How to Prevent Patient Wandering: A Guide for Caregivers Wandering is a common behavior in patients with dementia. Six in 10 people with dementia will wander, according to the Alzheimer’s Association.1 The reasons for wandering vary from person to person, but disorientation and anxiety are common reasons. Whether you’re a professional caregiver or a family member or spouse caring for a loved one with dementia, we’ll highlight the reasons patients wander and steps you can take to prevent wandering. Dementia vs. Alzheimer’s: What’s the Difference? Before we cover why patients wander, let’s define dementia and Alzheimer’s, terms that are often confused and sometimes used interchangeably. Dementia isn’t a disease—rather, it’s a group of symptoms that affect a person’s ability to reason and perform mental tasks. There are several forms of non-Alzheimer’s dementia. They include (but are not limited to): Vascular dementia: This type accounts for around 10 percent of all dementia cases and occurs from a brain injury such as blood vessel blockage. It was formerly referred to as post-stroke dementia. This form of dementia impairs a person’s judgment, ability to make decisions, and ability to plan and organize. Dementia with Lewy bodies: Lewy bodies are clumps of a type of protein that can cause dementia when they form in the brain’s cortex. People with Lewy bodies may have sleep disturbances, visual hallucinations, muscle rigidity, as well as memory loss and thinking problems. Alzheimer’s disease is a form of dementia—the most common form, in fact, accounting for 6080 percent of cases, according to the Alzheimer’s Association.2 Alzheimer’s is a progressive disease that impairs cognitive function and memory over time, sometimes many years. Alzheimer’s most often occurs in people age 60 and older; however, it can and does occur in younger individuals.
Why Patients Wander
Confusion, disorientation, anxiety, and restlessness are common reasons patients with dementia wander. A person may become disoriented in their surroundings and wander out of confusion, while another person may wander looking for “home”—they could be referring to their childhood home or the home where they raised their children. Some patients are doggedly determined to “go home,” wherever that may be in their mind, and may require additional monitoring. Who Is at Risk of Wandering? Anyone with memory or cognitive problems who is able to walk is at risk of wandering. Look for the following warning signs: Trying to fulfill former obligations, such as going to work or grocery shopping Returning from a walk later than expected—which could indicate that the person became lost or confused along the way Wants to “go home,” even when at home Has difficulty navigating familiar environments Becomes lost in new or changed environment Paces or is otherwise restless or agitated The Dangers of Wandering It goes without saying that a person with dementia who wanders is at increased risk of harm. If they get behind the wheel of a car, they may become confused and get lost or forget where they were going. They may find themselves lost on a walk and panic, or end up on a busy street with heavy traffic and dangerous intersections. This is why it’s so critical to keep patients safe in their environment. Tips to Prevent Wandering Create structure: Routine can help prevent the confusion, restlessness, and disorientation that can lead to wandering. Creating a daily plan can help provide structure. Ensure needs are met: A person with dementia will often wander to get their immediate needs met—they may need a glass of water or to use the bathroom. Ensuring the person has everything they need for comfort will help prevent wandering, especially at night. Make sure person carries ID at all times: The can be achieved in several ways, including having the person wear an identification bracelet, or by sewing tags into the person’s clothes. Identify the time of day/night the person is most likely to wander: Sundowner syndrome is common in patients with dementia. Identifying specific times of day when the patient becomes restless, anxious, or fearful, and planning activities during those times can help mitigate wandering. Utilize technology: GPS tracking devices can be useful in preventing wandering. Bracelets and tennis shoes with embedded GPS chips are effective at identifying patients who are wandering, as long as these devices are carefully tracked and monitored. In
nursing homes, hospitals, and assisted living facilities, a wireless nurse call system with a wandering patient notification feature is an effective tool for wandering prevention. Put up signs: Sometimes signs placed on doors inside a home or facility that read, “Do Not Enter” is enough to discourage a person from wandering. Be reassuring: If a person becomes disoriented or feels lost or abandoned, reassure them that they are safe and secure. If they insist they want to “go home” or “go to work,” refrain from correcting them. It may be necessary to say something like “You don’t work today, it’s Saturday,” or “We can go home tomorrow after you get a good night’s sleep”—whatever it takes to reassure the person and distract them from their urge to wander. Keep car keys out of sight and reach: A person with dementia or Alzheimer’s is at greater risk of an accident; they may forget where they were going and become confused, and their reflexes are not as sharp. Secure the perimeter of the building: Make sure exit doors, gates, and fences are locked and secured.
Make a Plan Should Wandering Occur Making a plan is especially important for home caregivers, who often have fewer resources at their disposal. If a patient or loved one with dementia does wander, search the immediate area for no more than 15 minutes before calling 911 to report that a person with dementia (considered a “vulnerable adult”) is missing. Ask neighbors to call you if they see the person out alone. Keep a recent photo of the person to show people and police. Know the places a person may wander to find, which could include their former home, the homes of family members, former places of employment, a favorite coffee shop, etc. It’s impossible to have a set of eyes on a person every moment of every day. This is where technology can be tremendously helpful. The nurse call systems offered by Systems Technologies can help caregivers at assisted living and long-term care facilities, hospitals, and clinics better monitor patients and ensure their safety.