Controlling Unsafe Wandering Behaviors in Alzheimer's Patients

Alzheimer’s disease is the most common cause of dementia among seniors 65 and older. According to the Alzheimer's Association, researchers estimate that approximately 5 million Americans have Alzheimer's disease, and project that the number may reach up to 16 million by 2050 if current populations continue and no preventative treatment is found.

Alzheimer’s prompts many behavioral changes, but perhaps one of the most dangerous behaviors is wandering. People with Alzheimer’s are more likely to wander than those with vascular or any other type of dementia. It is estimated that more than 60% of people with Alzheimer’s will wander at some point during the course of the disease. Wandering can be dangerous, and even deadly, to a person with Alzheimer’s disease, especially in areas with unsafe conditions such as heavy traffic, crime, and extreme climates. Why does dementia-related wandering occur, and how can it be managed?

What is Dementia-Related Wandering?

There is no standardized classification system to identify the different categories of wandering, but it generally falls into two categories: goal-directed and non-goal-directed wandering, which is also known as random wandering. In goal-directed wandering, the patient may be searching for something familiar, such as an object or place. Random wandering is simply wandering aimlessly.

No matter what type of wandering behavior the patient exhibits, without monitoring, it causes potential for harm. This may include getting lost, leaving a safe environment or putting oneself in a dangerous situation. The medical community sometimes uses the term critical wandering. Both wandering and critical wandering mean the same thing, referring to any person with dementia who wanders away from their caregiver or controlled environment such as a facility or home. Wandering may occur by walking, driving or other means, and it can also happen within a controlled environment. For example, a person with Alzheimer’s who is prone to wandering may put water on for tea, become distracted or confused, and leave the kitchen without turning off the stove. This, too, is considered wandering, and the dangerous situation it creates emphasizes the need for monitoring unsafe wandering behaviors.

Critical wandering that involves the senior leaving the home or facility where he or she lives is sometimes called elopement. Often occurring in conjunction with sundowning, elopement typically involves the person wandering outside the home or facility at night. This may involve the person being dressed inappropriately, either for the weather of the environment (e.g., wearing pajamas outside at night).