Getting on the Right Path; Tips for Handling Wandering

Dorian Martin Health Guide
  • I was always worried that Mom would wander and become lost and/or hurt herself when as her Alzheimer’s progressed. However, because her lungs were so badly weakened by the Chronic Obstructive Pulmonary Disease, she didn’t have the stamina to go for long distances.  Yet as the recent HBO documentary “The Alzheimer’s Project” illustrated, wandering can be a big concern. The documentary described how a daughter had secured all the fencing around their large yard because she was worried that her mother (who had Alzheimer’s) would wander off into the cornfields and become lost.

                    So what issues should you consider when a loved one with Alzheimer’s who is prone to wandering? Here are some tips, many of them gleaned from “The 36-Hour Day” by Nancy L. Mace and Peter A. Rabins:

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    • If the loved one can still read and follow instructions, writing down very simple directions on a card for the loved one to carry may be helpful.  Also, jotting down the words “stay calm” as well as a telephone to call can help remind the loved one what to do. Mace and Rabins suggest that the different types of cards may be needed for different trips.
    • The loved one needs to wear an identification bracelet which includes contact information.  Identification cards with contact information also may be useful and can be put in the loved one’s pockets.
    • To limit restless, you may want to schedule regular exercise that would relieve pent-up restless. Be sure to schedule regular walks as many times a day as needed or find other ways to encourage the loved one with dementia to exercise.

    A person with Alzheimer’s who is left alone outside may wander off and encounter many dangerous situations.  In the area near your home, Mace and Rabin suggest that you consider the following:

    • Make sure the person who has dementia is kept away from unsupervised swimming pools, even if the person was at one time a good swimming. The pool should be securely fenced, including being locked, so that if the person with Alzheimer’s is alone, he or she can’t enter into the pool area. Also, it is important to make sure that any neighbors who have swimming pools are aware of the loved one’s mental condition and that he or she cannot be trusted near a pool.
    • Take down any clothes lines so that the person doesn’t get hurt while walking.
    • If you live near a highway and the loved one with Alzheimer’s wanders off, notify the police immediately.
    • People with Alzheimer’s may wander in parking lots of stores and may not get out of the way of oncoming vehicles. Therefore, it’s a good idea to keep the person walking closely by your side.

    -          In some cases, wandering can be discouraged. For instance, Mace and Rabins noted that some people will not venture outside if they are not wearing shoes. Having the loved one wear slippers instead of regular shoes may cause them to voluntarily deter their venturing out.

     

    Another big issue is what to do when the loved one with Alzheimer’s wants to wander at night. Mace and Rabins encourage having the person exercise during the day and decrease dozing so that the he or she will have a better chance of sleeping throughout the night. The residence should be situated so that there aren’t any safety hazards if the loved one does get up in the middle of the night to wander. For instance, all doors and windows should be locked. The bedroom’s furniture should be arranged in a way to promote safety. If there are steps, place a gate to keep the person from falling on the steps.

  • Another idea for those who wander during the night is to look for innovative services that are available during that time period. For instance, The New York Times recently reported on Hebrew Home’s ElderServe at Night, which is a dusk-to-dawn drop-off program intended to strengthen the participant’s decaying mind while designed to allow the participant to be active after dark. The ElderServe provides an employee who goes with people with Alzheimer’s on a supervised stroll. “Participants are fetched from their homes by vans and spend 7 p.m. to 7 a.m. painting, potting plants, dancing and talking — or, for those immobilized by their disease, relaxing amid music, massage and twinkling lights. The patients rest as they need, for a few minutes or a few hours, and return home the next morning fed, showered and, usually, tuckered out,” Cara Buckley and James Estrin reported.

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    Another stimulus for wander is being placed in a new setting. The one time that I noticed that Mom had more of a tendency to wander was when she was moved to a new environment. You can try to ease the move through taking the loved one to the new place prior to the move several times prior to the actual event and also involve the loved one in planning the move. After the move happened, I tried to help orient Mom by placing a bright, festive quilt that she had seen for several years prior on her bed so that she would recognize her new room.

    Trying to think ahead to help a loved one who has dementia and who has a propensity to wandering can be difficult. Perhaps the best advice is to fill the loved one’s day with activities and exercise, be proactive in maintaining the area to ensure safety, and look for innovative programs that support the needs of someone with dementia. And I hope that if you have other suggestions in this area, you’ll share them below.

     

Published On: June 17, 2009