What Does It Mean When Someone Is Wandering?

According to the Alzheimer's Association, approximately 60% of individuals with dementia will wander at least once during the course of their illness. So, what does it mean when someone is wandering? It describes a person moving about aimlessly or becoming confused and lost in their surroundings, often a behavior linked to underlying cognitive, medical, or psychological conditions.

Quick Summary

Wandering is a complex behavior where an individual moves without clear purpose, often becoming disoriented and potentially lost. Common causes include dementia, autism, restlessness, stress, and unmet needs like hunger or pain. It poses significant safety risks, necessitating awareness, planning, and specific preventive measures for those at risk.

Key Points

• Wandering is Often Purposeful: Though it may appear aimless, wandering in people with dementia often stems from a forgotten routine, a search for something or someone, or an unmet need.

• It Is a Symptom of Underlying Issues: Wandering is not a standalone behavior but a symptom of conditions like dementia, Alzheimer's disease, autism, or other cognitive impairments.

• Early Detection is Crucial: Caregivers should watch for warning signs like restlessness, repeating phrases like "I want to go home," or trouble finding familiar rooms.

• Safety Measures are Essential: Securing the home with special locks, alarms, and fences is a primary strategy for preventing dangerous elopement.

• Proactive Planning is a Lifesaver: Having a wandering emergency plan, including tracking devices and informing neighbors, significantly increases the chance of a safe return.

• Redirect, Don't Argue: When a person with dementia expresses a desire to leave, redirect their focus to a calm, engaging activity rather than arguing or correcting them.

Understanding the Causes of Wandering

Wandering is a common behavior, especially among individuals with conditions that affect memory and judgment. This movement may seem aimless to an observer but often has a specific, though sometimes illogical, purpose to the person wandering. Understanding the root causes is the first step toward effective management.

Cognitive and Memory-Related Causes

Many underlying health conditions that affect the brain can lead to wandering. The most well-known of these is dementia, including Alzheimer's disease. As these diseases progress, they damage the brain's cognitive mapping ability, making it difficult for a person to recognize familiar places and retrace their steps. The disorientation can lead them to search for a person, place, or object from their past, or to attempt to fulfill an old routine, like going to a former workplace. The late afternoon and early evening, a phenomenon known as "sundowning," can also increase confusion and restlessness, leading to wandering.

Common cognitive triggers include:

• Memory loss: Inability to recall where they are or how to get home.
• Confusion and disorientation: Feeling lost even in familiar environments.
• Reliving the past: Trying to follow old routines or search for people from their history.
• Visual-spatial problems: Difficulty interpreting their surroundings and navigating.

Psychological and Environmental Triggers

Wandering is not exclusively tied to cognitive decline. Emotional and environmental factors can also trigger the behavior. A person might wander to escape an overstimulating or stressful environment, such as a noisy room. Boredom, loneliness, or anxiety can also provoke restlessness and pacing, which can escalate into wandering. For individuals with autism, sensory overload or a fixation on a specific object can trigger a wandering event.

Key psychological and environmental triggers are:

• Stress and anxiety: Reacting to a crowded or confusing setting.
• Boredom or loneliness: Seeking stimulation or social contact.
• Sensory overload: Escaping from loud noises, bright lights, or other overwhelming stimuli.
• Changes in routine: A disruption in a person's daily schedule can cause distress.

Unmet Physical and Emotional Needs

Sometimes, wandering is a non-verbal expression of an unmet need. An individual with impaired communication skills may walk around because they are hungry, thirsty, in pain, or need to use the bathroom. Instead of being able to state their need directly, their agitation and restlessness manifest as an attempt to find comfort or relief. It is crucial for caregivers to recognize these subtle cues and proactively address basic needs.

Comparison of Wandering Causes and Prevention Strategies

Cause of Wandering	Triggering Factors	Effective Prevention Strategies
Dementia/Cognitive Decline	Memory loss, disorientation, sundowning, reliving past routines, visual-spatial problems.	Create and maintain a strict daily routine. Ensure adequate lighting, especially at night. Secure home with alarms and locks. Use GPS tracking devices. Redirect attention rather than confronting.
Autism Spectrum Disorder (ASD)	Sensory overload, high anxiety, fixation on an object or place, impulsivity, poor sense of danger.	Identify and mitigate sensory triggers. Secure the home and yard with fences and alarms. Teach safety skills and communication strategies. Enroll in community-supported tracking programs like Project Lifesaver.
Unmet Basic Needs	Hunger, thirst, pain, need to use the bathroom, medication side effects.	Ensure a regular schedule for meals, hydration, and bathroom breaks. Proactively check for signs of pain or discomfort. Review medications with a doctor to identify potential side effects.
Environmental Stress	Noisy environments, crowded places, unfamiliar settings.	Reduce environmental clutter and excessive noise. Avoid crowded public spaces if possible. Create a calm, predictable, and engaging home environment. Provide a safe indoor or outdoor space for walking.

How to Help Someone Who is Wandering

If you are caring for someone who wanders, a proactive approach focused on safety and understanding is essential. Prevention and management strategies can significantly reduce the risks associated with this behavior.

1. Secure the living environment: Install locks on exterior doors and windows, placing them either high up or down low to be less noticeable. Motion sensors or door/window alarms can alert caregivers when an exit has been opened. Consider fencing a backyard to create a safe, contained space for outdoor activity.
2. Use identification and tracking: A medical ID bracelet or a GPS tracking device can provide critical information and help locate an individual quickly if they become lost. It is also wise to keep recent photos on hand to give to authorities if necessary.
3. Establish a routine: A structured daily schedule can provide a sense of stability and reduce anxiety that can trigger wandering. Regular walks or other physical activities can also help burn off excess energy and promote better sleep habits.
4. Redirect, don't confront: If a person with dementia insists on leaving to go to a former job or home, do not correct them. Instead, acknowledge their feeling and gently redirect their attention to another engaging activity, like a snack, a puzzle, or listening to music.
5. Inform neighbors and authorities: Let trusted neighbors, friends, and local police know that the individual may wander. Many areas have programs like Silver Alerts or local registries where information can be kept on file to aid in a search.
6. Create a wandering emergency plan: Have a plan in place for what to do if the person goes missing, including who to call and a list of familiar places they might visit. Immediate action is crucial, as the risks increase significantly the longer a person is missing.

What to Do If a Wandering Incident Occurs

If a person who wanders goes missing, it is an emergency that requires immediate action.

• Call 911 immediately and inform authorities that the missing person has dementia or a condition that affects their judgment.
• Search nearby areas immediately. People who wander often do not go far, so check the vicinity of where they were last seen.
• Utilize your pre-prepared plan. Enact the plan you've established with neighbors and family members.

Conclusion

Wandering is a complex behavior stemming from various underlying cognitive, psychological, and physiological factors. For conditions like dementia and autism, it is a significant safety concern. By understanding the common triggers—such as confusion, anxiety, and unmet needs—caregivers can implement effective prevention and management strategies. Securing the home, establishing routines, using identification and tracking technology, and having an emergency plan are all critical steps. Approaching the situation with patience and a focus on redirection rather than confrontation is vital for ensuring the safety and well-being of the individual at risk. Caregivers are not alone; resources are available from organizations like the Alzheimer's Association to help manage this challenging behavior.

Frequently Asked Questions

What is the difference between wandering and elopement?

Wandering is a general term for moving about aimlessly, while elopement refers specifically to a person leaving a safe area, such as a home or care facility, and becoming lost. Elopement is a more critical form of wandering that presents a serious safety risk.

Why do people with dementia feel the need to wander?

People with dementia may wander for several reasons, including confusion, restlessness, anxiety, or seeking to satisfy a basic unmet need like hunger or thirst. They might also be attempting to follow a past routine, such as going to work, or be disoriented and looking for a familiar place.

Does wandering happen only in people with dementia?

No. While common in people with dementia, wandering can also occur in individuals with other conditions like autism spectrum disorder (ASD) or Down syndrome. In these cases, it can be triggered by sensory overload, stress, or the impulse to explore.

What is "sundowning" and how is it related to wandering?

Sundowning is a state of increased confusion and restlessness that occurs in the late afternoon and evening, particularly in individuals with dementia. This can increase the likelihood of wandering behavior during these hours due to heightened agitation and disorientation.

What should I do immediately if a loved one with dementia is missing?

If a loved one who is prone to wandering goes missing, you should call 911 immediately. It is considered an emergency. Do not wait. Inform the authorities that the person has dementia, as this information is critical for their response.

Are GPS trackers effective for someone who is wandering?

Yes, GPS tracking devices, available as bracelets or other wearable technology, can be very effective for locating an individual who has wandered off. They can provide peace of mind for caregivers and facilitate a much quicker and safer retrieval if an incident occurs.

How can I calm a person who wants to leave the house to go "home" when they are already there?

Rather than trying to reason with them, which can cause more distress, gently redirect their attention. You can say something like, "Let's have a cup of tea first" or distract them with a pleasant, simple activity, like looking at old photo albums.