What do you do when a dementia patient starts wandering? A comprehensive guide for caregivers

An estimated 60% of people with dementia will wander at least once, creating a terrifying and dangerous situation for both the patient and their caregiver. Knowing exactly what do you do when a dementia patient starts wandering is crucial for ensuring their safety and peace of mind.

Quick Summary

When a dementia patient wanders, stay calm and begin a search immediately, calling 911 within 15 minutes if they are not found. Use proactive strategies like alarms, GPS trackers, and a structured routine to reduce the risk of future incidents.

Key Points

• Immediate Action: If a dementia patient goes missing, search immediately and call 911 within 15 minutes, informing them of the dementia diagnosis.

• Proactive Prevention: Implement door alarms, high/low locks, and camouflage exits to prevent unmonitored wandering from the home.

• Stay Calm and Redirect: When encountering a patient trying to wander, remain calm, validate their feelings, and gently redirect their focus to a different activity.

• Use Technology and ID: Utilize wearable GPS trackers and medical identification bracelets to ensure a faster and safer return if they get lost.

• Maintain Routine and Engagement: A consistent daily routine, combined with meaningful activities and regular exercise, can reduce restlessness and agitation.

• Address Underlying Triggers: Always check for unmet basic needs like hunger, thirst, pain, or a need to use the restroom, as these often trigger wandering episodes.

Understanding the Causes of Wandering

Wandering in dementia patients is not random; it is often triggered by confusion, disorientation, or a basic unmet need. Understanding the underlying cause is the first step toward effective prevention and management. Common reasons include:

• Searching for familiarity: The patient may feel they are in the wrong place and are trying to 'go home' or find a former residence.
• Following past routines: A person may be reliving an old routine, such as going to work, running an errand, or taking a child to school.
• Boredom and restlessness: A lack of stimulating activity can lead to pacing or wandering as a way to relieve agitation.
• Physical needs: The individual may be hungry, thirsty, uncomfortable, in pain, or need to use the restroom.
• Reaction to overstimulation: Busy or noisy environments, like a shopping mall or crowded room, can be overwhelming and cause them to seek escape.

Immediate Response: When a Patient is Missing

If you discover the person has left and cannot be found, immediate action is critical. Survival rates decrease significantly the longer a person is missing.

1. Start searching immediately: Do not wait. Check the immediate vicinity, including the house and yard. Think about familiar routes or past wandering destinations.
2. Call 911 within 15 minutes: If they are not found, call for help immediately. Tell the dispatcher the person has dementia, provide their name, a recent photo, and describe their clothing.
3. Use a recent photo: Keep a recent, close-up photo ready to share with police and neighbors.
4. Enlist help: Alert neighbors, family, and local businesses to be on the lookout.

Proactive Prevention: Creating a Safe Environment

The best way to manage wandering is to prevent it from happening in the first place. A combination of environmental changes, routine, and technology can significantly reduce risk.

Environmental Modifications

• Secure Doors and Windows: Install locks that are out of the person's line of sight, such as a deadbolt placed high or low on the door. Consider alarms that chime when a door or window is opened.
• Camouflage Exits: Make exterior doors less conspicuous by painting them the same color as the walls or covering them with curtains or posters. A black mat in front of a door can also act as a visual deterrent.
• Minimize Triggers: Keep items associated with leaving, such as car keys, shoes, coats, and purses, out of sight.
• Enhance Indoor Safety: Use motion-activated nightlights to illuminate paths to the bathroom and other common areas. Remove tripping hazards like throw rugs and clutter.

Routine and Engagement

• Maintain a Daily Routine: A consistent schedule provides structure and reduces anxiety and agitation.
• Plan Engaging Activities: Fill the day with meaningful tasks like folding laundry, listening to music, or light exercise to reduce boredom.
• Identify High-Risk Times: Note the times of day the patient is most likely to wander (e.g., during sundowning) and plan stimulating activities for those periods.

The Role of Technology and Identification

Technology offers powerful tools for both prevention and emergency response.

Wearable GPS Tracking

GPS trackers can be worn as a watch, pendant, or even inserted into shoe soles, allowing caregivers to monitor the individual's location via a smartphone app. This technology can provide peace of mind and speed up a search if they do become lost.

Medical Identification

Medical ID bracelets, pendants, or labeling clothing with contact information are simple but effective measures. Services like MedicAlert's Safe Return program offer 24/7 support and emergency response.

What to Do During an Encounter

If you see the person attempting to wander, your approach is critical. Forcibly restraining them can lead to injury and distress.

• Remain Calm and Reassuring: Approach them gently. Your body language and tone of voice are important. Don't show panic.
• Validate and Redirect: Instead of arguing or correcting them, acknowledge their feeling. If they say they need to go to work, you can respond, "You're right, let's have a cup of tea first". Distract them with an activity they enjoy.
• Meet the Underlying Need: A simple need for a snack, a bathroom trip, or a walk could be the trigger. Ask specific questions like, "Would you like a snack?".

Prevention vs. Response: A Comparison

Aspect	Proactive Prevention	Emergency Response
Goal	Reduce risk of wandering	Locate person quickly and safely
Tools	Door alarms, GPS trackers, locks, ID bracelets	Recent photo, contact list, 911 call
Environment	Modifying home, creating safe spaces	Searching immediate area, calling for help
Caregiver Role	Creating routine, engaging in activities, monitoring triggers	Acting swiftly, staying calm, providing information to authorities
Key Mindset	Prevention is always better than cure	Urgency combined with calm, logical action

The Importance of a Community Network

Informing neighbors, local police, and friends about the person's tendency to wander creates a critical safety net. This allows them to assist immediately by calling you if they see the person alone or confused.

What to Avoid During a Wandering Incident

• Avoid Arguing: Trying to reason with a dementia patient is ineffective and can increase their agitation and distress.
• Avoid Taking It Personally: Remember that the behavior is caused by the disease, not directed at you personally.
• Never Lock Someone In Alone: This is extremely dangerous. The person could panic and be unable to escape in an emergency like a fire.
• Don't Dismiss the Urge: If they insist on going 'home,' don't simply dismiss it. Respond to the emotion behind the words.

For more resources and information, visit the Alzheimer's Association.

Conclusion

Caring for a dementia patient who wanders requires a multi-faceted approach. By understanding the causes, implementing proactive safety measures, and having a clear emergency response plan, caregivers can significantly reduce the risks associated with this challenging behavior. The key is combining a safe, predictable environment with compassionate, non-confrontational care. Equipping yourself with the right knowledge and tools can make a profound difference in the safety and well-being of your loved one.

Frequently Asked Questions

Why do dementia patients start wandering?

Dementia patients wander for several reasons, including confusion, boredom, restlessness, looking for something or someone familiar, or needing to use the restroom. They may be reliving past routines or reacting to overwhelming stimuli.

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

Sundowning refers to a state of increased confusion, anxiety, and agitation that can occur in the late afternoon or evening. It is a common trigger for wandering behavior, as the person may become more restless during this time.

Should you correct a dementia patient who is trying to wander?

No, it is best to avoid correcting them. Instead, use a calm and reassuring tone, validate their feelings, and gently redirect their attention toward a different activity or need. Arguing can increase agitation.

What kind of technology can help prevent dementia patient wandering?

Helpful technologies include wearable GPS tracking devices (watches, pendants), door and window alarms, and pressure-sensitive mats that alert caregivers to movement. Medical ID bracelets are also highly recommended.

How can you make a home safer for a person who wanders?

To make a home safer, install locks out of sight (high or low), use door/window alarms, camouflage exit doors, remove tripping hazards, and ensure clear, well-lit paths. Consider securing outdoor areas with fences.

What should I do if a dementia patient asks to 'go home'?

If they are already home, avoid telling them they are wrong. Instead, respond to the emotion behind their words. Reassure them that they are safe and suggest a comforting activity, like looking at old photo albums or having a cup of tea.

Is it safe to leave a dementia patient with a tendency to wander alone?

It is not safe to leave a dementia patient who has a history of wandering unsupervised. They could become lost or injured very quickly. Caregivers should ensure constant supervision or arrange for respite care.