Dementia and wandering
If you are caring for a person with dementia, you may be faced with the problem of what to do if they begin to wander. Wandering is quite common among people with dementia and can be very worrying for carers who are concerned for the person's safety and well-being. You may feel guilty that they have managed to slip away without your noticing, but no one can keep a 24-hour watch on another person and you should certainly not blame yourself or anyone else who has been left in charge.
Failing memory and declining ability to communicate may make it impossible for the person with dementia to explain the reason they wandered off or even to remember themselves. The following suggestions may help you understand the reasons for wandering and how to cope with it.
Reasons for wandering
- Changed environment: a person may feel uncertain and disoriented in a new environment such as a new house or day care centre. Wandering may cease once the person becomes used to the change. The person may also want to escape from a noisy or busy environment.
- Loss of memory: wandering may be due to a loss of short-term memory. A person may set off to go to the shop or a friend's house, and then forget where they were going and why. Or they may forget that you have told them that you are going out and try to find you.
- Excess energy: wandering can be a way of using up excess energy, indicating that the person may need more regular exercise.
- Continuing a habit: people who have been used to walking long distances may simply wish to continue doing so and may not really be wanderers.
- Expressing boredom: as dementia progresses, people find it harder and harder to concentrate for any length of time—wandering may be their way of keeping occupied.
- Agitation: physical changes which have occurred in the brain may cause a feeling of restlessness and anxiety. Agitation can cause some people to pace up and down or to wander off with no apparent purpose. They may fail to recognise their own home and insist on leaving.
- Discomfort or pain: walking may ease discomfort, so it is important to find out if there is any physical problem or medical condition and try to alleviate it. Tight clothing, excessive heat or needing to find a toilet could all cause problems.
- Searching for the past: as people become more confused they may wander off in search of someone or something related to their past such as a partner who has died, a lost friend or a house they lived in as a child.
- A task to perform: sometimes people leave the house because they believe they have a task to do or are confused about the time of day or the season. This may be related to a former role such as going to work in the morning or being home for the children in the afternoon.
- Confusing night with day: people with dementia may suffer from insomnia or wake in the early hours and become disoriented. They may think it is daytime and decide to go out for a walk. Reduced sensory functioning may mean shadows or night sounds become confusing and distressing.
- Dreams: an inability to differentiate dreams from reality may cause the person to respond to something that they dreamed.
What can you do?
The precautions you take will depend on the person's personality, how well they are able to cope, their reasons for wandering and whether you live in a potentially dangerous or safe and secure environment.
Try to stay calm
- Always remember to comfort and reassure. Try not to get cross or show your anxiety because the person is already likely to be confused and frightened.
- Get them back into a regular, familiar routine as soon as possible.
- Try not to panic if the person does disappear.
- If you are unable to find them in the immediate neighbourhood, notify the local police.
- Make sure you get a break from caring: use local services such as day care, respite care.
Seek medical advice
- A physical check-up will help to identify whether illness, pain or discomfort has triggered the wandering.
- Try to avoid high doses of medication which will often increase confusion and cause drowsiness and possibly incontinence. Use only under medical supervision.
Keep a diary
- Some carers find it helpful to keep a diary so that they can see if there is a pattern to the wandering behaviour. It may occur at particular times of day or in response to particular situations and these variables can then be more carefully controlled.
- Examine the person's routine to see whether there are events or signals that may trigger wandering behaviour such as a hat and coat hanging at the door, or a particularly busy time of the day.
Precautionary measures
- External doors can be secured against wanderers by installing a deadlock which required a key on both sides; be sure to carry a key or hide it nearby in case of emergencies.
- Sometimes it is sufficient simply to relocate door locks where the person will not think to look for them.
- Consider bells and buzzers which sound when external doors are opened.
- Make part of the garden secure so that it becomes a "safe place" to walk around in.
- Provide a recent photograph of the person for your local police Neighbourhood Watch program in case the need arises.
- Monitoring devices are available but are often expensive (details are available from from the Alzheimer's Association).
For frequent wanderers
- Alert neighbours and shopkeepers and let them know you appreciate their help in keeping track of the person.
- If the person wanders and you have been unable to find them in the immediate vicinity, notify the police and give full details including height, build, colour of hair, whether they wear glasses, previous history of wandering, and the clothing they were wearing when they disappeared: a recent colour photograph will be very helpful.
- If the missing person returns home, notify the police immediately.
- It may not be wise to confront the person: instead, try accompanying them a little way, then diverting their attention and reassuring them about how good it is to be going home.
- Try accompanying the person on their walk: often a short walk can help relieve anxiety and this may help you both.
- Look at photographs together: this may be reassuring and help to ease anxiety.
Night wanderers
- Try to create a quiet and peaceful atmosphere which is conducive to sleep.
- Try to increase daytime activity to ensure drowsiness by bedtime.
- Consider going to bed later.
- Experiment with a glass of warm milk or soft music at bedtime.
- If the person wakes during the night, reassure them that they are safe and where they belong.
- Have familiar objects in the bedroom.
- Consider using a night light.
- A warm bath or shower may be helpful.
Last Reviewed: 09 March 2001
Sponsored links
