides a sense of purpose, no cost. | Requires consistent effort from caregivers, not always 100% effective. |
| Community Awareness | Low (Time and communication) | Creates a network of support, increases chance of quick recovery. | Relies on external support, not always immediate or reliable. |
Conclusion
Preventing wandering in a person with dementia requires vigilance, patience, and a blend of environmental, technological, and behavioral strategies. By creating a safe home, maintaining a consistent routine, and having an emergency plan, caregivers can significantly reduce the risks associated with wandering. The combination of these methods offers the best chance of ensuring the safety and security of your loved one.
For more in-depth information and resources on dementia care, visit the Alzheimer's Association website.
