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Departments |
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Planning For and Coping With
Wandering Behavior
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Studies suggest that at least 60% of all
individuals with a dementing illness such
Alzheimer's disease will eventually wander. Even
people who have never been inclined to be
adventurous, or who really don't like being
outside, are at risk for wandering as the
illness progresses.
On the other side of the coin, many people who
are caring for someone with dementia will deny
that wandering could ever be a problem for their
loved one. As they look to past behavior, they
will be certain that, because their loved one
has never before become disoriented and lost, it
cannot happen in their case. These are the
caregivers who should make a point of keeping an
unwashed shirt and pair of socks on hand,
because they may one day be needed for search
and rescue dogs.
If 60% of dementia patients eventually wander,
this does mean that 40% will not. Any one
particular patient may be in the non-wandering
40%. Unfortunately, just as with the lottery,
unless the individual is unable to move around
independently it's impossible to know for sure
until all the numbers have been played.
Caregivers who would rather not play this kind
of roulette, where the odds are not in their
favor, can choose to be prepared for wandering
behavior.
Those who wander generally fall into one of two
basic groups. The first group is those
individuals who become disoriented or lost while
doing an accustomed activity outside the home.
The gentleman in the early stages of dementia
who routinely walks out to retrieve the mail and
one day does not recognize "home" when he turns
around belongs in this group. He may wander for
blocks, even miles, trying to find his way home.
It is impossible to predict if and when an
episode of this kind will occur. Caregivers
should always be alert to "good" and "worse"
days. On "worse" days, keep a watch out the
window or go along. Just in case, be sure that
the patient always carries identification that
can't be lost or left behind, even for a trip to
the mailbox. A first initial, last name and
telephone number written in indelible ink on the
inside of all shirts is a good start. An
identification bracelet is excellent if the
patient will wear one. Women will often be
willing to wear an ID necklace. Those who have
served in the military will sometimes be proud
to wear dog tags on the traditional bead chain.
The second group is those in the middle stages
who require more assistance, and who are no
longer going out unaccompanied. These dementia
patients may, without warning, one day attempt
to march out the door.
Anyone caring for someone who cannot safely go
out alone should routinely keep all entry doors
locked. Of course, locking the door will not be
sufficient to keep a determined wanderer from
opening it. The first episode of working at the
lock will certainly give a caregiver notice that
a new and dangerous behavior is beginning. That
first time it might also give a caregiver time
to get to the door before it's successfully
opened.
Once an individual with dementia has tried to
leave once, the odds are overwhelming that he or
she will do so again. Putting alarms on the door
and adding additional slide locks at the top or
bottom of doors where they are less obvious will
work for some. Others are amazingly adept at
finding and working out new lock combinations.
For these patients deadbolts and a floor pad
with a built-in alarm which they cannot walk
around may be a deterrent.
For many dementia patients who develop the urge
to roam, the only deterrent is a "sharp"
caregiver who learns what behavioral signs to
watch for and how to divert the need to wander
before it is out of control.
For help identifying "triggers" and practical
suggestions for managing wandering behavior read
Planning For and Coping With Wandering Behavior:
Part Two |
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