Wandering: Practical Safety Steps at Home

For families caring for an older adult living with dementia, wandering can be a significant concern. It's a common behavior that can lead to stress for both the person experiencing it and their caregivers. Understanding why an older adult might wander and implementing practical, non-intrusive safety measures at home can significantly reduce risks and offer greater peace of mind.

This article offers practical steps for Northern Virginia families to create a safer home environment for a loved one prone to wandering. We focus on prevention, observation, and creating a supportive space, all within the home setting.

Why Wandering Happens: Understanding the Behavior

Wandering is not typically a deliberate act of defiance. Instead, it often stems from the confusion and disorientation caused by dementia. Several factors can contribute to an older adult wandering:

• Memory Loss and Disorientation: They may forget where they are, where they intended to go, or even that they are in their own home. They might try to "go home" even when they are already there.
• Searching for Something or Someone: An older adult might be looking for a past loved one, a previous home, or even an object they believe they need.
• Restlessness or Boredom: A lack of engaging activities or a feeling of restlessness can prompt movement.
• Basic Needs: They might be looking for a bathroom, food, or water, but cannot effectively communicate their needs or find their way.
• Changes in Environment or Routine: A new home, different furniture, or an altered daily schedule can increase confusion.
• Stress or Anxiety: Feeling overwhelmed, anxious, or fearful can lead to an urge to escape.
• Pain or Discomfort: An inability to express pain can sometimes manifest as restlessness or a desire to move.

Understanding these potential triggers can help families anticipate and sometimes prevent wandering episodes.

Consult with Your Health Care Provider

Any significant change in behavior, including new or increased wandering, should always be discussed with your loved one's health care provider. The doctor can rule out other potential causes, such as infections, reactions to medications, dehydration, or other health conditions that might contribute to confusion or restlessness. They can also offer guidance on how to manage behavioral changes and ensure comprehensive support for your loved one's overall well-being.

Securing the Home Environment

The home is the primary place where safety measures can be implemented. The goal is to make it difficult for an older adult to leave unsupervised, while still maintaining a comfortable and familiar environment.

• Door and Window Alarms: Simple, inexpensive alarms can be placed on doors and windows. These emit a chime or beep when opened, alerting caregivers that someone is attempting to leave. Look for models that are easy for caregivers to disarm but not obvious to the older adult.
• Concealed Locks: Install locks that are not easily visible or obvious, such as slide bolts placed high or low on doors, or childproof doorknob covers that are difficult for an older adult with dementia to manipulate. Avoid locks that require keys from the inside, as these can pose a fire hazard.
• Visual Deterrents: Sometimes, visual cues can be effective. Placing a dark mat in front of a door may appear to be a hole or an obstacle to someone with impaired depth perception, discouraging them from stepping over it. A "STOP" sign on the inside of the door can also be a simple visual cue.
• Remove Temptations: If your loved one tends to wander towards a specific object or area outside (e.g., a car, a garden shed), try to make these areas less accessible or appealing. For instance, keep car keys out of sight.
• Secure Fences and Gates: If there is a yard, ensure fences are secure and gates are locked. Consider privacy fencing to reduce visual prompts to leave.
• Create a Safe Outdoor Space: If possible, design a secure, enclosed outdoor area where the older adult can safely wander and enjoy fresh air without risk.

Routine and Engagement: Reducing the Urge to Wander

Often, wandering stems from boredom, restlessness, or a search for purpose. Creating a structured, engaging, and comforting routine can help reduce these triggers.

• Consistent Daily Schedule: Establish a predictable daily routine for meals, activities, and rest. Familiarity can reduce anxiety and disorientation. Try to schedule walks or safe outdoor time during periods when your loved one is typically most restless.
• Engaging Activities: Provide stimulating activities that match their abilities and interests. This could include sorting objects, folding laundry, looking at photo albums, listening to music, or simple craft projects. Meaningful engagement can reduce the urge to search for something else to do.
• Regular Exercise: Gentle physical activity, such as short walks or seated exercises, can help reduce restlessness and improve sleep patterns.
• Adequate Rest: Ensure your loved one gets enough sleep. Fatigue can increase confusion and agitation, contributing to wandering. Create a calming bedtime routine.
• Attend to Basic Needs: Regularly check for hunger, thirst, or the need to use the bathroom. Addressing these needs proactively can prevent wandering motivated by discomfort.
• Safe "Wandering" Areas: Consider designating a safe, supervised area within the home or a secure garden where your loved one can move freely without risk.

Personal Safety Measures and Community Resources

Even with home modifications and routines, accidents can happen. Having personal safety measures in place and knowing local resources can be crucial.

• Identification: Ensure your loved one carries identification at all times. A wallet with an ID, a health-related alert bracelet, or even embroidered labels on clothing with contact information can be vital if they do wander and become lost. Some families opt for shoelaces with embedded GPS trackers or ID tags for clothing.
• Current Photo: Keep a recent, clear photograph of your loved one on hand. This will be invaluable if you need to alert authorities.
• Neighbor Awareness: Inform trusted neighbors that your loved one has dementia and may wander. Provide them with your contact information and a photo.
• Enrollment in Alert Programs: Explore local alert programs designed for individuals with dementia. In Northern Virginia, resources like the Project Lifesaver program, often managed by local sheriff's departments, provide tracking devices to at-risk individuals. The Alzheimer's Association also offers a "wandering support and ID enrollment" program.
• GPS Tracking Devices: Personal GPS trackers, often worn as a watch or pendant, can provide real-time location information. Research different models to find one that is reliable and comfortable for your loved one.
• Caregiver Support Groups: Connecting with other caregivers can provide emotional support and practical advice. Many local organizations, including the Alzheimer's Association, offer support groups in Fairfax, Arlington, and Loudoun counties.

When to Seek Professional Support

Caring for an older adult prone to wandering can be exhausting and challenging. It's important to recognize when you might need additional support.

• In-Home Care Services: Agencies like Blue Haven Home Care Services LLC provide non-skilled care in the home, offering supervision, companionship, and assistance with daily activities. Having a trained caregiver present can help maintain routines, engage your loved one, and provide essential supervision to prevent wandering episodes. This allows family caregivers to rest or attend to other responsibilities.
• Respite Care: If the wandering behavior is particularly intense or frequent, consider respite care services. This can provide short-term relief for family caregivers, either in the home or at a specialized facility.
• Memory Care Facilities: For some families, a specialized memory care facility becomes the safest option if home safety measures are no longer sufficient or the level of supervision required exceeds what can be provided at home.

Creating a Safety Plan

Develop a written plan that outlines what steps to take if your loved one wanders. Share this plan with all family members and caregivers.

1. Immediate Search: Check familiar places inside and around the home. Call their name.
2. Contact Authorities: If they are not found within a short period (e.g., 15-30 minutes), call 911 or your local police department. Provide a description, a recent photo, and information about their habits or usual destinations.
3. Inform Community: Call neighbors, friends, and local businesses where your loved one might go.
4. Use Tracking Devices: Activate any GPS tracking devices or alert programs you have in place.

Proactive planning and the implementation of practical safety measures can significantly reduce the risks associated with wandering. By understanding the causes, securing the home, establishing routines, and utilizing available resources, Northern Virginia families can create a safer, more supportive environment for their loved ones living with dementia.