The Warning Signs of Wandering

Wandering is a real complication of dementia. The Alzheimer’s Association estimates that 60% of people living with Alzheimer’s will wander at least once. It also reports that if a person isn’t found within 24 hours, up to half of those who wander will suffer serious injury or death.

In a five-year Oxford study of 104 people with dementia living at home with a caregiver, 43 needed to be brought back home at least once, and five repeatedly got lost. The same study found that people who got lost were far more likely to end up permanently in an institution. It’s one of the biggest reasons that families cite as why they can no longer care for their loved one at home.

Where and how people go missing

Many families picture wandering as someone slipping out at night. The research shows something different. A University of South Florida analysis of 325 newspaper reports of missing people with dementia found that the main trigger, especially for people living at home, was getting lost during a normal, permitted activity alone in the community. A loved one with no history of wandering can still become lost on a routine outing.

We also have data about where people go when they wander. In a review of 93 fatal cases of wandering, 87% of people were found in natural, secluded areas such as woods, fields, ditches, and bodies of water, generally less than a mile from where they left. That is why searchers are advised to check close to home first, including overgrown and hard-to-see areas, and why families should never wait to call for help.

Those are all sobering statistics, but that doesn’t mean we are helpless to try and prevent wandering. Here are some tips to help keep a loved one with dementia safe inside the home.

• Install door alarms, chimes, or a monitoring system so you know when someone exits.
• Place locks or latches higher or lower than eye level. Many people with dementia won’t look beyond eye level.
• Disguise exits. Some families cover doorknobs or paint doors to blend into the wall. A dark mat in front of a door can look like a hole to a person with dementia.
• Keep car keys out of reach, since a person with dementia may not just wander on foot.

We can also help prevent wandering by understanding the urges that lead someone with dementia to leave the home.

• Note when wandering tends to happen and plan activities for those times.
• Build in daily exercise and purposeful tasks, such as folding laundry or helping with dinner. Getting enough exercise and sleep also helps.
• Provide visual cues and reassurance. Many people who try to leave are looking for something, such as the bathroom, a person, or a feeling of purpose.
• Don’t leave someone unsupervised in new surroundings, where confusion can quickly escalate.

Don’t go it alone

Caregiving for someone at risk of wandering is exhausting, and families shouldn’t feel they’ve failed if a loved one slips out once. Respite care, adult day programs, and memory care communities with secure environments and trained staff can offer safety and relief. The Alzheimer’s Association 24/7 Helpline, at 800-272-3900, can connect families with local support.