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Why Do People With Alzheimer’s Disease Wander?

In the U.S. and around the world, the population is aging, and that means an increase in people who are living with Alzheimer’s disease or other memory loss. Geriatricians say that over half of these seniors are at risk of becoming lost. It seems that every week we come across a news article about a senior with dementia who goes missing. Most of these stories have a happy ending—perhaps the person is found at a store they remember, or in a park, unable to remember the way home. Many are found very close to home, even hiding in the house. But some of these stories have a far less happy outcome, with the senior being found dead or never found at all.

To address this epidemic of wandering, 18 states and a number of countries have implemented “Silver Alert” systems that notify law enforcement and the public to be on the lookout for a senior with dementia who is lost. Just last month, experts from Queensland University of Technology in Australia made a recommendation that the Australian government implement such a system. Dr. Margie MacAndrew explained, “Characteristics of risky wandering include frequent and repetitive walking without resting, which can be very tiring. Also walking without knowing where you are and how to get back home without help from another person—in other words, wayfinding problems.” Dr. MacAndrew warned, “Wandering can result in potentially life-threatening outcomes such as malnutrition, increased risk of falls, injury, exhaustion, hypothermia, becoming lost and death.”

Reducing the risk that a senior loved one with dementia will get lost

Understanding why a loved one wanders is the first step. First of all, it’s important to realize that although wandering may seem like aimless walking around, in fact, the person may have a goal. Most likely, your loved one isn’t trying to “get away,” but to find something or someone—the bathroom or kitchen, a child (who is now an adult), their workplace (even if they retired long ago), or their car keys (even if they no longer have a car). They might be trying to go home, even if they are home. If they always went for a walk after dinner, they may be adhering to that pattern. They might be feeling anxious or in pain, but are unable to express it. Most likely, they are bored or lonely. Understanding these “triggers” can help you address these unmet needs.

It’s also important to seek a medical evaluation of the problem. Side effects of medications, infections, delirium and incontinence can increase wandering in a person with dementia.

If your loved one lives in a supportive senior living environment, the staff will have measures in place to protect them. Others live at home, often with the help of professional in-home care or adult day services. If your loved one lives at home or visits you there, here are seven steps to keep them safe:

  1. Provide appropriate activities and exercise. If your loved one is bored or lonely, they’re more likely to wander. Your loved one may enjoy appropriate art activities, crafts, household tasks, music, cooking simple foods, walks and outings. More communities these days offer dementia-friendly activities, where your loved one can socialize in a nonjudgmental setting.
  2. Learn to redirect. If your loved one expresses feelings of being lost or abandoned, reassure them they are safe. Redirect them to safe activities that fill the need for a sense of purpose. If “sundowning” (restlessness at night) is a problem, limit daytime naps. Dementia-care professionals have found that “correcting” a person with dementia can increase agitation. “Don’t correct—redirect” is their guideline.
  3. Adapt your home to keep your loved one safe. You can install special locks on doors, safety gates to prevent exit, and an alarm that will sound if the front door is open. Add loosely fitted doorknob covers so that the cover turns instead of the actual knob. (To preserve an emergency exit, use these only when someone else is present in the home.) Install devices to keep windows from opening all the way. Create visual cues to disguise the door, or place a “stop” or “do not enter” sign on the door.
  4. Be sure your loved one always carries ID, and a medical alert to tell others they have memory loss. If your loved one doesn’t consistently carry a wallet, try a bracelet, watch, pendant, or clothing labels. Contact your local Alzheimer’s Association office to learn about their MedicAlert program. Some families these days also take advantage of tracking technology to help locate loved ones quickly.
  5. Let neighbors and local merchants know about your loved one’s condition. Ask them to contact you if they see your loved one alone. Having this conversation with you makes it more likely that others will recognize the problem and feel comfortable getting involved. And they’ll be less likely to consider your loved one a “suspicious person” and post a photo on the neighborhood blog, as well!
  6. Call 9-1-1 sooner rather than later if your loved one is lost. Experts say if a person isn’t found within 24 hours, their risk of serious injury and even death is high. The Alzheimer’s Association recommends that you search for your loved one in the immediate area for no longer than 15 minutes. If you haven’t found your loved one by then, call 9-1-1 and report that a vulnerable person with Alzheimer’s disease is missing. Normally, police will not search for a person for 24 hours, but they typically don’t require this waiting period if an adult has dementia. Have a current photo of your loved one available to share with the authorities. You can call the Alzheimer’s Association Helpline at 1-800-272-3900 for help if police hesitate to step in.
  7. Don’t leave your loved one alone. If your loved one lives at home or is visiting, someone should be with them at all times. This can be exhausting for family, especially if the person wanders at night, so learn about respite services. Caring for a loved one with dementia is hard work, so you need to do this to take care of yourself.

Creative solutions that keep your loved one safe while meeting their emotional needs can help channel the wandering instinct into safe activities that will keep your loved one occupied and reduce the impulse to wander.

Other dementia safety articles:

When Is It Time To Give Up The Keys – Elder Advisory Group, August 7, 2017

Read More About: Dementia and Alzheimer's

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