Wandering

Six in 10 people with dementia will wander. A person with Alzheimer’s may not remember his or her name or address, and can become disoriented, even in familiar places. Wandering among people with dementia is dangerous, but there are strategies and services to help prevent it.

Who is at risk of wandering?

Anyone who has memory problems and is able to walk is at risk for wandering. Even in the early stages of dementia, a person can become disoriented or confused for a period of time. It’s important to plan ahead for this type of situation. Be on the lookout for the following warning signs:

Wandering and getting lost is common among people with dementia and can happen during any stage of the disease.

• Returns from a regular walk or drive later than usual
• Forgets how to get to familiar places.
• Talks about fulfilling former obligations, such as going to work
• Tries or wants to “go home,” even when at home
• Is restless, paces or makes repetitive movements
• Has difficulty locating familiar places like the bathroom, bedroom or dining room
• Asks the whereabouts of past friends and family
• Acts as if doing a hobby or chore, but nothing gets done (e.g., moves around pots and dirt without actually planting anything)
• Acts nervous or anxious in crowded areas, such as shopping malls or restaurants.

Tips to prevent wandering

Wandering can happen, even if you are the most diligent of caregivers. Use the following strategies to help lower the chances:

• Carry out daily activities. Having a routine can provide structure. Learn about creating a daily plan.
• Identify the most likely times of day that wandering may occur. Plan activities at that time. Activities and exercise can reduce anxiety, agitation and restlessness.
• Reassure the person if he or she feels lost, abandoned or disoriented. If the person with dementia wants to leave to “go home” or “go to work,” use communication focused on exploration and validation. Refrain from correcting the person. For example, “We are staying here tonight. We are safe and I’ll be with you. We can go home in the morning after a good night’s rest.”
• Ensure all basic needs are met. Has the person gone to the bathroom? Is he or she thirsty or hungry?
• Avoid busy places that are confusing and can cause disorientation. This could be a shopping malls, grocery stores or other busy venues.
• Place locks out of the line of sight. Install either high or low on exterior doors, and consider placing slide bolts at the top or bottom.
• Use devices that signal when a door or window is opened. This can be as simple as a bell placed above a door or as sophisticated as an electronic home alarm.
• Provide supervision. Do not leave someone with dementia unsupervised in new or changed surroundings. Never lock a person in at home or leave him or her in a car alone.
• Keep car keys out of sight. If the person is no longer driving, remove access to car keys — a person with dementia may not just wander by foot. The person may forget that he or she can no longer drive. If the person is still able to drive, consider using a GPS device to help if they get lost.

Make a plan

When someone with dementia is missing …

Begin search-and-rescue efforts immediately. Ninety-four percent of people who wander are found within 1.5 miles of where they disappeared.

The stress experienced by families and caregivers when a person with dementia wanders and becomes lost is significant. Have a plan in place beforehand, so you know what to do in case of an emergency:

• Keep a list of people to call on for help. Have telephone numbers easily accessible.
• Ask neighbors, friends and family to call if they see the person alone.
• Keep a recent, close-up photo and updated medical information on hand to give to police.
• Know your neighborhood. Pinpoint dangerous areas near the home, such as bodies of water, open stairwells, dense foliage, tunnels, bus stops and roads with heavy traffic.
• Is the individual right or left-handed? Wandering generally follows the direction of the dominant hand.
• Keep a list of places where the person may wander. This could include past jobs, former homes, places of worship or a restaurant.
• Provide the person with ID jewelry. Enroll the person in MedicAlert^®+ Alzheimer’s Association Safe Return^®.
• If the person does wander, search the immediate area for no more than 15 minutes. Call “911” and report to the police that a person with Alzheimer’s disease — a “vulnerable adult” — is missing. A Missing Report should be filed and the police will begin to search for the individual. In addition, a report should be filed with MedicAlert® + Alzheimer’s Association Safe Return® at 800.625.3780. First responders are trained to check with MedicAlert+ Alzheimer’s Association Safe Return when they locate a missing person with dementia. You do not need to be enrolled in MedicAlert+ Alzheimer’s Association Safe Return in order to file a missing report.

David Wingate is an elder law attorney at the Elder Law Office of David Wingate, LLC. The elder law office services clients with powers of attorneys, living wills, Wills, Trusts, Medicaid and asset protection. The Elder Law office has locations in Frederick and Montgomery Counties, Maryland.