Some people with dementia may wander away from their homes or caregivers if they experience confusion about where they are.
Dementia refers to symptoms affecting memory, communication, and cognition that result from underlying conditions and brain disorders, such as Alzheimer’s disease.
This article explores who is at risk of wandering with dementia, the stage at which this behavior may occur, and the causes of wandering. It also looks at ways to reduce the risk of wandering and steps to take when wandering occurs.
Information for caregivers
As a person’s condition progresses, they may need help reading or understanding information regarding their circumstances. This article contains details that may help caregivers identify and monitor symptom progression, side effects of drugs, or other factors relating to the person’s condition.
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According to the Alzheimer’s Association, all people living with Alzheimer’s disease or other forms of dementia are at risk of wandering. This is because Alzheimer’s disease causes people to lose the ability to recognize familiar settings and people.
Wandering can be dangerous, and the risks it poses can prove stressful for caregivers and loved ones.
Signs of increased risk
A person may be at risk of wandering if they begin:
- returning later than usual from a regular walk or drive
- forgetting directions to familiar places inside and outside the house
- talking about fulfilling former obligations, such as going to work after retiring
- trying to go home even when at home
- becoming restless and pacing
- making repetitive movements
- asking the whereabouts of deceased friends and family
- appearing lost in new environments
- becoming nervous in busy places
Read more about other behavioral changes associated with dementia.
The Alzheimer’s Association suggests 60% of people with dementia will experience wandering at least once. Some may do it repeatedly.
It notes that wandering can occur at any stage of dementia, but the risk may increase as symptoms progress.
It may be best for family or caregivers to speak with a doctor if they notice signs that a person may be at risk of wandering or if the behavior occurs.
People can seek support from organizations such as the Alzheimer’s Association. It organizes support groups that offer a safe place for caregivers and loved ones of people with dementia to meet and share their experiences.
Find out more about the stages of dementia.
Researchers still
- recent and remote memory
- time and place orientation
- the ability to react appropriately to a given conversation subject
They note that people with Lewy body dementia are more likely than those with vascular dementia to wander.
People with dementia who are receiving antipsychotic treatment, have comorbid conditions, or display behaviors such as arguing and threatening may also be more likely to wander. These conditions include depression and psychosis.
Potential causes
According to researchers, wandering behavior
- visuospatial dysfunction, which affects a person’s spatial awareness or ability to judge distances
- visuoconstructional impairment, which reduces the ability to accurately copy or draw objects, recognize shapes and patterns, and complete visual puzzles
- reduced
topographical memory , which affects a person’s ability to locate where they are
They suggest it may also be an attempt to fulfill physiological or psychological needs, such as a response to stress, trauma, or loneliness.
Alternatively, it may be due to unfamiliarity with the environment, changes to medications or schedules, or a severe decline in cognitive function.
The United Kingdom’s Alzheimer’s Society provides further potential reasons for wandering, such as:
- memory loss
- confusion about the time at which the person usually performs activities
- pain or distress
- anxiety or agitatation
- boredom
- a lack of physical activity
- continuing a previous habit
- searching for someone in the past
- feeling lost
Caregivers or family members may be able to reduce the risk of wandering. However, they may not be able to guarantee that a person living with dementia will not wander.
The following strategies may help:
- providing opportunities for structured and engaging activities throughout the day
- identifying the time of the day when a person is likely to wander, such as the “sundowner’s period” as night approaches, and planning activities during this time
- ensuring the person’s needs for food, drink, and use of the bathroom are met
- involving the person in daily activities, such as folding laundry or preparing dinner
- providing reassurance when the person is lost, anxious, or disoriented
- using a GPS device if it is safe for the person to go out walking or driving
- avoiding busy places that may be stressful, such as shopping malls
- assessing the person’s reactions and feelings toward new environments
In the early stages
The Alzheimer’s Association suggests individuals with early stage dementia may benefit from engaging in the following with family or caregivers:
- deciding on a set time each day to check in with each other
- reviewing schedules and appointments together
- identifying companions who can support the person when others are not available
- considering transportation to avoid wandering
Learn more about early stage dementia.
The
- keeping doors locked
- using loosely fitting doorknob covers
- placing signs on doors or diverting attention away from them using:
- posters
- removable gates
- curtains
- streamers
- installing devices on windows to limit how much they can open
- installing bells, alarms, or pressure-sensitive mats when the door opens
- securing outside areas with fencing and a locked gate
- keeping keys, shoes, suitcases, and other items that may trigger the instinct to leave out of sight
Safety measures
If the risk of wandering increases, the following safety measures may help:
- placing deadbolts on the door, out of sight, but only locking them when someone is in the house with the person
- camouflaging doors with the same colors as the walls
- supervising the person when they are in new or changed surroundings or a car
- creating a threshold in front of the door with paint or tape to create a visual barrier
- using night lights and safety gates
- monitoring noise levels to reduce excessive stimulation
- creating safe spaces to explore inside or outside the house
- labeling rooms with signs to explain their purpose
Alzheimer’s Association support groups may provide additional support and resources for caregivers of a person with dementia.
Read more about caring for someone with dementia.
Families and caregivers may also benefit from having a plan in place in case of an emergency. This may involve:
- enrolling the person living with dementia in a wandering response service
- asking neighbors or other people to call if they see a person wandering
- keeping recent photos of the person to give to police in case of emergency
- getting to know the person’s neighborhood well and identifying potential hazards
- creating a list of places the person may wander to
The
- make sure the person carries identification or wears a medical bracelet to let people know about their dementia
- sew labels on the person’s clothing to aid identification
- keep an item of the person’s worn, unwashed clothing in a plastic bag to aid in finding them with the use of dogs, if necessary
People can reach out to support groups and various organizations for additional advice.
Find out more about dementia support groups.
If a person with dementia wanders away from home, people can act immediately by taking the following steps:
- Start search efforts immediately and consider looking in the direction that relates to the missing person’s dominant writing hand first.
- Search the surrounding area and places where a person has wandered in the past, if applicable.
- Check local landscapes, such as ponds, tree lines, or fence lines.
- Call 911 if they do not find the person within 15 minutes and inform any other relevant local authorities.
People at any stage of dementia are at risk of wandering. Family and caregivers can look for signs a person may be at risk of wandering, such as forgetting directions, asking about deceased family members, or making repetitive movements.
Protecting a person from wandering may involve keeping the home as secure as possible and storing items that may trigger the instinct to leave the house out of sight.
Family or caregivers can also implement plans that allow them to act immediately in an emergency. For example, they may enroll the person in a wandering response service and create a list of places they may wander to. People should call 911 if they do not find a person with dementia who has wandered away from home within 15 minutes.