Dementia care for seniors - Eldercare Home Health

Seniors with Alzheimers Disease often wander. It is sometimes very difficult to figure out what the person who is wandering is trying to accomplish, but the more we understand, the more likely we will be successful in reducing the behaviour.

A wandering person is generally not a happy person.

A senior with Alzheimers Disease may be disoriented and unsure of where they are.
They may be agitated, believing that they have an appointment or something important to do – such as go to work.

A senior with Alzheimers Disease may be frightened – by unfamiliar surroundings, noise, groups of people… the specific reasons for each person’s agitation are unique to them. Certainly, enlisting the help of someone who knows the person well can give clues as to what their habits may have been in earlier years.

There are too many examples where people with Alzheimers have wandered away from their home environment and have come to harm. Tragically, some have even died as a result.

Understandably family members and caregivers of people suffering with Alzheimers want to do everything possible to ensure the person that they’re caring for is safe.

The Alzheimer Society of Canada makes a very important point about respecting an Alzheimers patient’s lifelong values and wishes about personal freedom and dignity.

This is especially important when it comes to physical, pharmaceutical or environmental restraints, such as electronic tracking devices that the person with Alzheimer’s might wear. The Society recommends that you and your family discuss these important issues with the person you’re caring for early in the onset of his or her Alzheimers disease. Learn more about the ethical aspects of Alzheimer’s.

Reasons a senior may wander

  • Searching for something; a person, a place from the past, food or drink
  • Needing to use the bathroom
  • Escaping from something; stress caused by too much noise or other stimulation
  • Reliving the past; the patient believes he or she is fulfilling a responsibility, such as going to work.
  • Undetected infection such as a urinary tract or respiratory infection.
  • Upsetting news from a recent visitor may cause restlessness etc.

The BrightFocus Foundation suggests you also consider these common reasons for wandering:

  • Agitation, sometimes caused by medication (or a change in medication)
  • Restlessness from lack of exercise
  • Confusion; the patient doesn’t realize he or she is at home and sets out to “go home.”

You can read about these, some prevention tips and find a list of resources at the BrightFocus Foundation.

By understanding the causes of seniors with Alzheimers wander, you and your family may be able to put some simple strategies in place to help manage or reduce incidents of – –wandering.

Suggestions for reducing wandering from Lisa Wiseman RN BScN GNC(C), President of Eldercare Home Health in Toronto:

  • Loud noise can agitate a person with Alzheimer and stimulate wandering. If you can’t reduce the noise, move the person to a quieter room. Note the result for future reference.
  • To combat restlessness or boredom, give the person with Alzheimers a simple (so that it does not become frustrating), but engaging task to do, such as folding towels, piling papers, grouping photos etc.
  • If the person is physically able, take them for a walk, help them be physically active in a way that is safe.
  • In her book Designing for Alzheimer’s Disease, Elizabeth Brawley quotes research done at the Corinne Dolan Alzheimer’s Center that has found that the most effective way to prevent wandering Alzheimer’s residents from going out the door was to hide the doorknob with an 18” cloth barrier. It is not necessary that the cloth match the colour of the door. Residents appeared to be unable to correctly interpret the image and are in-turn, not able to recognize the door or manipulate the knob.
  • The centre also found that views seen through a door with glass panels encouraged wandering. Providing views that the person with Alzheimer’s did not have access to caused frustration. Covering the glass with blinds that were are similar colour as the door, helped to create the illusion of a solid surface, helping to address these issues.

Increase the chances that searchers will find a wandering person with Alzheimer quickly:

  • Alert the police immediately that you know the person has gone missing.
  • Try to ensure that the person with Alzheimer’s always wears an obvious I.D. tag. The Alzheimer’s Society of Canada has a new program called MedicAlert® Safely Home®. It’s a nationwide registry designed to help identify the person who may get lost and assist in a safe return home. He or she will receive an engraved I.D. tag (over 100 styles; bracelets, necklaces, watches and more). The tag will enable police and emergency responders to quickly identify the wanderer and bring the family back together.
  • Place a card with the family or facility contact information in the person’s pocket or wallet.
  • Consider a permanently wearable geo-tracking device for the person. The Alzheimer Society of Canada goes into detail about GPS and radio frequency devices.
  • Dress the person with Alzheimer’s in bright clothing.

The BrightFocus Foundation also recommends that you have ready, and provide the following to the search team:

  • Copies of a recent close-up photo of the person who has gone wandering.
  • Copies of a list detailing the person’s age, sex, height, weight and other physical characteristics, as well as blood type, health issues, medications, dental work, dietary needs and other information pertinent to search and rescue personnel.
  • A list of the places the person likes to go, such as a shopping centre.
  • They also recommend that you place an unwashed article of clothing that the patient has worn in a plastic bag. Wear latex gloves when you pick it up. Replace the article every month. This can be helpful if tracking dogs are available to aid in the search.

Learn more from the Mayo Clinic on how to manage a wandering Alzheimer’s patient at “Controlling Alzheimer’s Wandering.”

It is impossible to anticipate all of the reasons why some seniors with Alzheimers wander. Whether the person lives in a retirement home, nursing home or in the community, the opportunity for wandering is an issue. Understanding the issues and being aware of solutions can minimize wandering episodes and help keep the person you’re caring for as safe as possible.

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