If someone with Alzheimer's wanders, first consider the causes
"Wandering," which includes pacing restlessly in a room, meandering aimlessly through the house, or wandering away from home or from companions in a public place, is no small hazard: People with Alzheimer's have been known to wander away from homes or nursing facilities and been found very ill or even dead from stress, lack of proper medication, or exposure to the elements.
The first step to ensuring a patient's safety is to think about what might prompt the wandering.
Look for the trigger
- If the behavior is new, determine if there have been any big changes in her life. A recent move or change of caregiver can be stressful, for example, and frustration and anxiety can cause wandering. Take extra measures to calm her in stressful times, such as going on fewer outings and following a steady routine. A new medication could be causing agitation as a side effect; mention the wandering to the prescribing doctor.
- Look for a pattern in wandering episodes. If it always happens at night, for example, it could indicate fear or loneliness and she may need extra support after dark. If it's at mealtimes, she may be hungry or thirsty and unable to follow through on these desires. Some people wander at specific times linked to activities from their previous work life or other former routines.
- Assess whether your friend or relative is busy enough. Sheer boredom is a common cause of wandering. She should ideally have access to a variety of activities (sorting laundry or blocks, making art or crafts, watching calm nature-type videos, and talking). It's also good to provide some time out of doors with a companion and some interaction with other people.
Reduce temptations and stressors
- Keep keys out of sight. A friend or relative who has Alzheimer's that's severe enough to include wandering shouldn't be driving. But she may still recognize keys left hanging in a familiar place and drive off -- even if you don't think she has memories of driving or still knows how.
- Avoid crowds. Crowded situations can produce stress that leads to wandering once she's back at home. And from a practical standpoint, it's hard to keep track of someone who wanders when you're in a shopping mall, fair, or other large public gathering.
Take Basic Safety Precautions to Protect an Alzheimer's Patient Who Wanders
- Don't let a wanderer go out alone. Even if the person you're caring for is a longtime walker, she shouldn't venture out on her own. She could become confused and lose her way home or meander away from her usual turf.
- Don't leave her in the car. If you leave someone prone to wandering alone in the car while you're running a quick errand in the bank or drugstore, she's liable to become frightened or worried and slip out of the vehicle.
- Make the house safer for walking. If you haven't done so already, remove throw rugs, arrange furniture so the person has clear pathways to move through, and eliminate clutter and low-to-the-ground hazards such as magazine racks or plants.
- Install nightlights. Illuminate preferred safe paths, especially in hallways and rooms that are used most.
- Consider childproof locks for dangerous doors. Doors leading to stairways or the outdoors are the most problematic. Try plastic pinch-grip style doorknob covers, which can be hard for an older person to open. Block sliding glass doors.
- Try new locks. Any kind of door lock that's different from what the person always used, especially if it's a bit challenging, such as a high chain lock or a key lock for a door that once had a button lock, might work because it's difficult for her to learn new things.
- Try a "Do Not Enter" sign on an exit door. Some people are deterred by this simple measure.
Try safety tools
- Look into alarms that signal movement. Bed pads or chair pads with wireless remote alarms aren't inexpensive, but they offer an immediate alert that a wanderer is getting up. Other devices include floor mats with remote alarms, motion detectors that go off only on a portable receiver the caregiver can carry around, and conventional door chimes that sound when a door is opened and are installed by an electrician.
- Disguise dangerous doorways. A gentler alternative to door locks is to lead the person away from certain doors with visual cues that convey that the door is something else. Camouflage possibilities include painting the door to match a surrounding wall or hanging posters, mirrors, or murals on the door that are especially designed to make it look like a bookshelf or pantry shelf.
Enlist the help of others
- Tell immediate neighbors about the person's Alzheimer's. Ask them to call you if, say, she uncharacteristically comes over to visit or is seen walking alone.
- Use daycare and professional help. If someone with Alzheimer's begins leaving home when she wanders, she should no longer be left alone even for short periods. Take advantage of adult daycare programs or a relief caregiver when you must go out, if you're the primary caregiver.
- Enroll her in the Safe Return program. This Alzheimer's Association-sponsored program is designed to provide help if a person with dementia wanders away. An enrolled person's identification information is immediately given to local law enforcement. The enrollee also receives an identification bracelet and clothing labels, which bear the 800 number of the program's help line. Anyone who finds the person wandering can call the number.
- Consider identification. Even if you don't register in a Safe Return program, having identification on the person that gives her name, disease, and a contact number is useful. Many options resemble regular jewelry.
- Keep track of clothes. If your friend or relative is a chronic wanderer, some caregivers recommend making sure she's always dressed in bright colors. That way, if she does slip away she can be more easily identified and found. The caregiver should keep track of what she's wearing each day.
- Keep a recent photo handy. It's common to avoid photographing an older person who appears greatly changed because of the disease. But an up-to-date shot will help searchers identify her if she's ever lost.