Understanding and Preventing Wandering Behavior with Alzheimer’s

According to the Alzheimer’s Association, up to 60% of people with dementia will wander and get lost.

So, what does this mean?

In the year 2016, an older woman who lived in California wandered off while picking avocados in her family’s orchard. Due to her mental condition, Alzheimer’s – which causes disorientation and confusion, the woman was not able to make her way back home. 3 long days later, rescuers finally found her asleep under an avocado tree with nothing but some brush covering her cold body. She was tired and very dehydrated, but luckily she was found alive. 

According to the Alzheimer’s Association, up to 60% of people with dementia will wander and get lost.

So, what does this mean?

In the year 2016, an older person who lived in California wandered off while picking avocados in her family’s orchard. Despite the familiar surroundings, her mental condition and memory impairment prevented her from making her way back home. Three long days later, rescuers finally found her asleep under an avocado tree with nothing but some brush covering her cold body. She was tired and very dehydrated, but luckily she was found alive. This woman had Alzheimer’s disease, which can cause changes in behavior, such as disorientation and confusion.

In this article, we will help you better understand the symptoms of Alzheimer’s disease and the potential for wandering behavior, as well as how to support your senior loved one who struggles from this memory condition.

Who Is At Risk for Wandering Behavior?

The truth is, anyone who has memory problems and can walk is at risk for wandering and may need memory care assistance. 

Individuals with Alzheimer’s disease fall under the same memory “umbrella” as any other cognitive impairment. Dementia is a broad medical category used to describe people with a deteriorating memory or a decline in other language or cognitive abilities. It is more than just short-term memory loss that comes with the normal aging process. There are over 100 forms of dementia, with Alzheimer’s disease accounting for 60% to 80% of all cases. Alzheimer’s and dementia have also been linked to complex changes and cognitive decline of the brain. One of the changes is the reduced loss of connections between the nerve cells, brain cells, brain tissue, and the lack of blood flow. Other common types of dementia or memory-related disease include progressive dementia, Parkinson’s disease, vascular dementia, Huntington’s disease, frontotemporal dementia, Creutzfeldt-Jakob disease, multi-infarct dementia, Pick’s disease, and Lewy body dementia among others.

Here are some warning signs and symptoms you should look out for if you’re concerned a loved one may be at risk of wandering:  

• Shows forgetfulness in how to get to a familiar place
• Talks about how they need to “go to work,” or some other former obligation of theirs
• Attempts or says they want to go home, even if they are at home
• Comes home from a regular drive or walk later than they usually do
• Performs repetitive behavior, exhibits restlessness or paces a lot
• Problems with finding the bathroom, bedroom or dining room in familiar living spaces
• Asks where a friend or family member is, even after they’ve passed away
• Difficulty with daily hygiene, bathing, cleaning, making meals, or performing daily activities
• A decline in the cognitive function of problem-solving skills, or the ability to do simple math or recite things from memory
• Memory loss and forgetfulness in old family stories
• Acts anxious or confused in public places, like the mall or grocery store
• Struggles with any sort of social interaction

Why do People Wander?

There are many reasons why someone with stages of memory loss or dementia and Alzheimer’s disease may wander. To help you better understand what might trigger this event and increase the risk of wandering in those with dementia symptoms, we’ve listed some common causes below:

• They’re experiencing a lot of stress or fear – If the environment is overstimulating or they’re in unfamiliar surroundings, your senior loved one may resort to walking around aimlessly as their health and well-being decline. The same goes for situations they don’t understand or a loud noise that startles them.
• In search – If your loved one is searching for something or someone, they may begin to wander and get lost in the process.
• They are bored – If they have nothing to do and are experiencing boredom, the chances of wandering around the community may increase. 
• Needs aren’t met – Looking for toilet paper, food, or some other basic need can result in wandering about in search of it, as their alertness to the world around them is not as sharp as before.
• Past routines – An episode of wandering can be triggered by previous routines, such as going to work, doing chores, or grocery shopping.

People with a diagnosis of Alzheimer’s disease often feel restless, a symptom that increases their desire to go out and participate in some meaningful activity from daily living. They may feel the need to go to work, pick their kids up from school, or go to the shopping mall. Often, the time of day does not matter; if they can get out of the house, they will. From there, the wandering happens – all due to their itching desire to move. There may be risk factors relating to wandering somewhere unsafe or hurting themselves with dangerous objects because they are not aware of the world around them.

Dementia residents who wander are usually overcome with the desire to go back to their childhood home, where they felt safe with their mom, dad, siblings, and dog. It is an environment that no longer exists, but due to their age-related memory loss, they don’t realize it. At this time, they may benefit from living in memory care facilities, senior living communities, hospice care, or Alzheimer’s care facilities, where they can be supervised and receive a specialized continuum of care from professional staff, caregivers, or licensed nurses 24/7.

Coping Strategies for Wanderers with Alzheimer’s Disease

First and foremost, you should try and determine the reason, or emotion, being expressed by the wanderer with mild cognitive impairment. It could be feelings of anxiety, depression, fear, or insecurity, among others. If the individual is expressing a strong need to “go home,” try and figure out why. What connects them to their childhood home? Are there ways to make their home or memory care residence more inviting? Do they have unresolved issues that need to be worked out through counseling?

It’s best if the resident with dementia is in a senior living environment that is warm and welcoming but does not remind them of their childhood home. To help prevent memory loss, remove any objects, furniture, or other reminders of their youth and growing up. 

If you’re with the dementia patient when they are trying to wander off, try to distract them by participating in different social activities they enjoy. You could also engage in some physical activity and go for a walk together to get fresh air and stretch out your legs. Help them to relax and lower their high blood pressure. Another good idea is to make the patient with memory loss and dementia their favorite treat or dessert and enjoy it together with a cup of soothing tea.

In regards to a person with mild or severe dementia wanting to go back to their childhood home – you should never argue or contradict their desire for home. Instead, as a caregiver, do your best to reassure the individual of your love for them, and that they are safe with you as you will always take individualized care of them.

How to Reduce the Risk of Wandering

No one is going to be able to fully and completely prevent wandering in a person living with dementia. It just isn’t possible; even if you or another caregiver could spend every waking moment with the person suffering from cognitive functioning problems, they could still find a time to sneak past you and leave. Always do your best to help, but remember that you cannot control their every behavior when they are suffering from memory lapses and cognitive problems. You may want to consider Alzheimer’s care or treatment options for those at risk of dementia or memory loss to help their quality of life.

Now, let’s talk about how you can reduce the risk of wandering when providing long-term care and dementia treatment. It’s essential to try all you can to ensure that the solutions enforced honor the person’s independence and freedom. Of course, the approach you go with will vary from person to person and situation to situation. What’s appropriate and sufficient for the symptoms and common behavior of one person, may not work for another. The physical environment in which the residents with dementia live will also factor into how you deal with the situation. 

Here are some ways to help reduce wandering with Alzheimer’s disease and dementia-like symptoms:

• If the person has wandered before or shown signs of mild cognitive decline, make sure to keep a record of where the person with a diagnosis of dementia wanders off to. Look for a pattern as this can give you a good idea of what is triggering their behavior and where to find them if they try and do it again.
• It’s a good idea to keep items such as keys, jackets, and shoes out of plain sight when you are providing in-home care for older adults living with dementia.
• You could consider having alarms installed to warn you when your loved one opens a door or window with stages of Alzheimer’s disease.
• Often, people with signs of dementia will wander at night – this is known as “sundowning.” 
• Make an appointment with the person’s doctor to review the medications or over the counter drugs they are taking. Sometimes a particular medication can increase the risk of delusions and confusion – which causes wandering in the first place. As a last resort, you can ask their doctor about medication options made to help prevent wandering in dementia and Alzheimer’s patients.
• Since agitation is one of the leading causes of wandering in those with early stages or later stages of memory loss, encourage the person with dementia to regularly participate in some form of physical activity to improve their health. This can help reduce the antsy feelings they’re experiencing.
• If it becomes a significant issue, consider informing the neighbors, police, and local stores about the wandering problem at hand. If they see the person wandering and recognize him or her, they may be able to help the person with Alzheimer’s symptoms.

Make a Plan

When those with dementia wander and become lost, both the family and Alzheimer’s caregiver suffer from significant stress and worry. Gather everyone together to create a plan before this happens, so you’re prepared in case of an emergency.

Here are some points to discuss when making an emergency plan for a loved one with dementia, who’s at risk for wandering:

• Reach out to neighbors, family, and friends with the request to have them call you if they see the person wandering or outside alone. Additionally, ask them to reach out if the person appears to be confused. That way, you can have some support in their Alzheimer’s and dementia care.
• Compile a list of contacts with names and numbers to call in case of an emergency. This list should be easily accessible to all carers of the Alzheimer’s patient and those in contact with them.
• Always have a recent, up-close photo of the person with their medical information on hand if you need to give it to the police for reference.
• Get to know the neighborhood where your loved one with the potential to wander lives. It’s a good idea to point out areas of danger, such as open stairwells, dense foliage or forest-like areas, public bodies of water, tunnels, bus stops, and roads with heavy traffic.
• If they have wandered before, keep a list of where they tend to wander off to. Keep a list of areas or places they may end up walking to. This can include previous places of employment, places of worship, their favorite restaurant, or locations that they may have visited frequently in past years.
• Ask yourself: Is this person left or right-handed? Believe it or not, studies have shown that dementia patients tend to wander in the general direction of their dominant hand. Keep that in mind if they’ve wandered, as you are searching for them.
• Have you ever heard of a wandering response team? Consider educating yourself on this service and enroll the individual with memory issues in it for extra help.
• If the person does end up wandering, call 911. They will file a missing person’s report and inform authorities that the person has dementia and will need help when found.

If an Episode of Wandering Occurs

When a person living with mid-stage dementia or late-stage dementia is lost, it can be nearly impossible to remain calm, and your blood pressure will rise. In a state like this, it also becomes increasingly difficult to think clearly. Just remember, you’re not alone in this. Many people are going through the same struggle and worry as you are. 

When a person with a stage of dementia or Alzheimer’s goes missing, it is a dire emergency. A quick response to this occurrence is the best and most helpful reaction you can offer. As previously mentioned, the minute you realize the person is missing, contact the police and notify neighbors and local stores/restaurants. Look at credit and debit card transaction histories if you’re coming up empty-handed. 

Conclusion

Most wandering stories have a good ending. You can be a good Samaritan by reporting a missing person if you happen to come across an older adult wandering around. There is no need to be hesitant when it comes to approaching a senior who appears to be confused; they very well may have mild dementia or early-onset Alzheimer’s disease. Always approach the topic gently, but do your best to plan in case of a wandering emergency. There is no cure for Alzheimer’s disease, but we can do all we can to help the person with an Alzheimer’s diagnosis.