Notes

How Long Does Wandering Behavior Last in People With Dementia?
In people with dementia who have a tendency to wander, we try to anticipate the times when they tend to leave. Exercise, distraction and ensuring they have food and water may help.

We also try to address underlying issues like pain and sleep deprivation. We encourage them to register with safe return programs.
Symptoms

People with dementia who wander often do so because they are feeling restless or agitated. They may have a desire to go back home or to a familiar place like a favorite park or church. They may also be seeking a way to escape from something they are hearing or seeing like thunder or other loud noises.

Experts recommend that families enroll their loved ones in a safe return program such as MedicAlert, Project Lifesaver or Silver Alert and make sure they have a phone tree so others can be contacted quickly if the person becomes lost. They should also review the person’s medications with their doctor and see if any can contribute to confusion or delusions.

Keeping the person with dementia engaged in activities, limiting the number of people they interact with and making their environment more predictable can reduce wandering behavior. Also, reducing overstimulation by turning off the television and limiting the amount of noise in the home can help to prevent this behavior.
Causes

Sometimes, people with dementia wander because they are looking for something, like a familiar person or place. They may also feel a need to fulfill a former obligation, such as going home or getting work done.

They might also be trying to find a way out of an uncomfortable situation, such as loud noises, crowded spaces or an unfamiliar environment. These can trigger disorientation and fear in older adults, causing them to want to escape the stimuli and search for a quieter or calmer place.

Other causes of wandering behavior include pain, lack of sleep or unmet needs, such as hunger or boredom. The tendency to wander may be exacerbated by certain medication side effects or environmental factors, such as an abrupt change in routine or natural disasters. It is important to understand the cause and address it appropriately to reduce the risk of your loved one becoming lost or injured. For example, if your loved one tends to walk about at night, keep their bedroom door closed and use a night light.
Significance

Wandering is an important issue for people with dementia, particularly those who have Alzheimer’s. It is one of the most dangerous behaviors associated with the condition because if people aren’t found within 24 hours, 50% end up severely injured or dead (Silverstein, Flaherty, Salmons Tobin, 2006).

It can cause fear and anxiety in loved ones, who worry about their safety. It can also be costly to families and care facilities, as individuals who wander are often in need of medical attention or hospitalization.

We should be careful about trying to control troubling dementia behaviors through medications or physical restraints. Medications can cause sedation and contribute to falls, and the use of restraints increases the risk of poor circulation, pressure ulcers, weakness, incontinence, depression and isolation. These types of restraints should only be used as a measure of last resort after nonpharmacological modalities have been explored. Instead, we should strive to understand the reasons for problematic behavior and implement strategies to reduce it.
Prevention

People with dementia who wander can become disoriented, lost or injured. Those who aren’t found within 24 hours often end up severely hurt or dead. So, it’s important to prevent this behavior as much as possible.

Look for patterns in your loved one’s wandering behavior. If they tend to wander at a certain time of day, take steps to prevent this from happening, such as leaving night lights on. Address any unmet needs that may be triggering their wandering behaviors, such as hunger, thirst, pain or restlessness.

Reduce distractions and overstimulation, especially in unfamiliar environments. This can include loud noises, crowded places or even new clothing and furniture. Labeling rooms and items can help your loved one feel more oriented. Verbal reminders and signs are also helpful. Personal Alarms And, be sure to start search efforts immediately -- many individuals who wander are found within 1.5 miles of their disappearance. Lastly, consider involving your local community in dementia safety programs and making disaster preparedness a priority.
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