Wandering

It’s a common scenario: Mom has been diagnosed with brain change, but she’s still managing surprisingly well at home. She gets dressed each morning, fixes herself breakfast and enjoys her favorite television programs. With a little help from family, she seems perfectly capable of continuing to live independently.

Then one day, Mom walks out the front door and can’t find her way home.

For families, an incident of wandering can be terrifying. And it’s often the event that changes everything.

“We often hear from families for the first time after something frightening has happened,” said Shelley Kutina, Community Liaison – Houston. “Mom was fine, but then one day the neighbors called because they’d spotted her several blocks away from home. That’s when the family realizes she can’t be left alone anymore.”

Wandering is common among people living with Alzheimer’s and other forms of dementia. According to the Alzheimer’s Association, six in 10 people living with dementia will wander at least once, and many who wander do so repeatedly.

Why wandering happens

Wandering doesn’t necessarily mean walking aimlessly. Usually, the person believes there is a reason to go somewhere.

A mother may be convinced it’s time to pick up her kids from school, even though her children are now in their 60s. A retired professional may think he needs to get to work. Another may be looking for a spouse, parent or friend from years ago.

Other triggers can include boredom, restlessness, anxiety, confusion or an unmet need such as hunger or needing to use the bathroom. Some people become more restless later in the day, particularly if they experience sundowning.

Brain change can also affect a person’s ability to recognize familiar surroundings and navigate from one place to another. A person may set out on a familiar walk or errand and suddenly become confused about where she is or how to get home.

That unpredictability is what makes wandering particularly challenging.

“A person can be very capable in many ways and still be at risk of wandering or getting lost,” said Shelly Schultz, Community Liaison – Houston. “That can be difficult for families because they want to respect their loved one’s independence. They don’t necessarily see a need for someone to be there all the time — until something happens.”

Prevention starts with attentive care

For a person at risk of wandering, supervision can make the difference between a restless moment and an emergency.

The team at Cambridge Caregivers is trained to keep a close eye on clients with brain change and to watch for signs that they may be preparing to leave. That might include pacing, repeatedly checking a door, putting on a coat, gathering a purse or keys, or saying, “I need to go home.”

Caregivers also learn techniques for redirection.

Instead of arguing — “You can’t go to work; you retired 20 years ago” — a caregiver might acknowledge the person’s concern and gently redirect their attention: “We have a little time before you need to leave. Let’s have some coffee first.”

A snack, a favorite television program or a supervised walk may shift the person’s focus. Redirection respects the emotion behind the behavior rather than trying to convince someone with brain change that her perception is wrong. 

Making home safer

Families can also take practical steps to reduce wandering risk:

• Watch for patterns. Does your loved one become restless at a particular time of day? Identifying patterns can help you plan activities or additional supervision during higher-risk periods.
• Add door alerts. Bells, alarms or monitoring devices can alert a caregiver or family member when an exterior door opens.
• Keep departure cues out of sight. Car keys, coats, hats and purses can sometimes prompt someone to leave.
• Provide meaningful activity. Exercise, household tasks, music and familiar hobbies can reduce boredom and restlessness.
• Consider identification and location technology. An ID bracelet or appropriate GPS/location-sharing device can be invaluable if someone does become lost.
• Prepare for an emergency. Keep a recent photo available and make sure neighbors or others nearby know whom to contact if they see your loved one outside alone. If your loved one goes missing, contact law enforcement immediately. In Texas, law enforcement may activate a Silver Alert when a missing older adult with a qualifying cognitive impairment meets certain criteria. The statewide notification system helps enlist the public in locating missing individuals.

No single strategy can eliminate the possibility of wandering. But attentive supervision, a safer environment and an understanding of what prompts the behavior can help reduce the risk.

Most importantly, families don’t have to wait for a frightening incident to seek help.

“If you’re starting to worry about whether Mom or Dad might walk out the door, pay attention to that concern,” Shelley Kutina said. “Having someone there can help your loved one stay safe while continuing to enjoy the comfort and familiarity of home.”