Tips on How to Prevent and Manage Dementia Wandering

December 19, 2023 Dave

Submitted by Beth Rush
Founder and Managing Editor
Body+Mind Magazine

Wandering can occur in those living with dementia and is one of the scariest parts of caring for a loved one in a deteriorating mental state. Fortunately, there are ways to prevent and manage wandering to keep your loved one safe and you sane.

What Is Dementia Wandering?

Six out of 10 people living with dementia will wander at least once during their condition. It’s common but can be dangerous. Unsafe wandering is stressful for families and caregivers since their loved one can leave without their knowledge at any time of day and won’t tell them where they intend to go.

Everyone with Alzheimer’s Disease or other types of dementia is at risk for wandering. Most who do it multiple times per week are commonly in the moderate stage of the disease. Wandering tendencies increase as cognitive impairment decreases. Research shows that the people at the highest risk of wandering have a Mini-Mental State Exam (MMSE) of 13 or less.

Common signs that a person living with mild dementia could wander include returning home later than usual, not telling anyone if they’re leaving or where they’re going, forgetting how to get to previously familiar places, seeming lost in a new environment, getting restless or pacing, and getting nervous in crowds.

As their condition progresses, they may do the following.

Talk about going or trying to “go home,” even if they are home.
Discuss or try to go to work or another previous commitment.
Have trouble finding rooms in their own home.
Act like they’re doing a chore or hobby without actually doing it.
Ask for updates on family members and friends who passed away.

Exact Cause Not Understood

It can get frustrating because the exact causes of wandering aren’t well understood and can be very different. It could be a disconnection between areas of their brain responsible for motor function, memory and visuospatial function. A 2018 study of positron-emission tomography (PET) in Alzheimer’s patients found different hypermetabolism in some brain areas for wandering patients compared to people who didn’t wander.

Some people’s wandering might seem ordinary at first. They could search for something or act like they want to go to your yard. Always communicate with the person to understand their level of understanding and intention. Once someone starts showing signs of wandering behaviors, they’re at higher risk of wandering away and getting lost.

There are things that can trigger wandering. As dementia worsens, a patient might start to defy instructions. They might leave if you tell them to stay in a location. As vision worsens, they may not recognize a room’s layout and think they’re elsewhere. Sometimes, they will know where they are going but forget to let anyone know. They may have trouble expressing their thoughts and feelings, leading to a caregiver not knowing their intention or whereabouts.

Sundowning and Wandering

“Sundowning” increases a patient’s likelihood of wandering. People with dementia can become agitated and disoriented in the evening, bouncing back to a better mental state in the morning.

While there may be other factors, the cause of sundowning is a link between dementia and the person’s circadian rhythm. It’s one of the most common occurrences in moderate to severe dementia. It’s also one of the most common reasons a patient begins living in a care facility.

Wandering with sundowning is particularly dangerous because patients who wander off are likely doing so in the dark. It makes it much harder to locate them, and being without sunlight quickly can be more disorienting to the patient.

Thankfully, there are ways to make their environment safer and reduce the risk of wandering away.

How to Prevent Wandering

You can help prevent wandering by taking actions to limit or eliminate a loved one with dementia’s ability to leave unaccompanied.

For patients with memory loss who are able to live independently, check on them throughout the day to ensure they are safe. Discuss any appointments or activities they have coming up so you know where they should be if they are not home.

If they can still drive but have trouble remembering how to get places, consider programming a GPS to guide them to the store, doctor’s offices and any regular activities. If you’re concerned about them driving, you could discuss delivery services, shuttles or other public transportation options.

As their condition worsens, they will need caregivers who can meet their needs and serve as a companion. Around 14% of adults who live with someone else are older parents or loved ones. If you are the primary caregiver, keep them as involved as possible in daily activities. Try to keep a routine to reduce the chance of them becoming disoriented.

Doors

You can’t keep your eyes on them every second, so lock your doors to prevent them from wandering off when you prepare a meal or use the restroom. You can place security alarms if needed on doors or windows to quickly alert you if they try to leave.

Childproofing door knob covers can also delay them from getting away. Sometimes, a sign is all it takes for the person to realize they are wandering off. You could also label other rooms to help them stay aware of their surroundings, such as a toilet for the bathroom or a bed for the bedroom.

Fencing

A fence can also help keep your home secure. It can keep the patient in your yard instead of them wandering into the street. The fresh air and sunshine could even help them reorient.

Planning Ahead

Keep your car keys in a safe place so they can’t access them if driving is unsafe. If they come with you to appointments or errands, don’t leave them alone in the car.

If the person shows signs of wandering, try to identify when they get the most agitated or disoriented. Plan activities around those times to keep them busy and reduce their restlessness. Enlist their help with folding laundry, preparing meals or cleaning up. Make them feel like you need them for those important tasks. You can also find a game or show they enjoy to help fill those hours.

When your loved one starts to feel anxious or overwhelmed, reassure them they are safe and in a familiar place. Ensure all of their needs are met so they won’t feel like they need to go out to fulfill them.

If you go out with them, try to avoid busy or disorienting places. Keep an eye on the person as they adjust to the new setting. Staying with them can offer reassurance that they are in a safe place.

Managing Wandering

Despite a caregiver’s best efforts, someone living with dementia may still wander away. A “missing incident” are stressful, but there are ways to manage these situations to keep your loved one as safe as possible.

Make Them Stand Out

Dressing them in bright clothes can make them more visible if you need to look for them. It can also make them easier to spot in a crowd. Having a recent photo of them available can help authorities and neighbors spot them. A good strategy is to take a photo after they get ready for the day to document their clothing.

Keep An ID On Them

If your loved one carries identification on them, it can help someone identify them when lost or disoriented. The police can then notify you. A medical ID necklace or medical identification bracelet can say who they are, where they live and that they have dementia. Knowing their condition could make a stranger more sympathetic and help your loved one get the help they need. You could also sew information into their clothing.

The Alzheimer’s Association’s 24/7 Wandering Support program provides specialized ID bracelets. They can then activate an alert with your loved one’s ID number to help identify them.

Use a Tracking Device

Placing a tracker on a dementia patient can help you quickly find them if they wander off. You can place a tracking tag in a wallet or purse. Smartwatches can also pair with another device to help you keep track of them.

Project Lifesaver is a safe return program that provides trackers to dementia and Alzheimer’s patients free of charge. You can register your loved ones and the program can use the tracker if you need help finding them.

Whatever you use to identify your loved one, it’s important to ensure your loved one will have it with them.

Getting Support

Education about your loved one’s form of dementia can help you customize a wandering plan for them. You can join a caregiver support group to get advice and come up with new ideas to prevent a dementia patient from wandering. If your loved one starts wandering, you can talk to their doctor about routine or medication recommendations that can help your loved one’s anxiety.

What to Do If Your Loved One Wanders

It’s terrifying to not know where your sick loved one is but there are best practices you can follow to quickly find them. As tempting as it can be to start driving around, the first thing to do is call 911. Explain that your loved one has dementia and is at risk. Give your local law enforcement officials a description and they can pull on their resources to find them.

Alert any programs such as the Alzheimer’s Association’s Wandering Support or Project Lifesaver to activate their alerts.

The more people you trust looking for your loved one, the better. If they leave from home, ask your neighbors if they can keep an eye out as well as any local businesses. If you live near a bus or other public transportation station, notify officials that they shouldn’t travel.

In the worst-case scenario, wandering could lead to illness, injury or death, so quick action is vital. Remember that your loved one doesn’t realize what they’ve done. Take a breath when you find them and try to stay as calm as possible. Lashing out from anxiety and anger could further confuse your loved one.

Handling Wandering As A Dementia Caregiver

With the right steps, you can keep your dementia patient safe. Giving back to the loved ones who took care of you is a noble act and you’re not alone. Taking advantage of the programs offered can help you find the best tips to prevent and manage wandering.