There are many reasons for and modes of wandering . . .
Wandering, when in the context of Alzheimer’s disease, is defined as getting lost and becoming disoriented. It is a common behavior in those with Alzheimer’s. In this article I will share some causes of wandering and preventive measures you can take as a caregiver. I also share my experiences with my mother’s wandering.
There is usually a trigger that causes wandering, such as confusion. Brain changes due to dementia may cause confusion and/or disorientation even when those with dementia are familiar with their surroundings. Their confusion/disorientation may trigger them to search for something or someone. One evening my mother was found by a neighbor wandering up and down the block where she lived. She was looking for me because I was living with her as her caregiver at the time. I had decided to attend a class that evening and had explained it to my mother verbally and also left her a note reminding her where I was going. Even with these precautions, she became confused as to where I was, which led to her wandering search.
Another possible cause for wandering might be that a person with dementia believes they need to escape from something. They can easily become over-stimulated, anxious, or stressed by something as simple as loud noise, or possibly too much conversation that they don’t understand. Sometimes wandering is brought about because an Alzheimer’s patient is reliving their past in some way, such as shopping in a particular location, or some other past routine. Dementia patients are often restless and can be motivated to stay in constant motion to soothe these feelings which can lead them to wander.
Caregivers need to be aware that anyone with dementia can be prone to wandering. They must remember that dementia causes confusion, which can lead to wandering. The urge or need to wander may make no logical sense to the caregiver. You most likely will get no warning that your person with dementia will wander until the first incident. Wandering leads to risk of injury and steps must be taken for prevention. Provide 24/7 supervision, even if you have to ask for help to cover your absence, should you need to leave for any reason. Install home safety devices such as window locks, night lights, and stair gates. These measures also help prevent falls. One safety measure that is on the top of this list is a door alarm. These warn the caregiver that an exit door has been opened.
In the board and care home where my mother lived, they had a door alarm, which was required by law for state-licensed board and care homes. Every time I’d visit and the front door was opened to admit me, that alarm emitted a loud squawk. Errors can occur even when such failsafe devices are employed. One night at the board and care, they forgot to turn on the door alarm after it had been disabled. Wouldn’t you know it, that was the time Mom chose to wander.
Early the next morning she left her room carrying only a blanket. The caregivers had pushed a small couch to block the end of the hall to her room. Mom was able to push it aside to reach and exit the front door. Everyone else in the house was still sleeping so no one heard her leave. Later a caregiver, Mary, awoke and went down the hall to check on the residents and found that Mom had disappeared. Mary ran down the hall in a panic and called Safe Return to report that Mom had gone missing.
Caregivers of people with dementia are wise to register them with the Safe Return program. This program is run by the Alzheimer’s Association® and is a 24-hour nationwide emergency response service for individuals who have Alzheimer's or other dementias and wander or get lost. You can read all about Safe Return at: https://www.alz.org/help-support/caregiving/safety/medicalert-safe-return. Once the dementia patient is reported missing, a community support network is activated which includes local Alzheimer's Association® chapters and law enforcement agencies. They help reunite the person who wandered with caregivers or family members. The patient simply wears a piece of jewelry purchased and ordered through Safe Return; a necklace or bracelet, with an emergency phone number. There is an annual fee for this service.
Mary dashed outside to search for Mom and ran right past her, but abruptly stopped and turned back as soon as she realized what she’d done. There was Mom, sitting on the next door neighbor’s front lawn in her pajamas and a sweater with the blanket. This is a very happy ending as many wanderers get farther afield and get lost, and others wind up very far away and are found several days later either in bad physical condition or possibly dead from exposure or an accident. Mary and Mom were lucky. Mom only needed to be returned to her room and warmed up a bit and she was fine. Safe Return had called me to let me know that Mom had wandered away from the residential board and care home, so I knew to call there and later visit to make sure Mom was OK. The door alarm was activated at the home assiduously from then on.
Another way to help prevent wandering is to make sure there are visual cues in the dementia patient’s room so they recognize where they are if they forget or become confused. Also insure that items they’d normally use to leave the house such as keys or a purse are out of sight so they aren’t encouraged by such cues to wander away. If the person is away from home, be aware that busy, loud environments can lead to added confusion and may cause the urge to wander.
I invite all interested readers to visit my website for the book I wrote about my experiences as my mother’s caregiver, which includes dealing with doctors, hospitals, finances and financial institutions, to name a few. My book is The Gift I Found in Alzheimer’s: My Growth and Transformation as Mom’s Caregiver. Learn more at www.averytstone.com .
I want to give due credit to The Alzheimer’s Association of Orange County for information about wandering.
I cared for Mom for seven years and learned so much from my experiences with her and Alzheimer's.