Wandering

Behaviors That Often Precede Wandering
Two behaviors that typically occur before wandering are pacing and disorientation. If a person with dementia has a need, he is often unable to verbalize that need and will exhibit a sudden change in behavior instead. Check for clues that may indicate an unmet need.

• Ensure that appropriate fluids are offered at regular intervals throughout the day.
• He/she may be hungry if a mealtime is near.
• He/she may pull at clothing if needing to use the toilet.
• Check to see that clothing is suitable for the environmental temperature.
• Consider pain medication if appropriate.
• Providing a calm, predictable, and relaxed atmosphere may decrease anxiety.
• Sudden increased disorientation, or delirium, may indicate an infection or medication reaction, so notify the healthcare provider if the change in behavior persists or is cyclic.

Watch for Patterns of Wandering in People with Alzheimer’s
Many people with Alzheimer’s disease have a pattern to their behaviors. By watching for patterns, caregivers may be able to distract the person with specific activities at those times. Watch for triggers in addition to physical needs above, such as the time of day and environmental changes. Many people with dementia tend to become increasingly agitated in the transition between daylight and darkness, a condition known as Sundowners syndrome. A new or change in a familiar environment may result in increased agitation – it is helpful to introduce changes slowly if possible. For example, brief visits to a future home or with a new caregiver may be helpful to help prepare for the change. If the behavior seems to be related to medications, immediately notify his or her healthcare provider.

Safety Suggestions for Those Who Tend to Wander Away From Home
Fewer than 4% of people with dementia can find their way home unassisted. This presents a major safety challenge, especially during weather extremes because a person with dementia may be inadequately dressed for environmental conditions. People with Alzheimer’s may be quite lucid at times and may be able to disarm many safety devices, so always ensure that the person with dementia is properly supervised.

• Place a large sign on exit doors saying “Stop” or “Do Not Enter.".
• Hide doorknobs with a color-matched cloth or a curtain.
• Keep temptations, such as keys, out of sight.
• Install motion sensors or a device that will alarm if an exit door is opened.
• Provide reassurance and redirect conversations if he appears anxious or insists on “going home” or “going to work," or attempts to fulfill former responsibilities.
• Keep a recent photo and detailed physical description of the person readily available.
• Utilize programs designed to help track someone who is lost, such as MedicAlert+SafeReturn and Project Lifesaver International.

Ed Picard
Respite Center Coordinator