Dementia Wandering: How to Prevent It — and What to Do When It Happens

Wandering is one of the most stressful and frightening dementia behaviors families face.
Whether you're scared your parent may slip out the back door at night, get lost on a daily walk, or not recognize how to get home from an appointment, the risks are real — but so are the ways to reduce them.

This article covers:

• How to lower wandering risk

• Real world home safety steps

• How to prepare before wandering happens

• What to do immediately when a loved one is missing

WHO'S AT RISK OF WANDERING

Anyone with dementia or Alzheimer's is at risk of wandering. The Alzheimer’s Association estimates that 60% of those suffering with dementia will wander at least once "with many doing so repeatedly".

WHY PEOPLE WITH DEMENTIA WANDER

• Searching for someone (spouse, parents, children)

• Trying to fulfill an old routine (work, school, chores)

• Stress, anxiety, or overstimulation

• Disorientation with time or place

• Physical needs (bathroom, thirst, restlessness)

• Boredom or lack of stimulation

HOW TO REDUCE WANDERING IN THE FIRST PLACE

Although anyone with dementia is at risk of wandering, there are some things family members can do to reduce the likelihood of their loved from wandering in the first place. That said, nothing can eliminate the risk entirely.

Maintain routine and structure: New activities or break of routine often cause anxiousness, which can trigger wandering. Stick to regular dressing, meal, bathing and recreational activity times.

Provide stimulation: It's essential to keep your loved one stimulated, or they'll seek it out themselves! Think crafts, games, TV shows, cooking, folding laundry, daily exercise or an adult day program to help fill in the gaps.

Avoid large busy malls: Busy shopping centres can cause confusion and disorientation. If you want to bring your loved one shopping, try single store fronts, strip malls or smaller malls during quiet periods, like on a Monday at 10 am.

Practice redirection: If your loved puts on her coat and says she's "going to school", don't correct her. Instead redirect her attention with words like "the school bus comes in 45 minutes, why don't we eat breakfast in the meantime."

Don't leave your loved one unattended in public: Never ask your loved to wait for you in the food court in the mall or leave them in the car alone while you run an errand.

Avoid late night liquids and caffeine: Avoid any stimulants that can either make it harder to fall asleep or can cause us to wake up at night like caffeine, alcohol or drinking water close to bed time.

Remove wandering cues: Remove keys, purses, shoes, jackets and other reminders of "departure" from view.

*Please understand that at some point, your loved one may need additional supervision as the disease progresses, which you can discuss with a dementia specialist.

WANDERING PREVENTION TIPS

Some times we just can't get the wandering bug out of our loved ones. Here are a few things we can do to limit how far off the reservation they can go.

Some strategies are appropriate only if they live with someone else, who can help them in the event of a fire.

Redirection: Place "Stop", "No Exit", "Do Not Enter" or "Closed" signs on exit doors.

Concealment: Hide exit doors with a sliding curtain or paint the door the same color as the adjoining wall.

False floor barrier: Place a dark mat or black tape (2 X 2) in front of your door, that can act as a visual barrier

Extra door locks: Place deadbolt locks, high or low, so they are less visible on exit doors. (Never lock anyone in if they are unattended).

Childproof locks: Place childproof locks on exit doors.

Door chimes: Place a door chime or bells on exit doors to alert you when the door is opened.

Door Alarms: Place door alarm sensors on all exits, that notify caregivers when they are opened (either by phone or loud speaker)

Motion sensor alarms: Activate indoor motion sensor alarms at night, and receive notifications when they engage.

Motion sensor cameras: Activate motion censored cameras by exit doors, so you can be alerted on your phone if there is movement by the exit points. Cameras help you tell the difference between delivery, visitors and wandering.

Floor mat monitor: Place a bedside floor mat alarm that notifies caregivers when it's stepped on.

Back yard fencing: Place a fence in the back yard and make sure to keep the gate locked.

Keep garage opener and car keys hidden: Place both items out of view and reach.

Safety gates: Place easily seen safety gates or netting in front of stairs (this can also prevent night time falls down the stairs).

Supervision: There may be a point where a loved one can no longer be left unattended, without serious risk. Consult with a geriatrician, social worker or eldercare expert for advice.

TIPS TO GET FOUND

Now that we know how you can reduce the likelihood of wandering and how to prevent if from getting out of hand, let's take a look at some of the things you can do to make it safer when wandering does occur, both in and outside the home.

ID Bracelet: You can get a simple engraved ID bracelet that has name, condition (dementia), address and a list of up to three contacts.

Electronic ID Bracelet: You can also get new electronic ID bracelets with NFC and QR codes that contain an almost unlimited amount of information and instructions.

Wearable GPS tracker: Have your loved one wear a GPS tracker they won't take off or that has too many additional functions that cause confusion. Multiple Apple tags can work well and they can be placed on wrist bands, in purses, jackets and shoes!

Phone GPS: Enable GPS tracking or Find Me feature on their smart phone. Also tape their name, address and your contact info on their phone (especially important if their battery dies).

Alternative ID: Make sure they leave home with ID (wallet) or sew their name, address and contact info as labels in their jackets, sweaters and clothing.

Inform neighbours: Let your neighbours know that if they see your loved one wandering, dressed inappropriately or unattended to give you a call. Provide them with your loved one's picture and contact information.

Print a picture in advance: Keep several copies of your loved one's picture, name and contact info so that in the event they do wander and get lost, you can provide police, security, neighbours or local media with a copy.

Call the Police: If you can't find your loved one within 15 minutes of looking call the police. Be prepared to provide them with a description of your loved one, medical conditions and habits. The Herbert Protocol is a great guide to help you and emergency responders.

TIPS TO AVOID ACCIDENTS WHILE WANDERING

All the alerts, locked doors and tracking in the world won't necessarily prevent your loved one from wandering in the middle of the night to the kitchen, bathroom or den. If that's the case, it's best to make the environment as safe as possible to avoid trips, falls, bumps and bruises.

Motion sensored nightlights: Get motion censored nightlights that go on automatically when they detect movement. Place them in known routes.

Remove tripping hazards: Get rid of wires, area rugs, shoes or other obstructions that might not be easily seen, especially at night.

Stair gates: Place highly visible gates in front of stairs, especially at night, to redirect your loved one away from the stairs and a potential night time fall.

Caring for someone with dementia can be exhausting and overwhelming — and wandering is one of the most stressful challenges and worries. But with preparation, the right tools, and a clear safety plan, you can dramatically lower the risks.

Above all, remember this: wandering isn’t your loved one’s fault — and you’re not alone.