Just the Facts and More: Wandering
There are many reasons why an Alzheimer patient wanders or walks away from home or a well-known path or area. As a first step, try to determine the reasons behind wandering by asking these questions:
Medication
Some medications have side effects that result in confusion and restlessness. Is the patient on such medication? If so, consult your physician.
Stress
Is the person trying to handle stress, noise, unpleasant people, crowding, or isolation? If so, consider changing the situation.
Time confusion
Does the person become confused during certain parts of the day, such as the middle of the night or early evening? Does the person claim that people have been gone for days or weeks and then searches for them?
Basic needs
Is the person looking for something specific such as food, drink, the bathroom, or companionship?
Restlessness
Does the person have enough movement and activity during the day? Is it possible that the person wanders in order to get up and move around?
Lack of recognition
Is the person in a new or changed physical environment that makes him want to search for familiar objects, surroundings or people?
Fear
Is the person trying to escape from something frightening? Is the person experiencing a delusion or hallucination, or has the person simply misinterpreted sights and sounds?
Past behavior
Is the person trying to meet former obligations involving a former job, home, friend, or family member?
Other factors that may contribute to wandering include medical conditions such as stroke or other factors such as consumption of alcohol, changes in the weather, or feeling abandoned, useless or helpless. Wandering may be frustrating and irritating for caregivers, but it becomes a problems only when the person moves into an unsafe or unhealthy area or climate, puts others at risk or invades others' property.
For this reason, many people who care for Alzheimer patients decide to overlook wandering behavior until it becomes dangerous to the patient and to others. They may even permit the person to wander within safe boundaries or follow the individual on special outings.
Be Prepared.
Be aware that wandering may or may not happen. There is no way to predict who will wander or when and how it might happen. Some people never get lost and others get lost frequently. The best advice is to be prepared. If the person has a daily exercise routine and hasn't yet wandered, you needn't be overly concerned. However, once the person begins to wander or gets lost, you should watch him more closely.
Encourage movement and exercise.
Allow the person to move within safe areas or make a shared exercise such as walking part of your daily routine. Although walking in a circle might seem unusual, keep in mind that physical activity - from walking and sweeping, to rolling yarn or folding clothes - is a positive experience for the person with Alzheimer's.
Be objective.
Don't take the person's wandering behavior personally. The individual is probably trying to make sense of a world that no longer seems predictable.
Be aware of hazards.
Remember that places that look safe might be dangerous for the person with Alzheimer's. For this reason, you should review the environment around your home for possible hazards, such as fences and gates, bodies of water, swimming pools, dense foliage, tunnels, bus stops, steep stairways, high balconies, and roadways where traffic tends to be heavy.
Secure your living area.
Do whatever you can to keep your home safe and secure. Place locks out of the normal line of vision - either very high or very low - on doors. In addition, use a double bolt door lock, keeping the key handy for emergencies. Also use a childproof door knob that prevents the person with Alzheimer's from opening the door. Other effective safety actions include the following:
- Put hedges or fences around your patio or yard;
- Place locks on gates;
- Consider electronic buzzers, infrared electronic eye alarms or chimes on your doors;
- Camouflage some doors with a screen or curtain, or put a two-foot square of a dark color in front of the doorknob;
- Use a recliner or rocking chair; the person may then need assistance to get up;
- Use nightlights, signs, and familiar objects to help the person move around in a safe area;
- Put gates at dangerous stairwells.
Communicate with the person.
Remind the person that you know how to find him and that he is in the right place. If possible, take the person for rides in cars or buses in addition to providing regular activity and exercise. Continually reassure the person, who may feel lost or abandoned.
Identify the patient.
Investigate local the Alzheimer Chapter's identification program. You may want to invest in a discrete identification bracelet or locket that includes the person's name, telephone number, memory problem, and medical condition. Some experts even recommend putting identification on the person's dentures or attaching a sensor to the patient's ankle or wrist. In addition, choose bright-colored clothing and mark it with sew-on or iron-on label, permanent marker, or reflective material. Also identification may be placed on the person's shoes, eye glasses and keys.
Involve your neighbors.
Inform your neighbors of the person's condition and keep a list of their names and telephone numbers handy. Although neighbors can be helpful in guiding the person home, you'll probably want to teach them how to approach the person with Alzheimer's disease by using these steps:
- Approach the person from the front;
- Introduce yourself and call or ask his/her name;
- Gently look for or ask to see identification;
- Offer help and reestablish the day, date, and time;
- Avoid pulling or pushing the person;
- Report the patient found
Involve the police.
Some police departments keep a photo and fingerprints of people with Alzheimer's on file. Many local Alzheimer's Association Chapters sponsor some kind of identification program to help with wandering patients. If a person with Alzheimer's become lost, take a photo and an article of unwashed, worn clothing in a plastic bag to the police. Also have data on the following items:
- Age
- Hair color
- Blood type
- Eye color
- Identifying marks
- Medical condition
- Medication
- Dental work
- Jewelry
- Allergies
- Complexion
Offer suggestions about where the police might find the patient, such as old neighborhoods, former work places, or favorite places.
Be prepared for other modes of wandering.
Although most wandering takes place by foot, some individuals with Alzheimer's disease have been known to drive 300 miles - sometimes in an automobile that belongs to someone else. You can prevent these problems by keeping car keys out of sight or by temporarily disabling the car by removing its distributor cap.
Special Recommendations for
Long-term Care Facilities |
Use medication with caution.
Keep in mind that no medication controls wandering. If medicated, some patients actually become more agitated. Other medications bring about complications related to immobility.
Respond to wanderers as individuals.
Keep the patient busy in full view of the staff and help the patient develop a walking route around the facility.
Develop a procedure for handling missing residents.
Be sure to include such steps as searching the facility, calling the administrator and notifying a family member who will then notify the police. In some cases, the facility may need to notify the police.
Inform people about how to approach a patient.
Invite local police, firefighters/paramedics, business people and family members to inservice workshops on how to help wanderers. Help them understand that wanderers should be approached calmly, reassured and guided back to the facility.
Compiled by the Lincoln/Greater Nebraska Chapter of the Alzheimer's Association, 1999.
One of the best places to turn for additional help is the Alzheimer's Association. The Alzheimer's Association has more than 83 Chapters and 1,600 support groups nationwide, where family members of people with Alzheimer's disease or a related disorder share their experiences, provide each other with emotional support, hear practical suggestions and learn to rebuild their lives.
The primary resource for this fact sheet was Lisa P. Gwyther, ACSW, educational director of the Joseph and Kathleen Bryan Alzheimer's Disease Research Center of Duke University, Durham, North Carolina.
Special thanks to the following Chapters of the Alzheimer's Association: Honolulu, Hawaii; Indianapolis Area, Indiana; Topeka, Kansas; Eastern Massachusetts; Southeastern Wisconsin and South Central Michigan.
Other Resources include:
- Lisa P. Gwyther. "Care of Alzheimer's Patients: A Manual for Nursing Home Staff." Washington, DC: American Health Care Association, and Alzheimer's Disease and Related Disorders Association. 1985.
(Compiled by the Lincoln/Greater Nebraska Chapter of the Alzheimer's Association, 1999.) For further information about Alzheimer's Disease or related disorders, contact the Alzheimer's Association at: