Understanding the Causes of Wandering
To effectively manage wandering, it's essential to first understand its root causes. Wandering is often not a random act, but a purposeful behavior driven by confusion, anxiety, or unmet needs. Some common triggers include:
- Reliving the past: A patient may be looking for a past home, a loved one, or a former workplace, driven by a deeply ingrained memory.
- Anxiety and stress: Overstimulation, changes in routine, or a confusing environment can lead to agitation and the urge to flee or pace.
- Searching for something: They may be looking for a lost item or searching for food, the bathroom, or even fresh air, but lack the cognitive ability to communicate their needs.
- Boredom and restlessness: A lack of physical or mental stimulation can cause restlessness, leading to aimless pacing or an attempt to go outside.
- Physical discomfort: Hunger, thirst, pain, or a need to use the restroom can prompt wandering behavior.
Immediate Strategies for Responding to Wandering
If you find your loved one is attempting to wander or has already left, your response is critical. Staying calm can prevent further agitation. Here are the steps to take:
- Approach calmly: Avoid sudden movements or a confrontational tone. Approach from the front and maintain eye contact while using a soft, reassuring voice.
- Redirect and distract: Instead of arguing or correcting them, redirect their attention. If they say, “I need to go home,” respond with, “How about we have a cup of tea first?” or “Let's look at your photo album.”
- Validate their feelings: Acknowledge their emotions. If they seem anxious, say, “I can see you're upset. Tell me about it.” This validates their feelings and can de-escalate the situation.
- Assess their needs: Check if they are hungry, thirsty, or need to use the bathroom. A simple need can often be the trigger.
- Engage in a simple activity: Once they are calmer, suggest a familiar activity like folding laundry, watering plants, or listening to music to help settle their restlessness.
Proactive Prevention and Home Safety
Prevention is the most powerful tool in managing wandering. By creating a secure and predictable environment, you can significantly reduce the risk. Here’s how to make your home safer:
Environmental and Physical Modifications
- Secure doors and windows: Install locks that are placed either high or low, out of the patient's typical line of sight. Consider key-operated deadbolts or door alarms that chime when opened.
- Camouflage exits: Make doors blend in with the surrounding wall by painting them the same color or hanging curtains or posters over them. A black floor mat in front of an exit can also act as a visual barrier, as it may look like a hole.
- Remove triggers: Keep coats, hats, purses, car keys, and other items that suggest leaving out of sight. Store them in a locked closet or a less accessible location.
- Create safe wandering paths: Fence in a yard or garden with a locked gate, providing a safe, enclosed space for your loved one to walk freely and burn off restless energy.
Creating and Maintaining a Routine
- Daily schedule: Establish a consistent daily routine for meals, activities, and sleep. Predictability can reduce anxiety and confusion.
- Physical activity: Incorporate regular, supervised physical activity, such as walks or simple exercises, to reduce restlessness and promote better sleep.
- Meaningful engagement: Provide engaging activities that utilize your loved one's remaining skills. This could include sorting objects, looking at old photographs, or listening to favorite music.
Technology and Identification for Safety
Modern technology offers valuable tools for tracking and emergency response. In addition to home modifications, incorporating these devices can provide an extra layer of security.
| Technology Type | Best For | Pros | Cons |
|---|---|---|---|
| GPS Trackers | Active and mobile individuals | Real-time location tracking, alerts for designated zones | Can be lost or removed by the patient, requires charging |
| Medical ID Bracelet | Memory loss identification | Non-electronic, always-on ID, clear medical info | Relies on others to notice and call, not a tracker |
| Wearable Alarms | In-home monitoring | Detects if a door opens or if the patient leaves a bed | Not for tracking outside the home, limited range |
| Smart Doorbell | Monitoring exits | Alerts caregiver via smartphone when door is opened | Can be triggered by anyone, no tracking |
The Emergency Plan: When Wandering Happens
Even with the best preventative measures, wandering can still occur. A solid emergency plan is critical for a rapid and safe response.
- Enroll in a Safe Return program: Consider enrolling your loved one in the Alzheimer's Association's MedicAlert® + Alzheimer's Association Safe Return® program. It provides an ID bracelet and a 24/7 emergency hotline.
- Notify local authorities and neighbors: Inform your local police department that your loved one has Alzheimer's and tends to wander. Provide them with a recent photo and their potential destinations. Also, inform trusted neighbors and provide your contact information.
- Prepare an emergency kit: Keep a recent, close-up photo of your loved one readily available. Additionally, save a bag with an unwashed item of their clothing in a sealed plastic bag. The scent can aid search dogs if necessary.
- Initial search efforts: If your loved one is missing, act immediately. Check all potential hiding spots inside the house, including closets and the garage. Search the immediate vicinity, including your yard and neighboring properties. A person who wanders is often found within a 1.5-mile radius.
- Call 911: If the person is not found within 15 minutes, call 911. Be sure to inform them that the missing person has Alzheimer's or dementia, as this may trigger a wider community alert, like a Silver Alert.
Conclusion: Prioritizing Safety and Dignity
Managing wandering with an Alzheimer's patient is a significant challenge, but one that can be navigated with patience, preparation, and the right strategies. By understanding the reasons behind the behavior, implementing proactive safety measures at home, and having a clear emergency plan, caregivers can significantly reduce the risks associated with wandering. The ultimate goal is to balance the individual's need for activity and independence with the crucial need for their safety and well-being, ensuring they can age with dignity in a secure environment. Remember, you are not alone, and resources like the Alzheimer's Association exist to offer support.
