Environmental Safety: Securing the Home
One of the most immediate and effective strategies for preventing wandering is to create a safe, secure living environment. This involves a combination of physical barriers and visual cues designed to deter a person from leaving without proper supervision. These measures are foundational for a comprehensive safety plan.
Locking Doors and Windows
Securing all exits is a top priority. Simple modifications can make a significant difference. Consider installing keyed deadbolts or slide locks placed out of the person's typical line of sight, such as high on the door frame or low near the floor. This makes them less visible and harder for someone with cognitive decline to operate. It is crucial to always have keys readily accessible for emergency situations but stored where the person cannot find them. In addition to exterior doors, all windows should be fitted with safety locks or devices that limit how far they can be opened.
Creating Visual Barriers and Cues
Sometimes, the illusion of a barrier is enough to deter wandering. This is a behavioral technique that can be very successful. Strategies include:
- Camouflaging doors: Painting exterior doors the same color as the surrounding wall can make them visually blend in, reducing their prominence as an exit point. Another option is to cover doors with posters that resemble bookshelves or scenic views.
- Using visual stops: Placing a dark-colored mat or a strip of black tape on the floor in front of an exit can be an effective visual deterrent. To someone with dementia, this may appear as a hole or drop-off they cannot cross.
- Clear signage: For internal navigation, use clear and simple signs with large font and pictures for common rooms like the bathroom or bedroom. This can reduce confusion and anxiety that often precedes wandering.
Behavioral Management and Consistent Routine
Often, wandering is not random but is triggered by a specific need, an unmet emotion, or a shift in routine. Addressing the root cause can significantly reduce the behavior. This is where behavioral interventions and maintaining a predictable daily schedule come into play.
Establishing a Predictable Daily Schedule
A consistent routine provides a sense of security and reduces anxiety. Wandering frequently occurs during transitional times or when the person is bored or restless. Building a reliable schedule for meals, exercise, and activities can help. For example:
- Wake up and morning hygiene at the same time each day.
- Schedule walks or physical activity to use up restless energy.
- Engage in meaningful activities during typical wandering times.
- Follow a relaxing evening routine to manage 'sundowning' behaviors.
Providing Engaging and Meaningful Activities
Boredom and restlessness are major motivators for wandering. Providing engaging activities tailored to the person's interests and abilities can offer purpose and stimulation. These could be simple, repetitive tasks that mimic past hobbies or work, such as:
- Folding laundry
- Watering plants
- Listening to favorite music
- Looking through old photo albums
Technology and Monitoring Solutions
Technology offers another layer of protection, providing peace of mind for caregivers while allowing individuals a measure of independence. These solutions should be used in conjunction with other interventions, not as a replacement for supervision.
Wearable GPS Tracking Devices
For a person prone to wandering, a GPS tracking device is an invaluable tool. These can be worn as a watch, pendant, or even discreetly placed in shoe inserts. In the event of a wandering episode, these devices allow caregivers to quickly pinpoint the person's location, significantly increasing the chances of a fast and safe recovery.
Home Monitoring Systems
Various sensors can be installed around the home to alert caregivers to movement. These include:
- Door and window sensors: These trigger an alarm or notification when an exit is opened.
- Pressure-sensitive pads: Placed by the bed or near an exit, these can signal when a person gets up during the night or approaches a door.
- Motion sensors: These can be used to track movement in certain areas of the house and alert a caregiver to unusual activity.
The Person-Centered Approach: Compassionate Redirection
The final and most critical intervention focuses on treating the person with dignity and addressing their behavior with empathy. Wandering is often an expression of an unmet need or a fear.
Understanding the Triggers and Underlying Needs
Instead of viewing wandering as a problem to be stopped, try to understand what is motivating the person. Keep a log of when wandering occurs and what happened beforehand. Are they looking for something? Are they anxious or lonely? Perhaps they are trying to fulfill a past routine, like going to work or picking up their children.
Effective and Gentle Redirection
When a person attempts to wander, avoid confrontation. Arguing or blocking their path can cause distress and escalate the situation. Instead, use gentle redirection techniques.
- Validate their feelings: If they say they want to go home, respond with, "It sounds like you want to go home. Tell me about that." This acknowledges their emotion without reinforcing the incorrect reality.
- Distract with a familiar task: Offer a snack, a walk in a safe, fenced-in area, or a favorite song to shift their focus.
For more information on understanding and managing wandering, the Alzheimer's Association is an excellent resource.
Comparison of Monitoring Technologies
| Feature | GPS Smartwatch | Pressure-Sensitive Mat | Door/Window Alarm |
|---|---|---|---|
| Tracking Range | Unlimited (Cellular/GPS) | Within the home | Per door/window |
| Alert Type | Text/App Notification | Audible Alarm | Audible Alarm |
| Wearability | High (worn on wrist) | Not applicable | Not applicable |
| Primary Use | Locating person once they've left | Detecting a person's exit from bed/room | Alerting to an opened door/window |
| Cost | Varies (often monthly fee) | Moderate (one-time purchase) | Low (one-time purchase) |
