Wandering Behavior in Alzheimer's Patients
Over 60 per cent of people with Alzheimer's will, at some time, wander away from their home or place of residence*. Wandering is a common and potentially life threatening aspect of dementia, particularly at times of the year when the weather is bad or if the person lives in an area surrounded by hazards such as fast traffic or open hostile countryside.
What exactly is wandering? There is general consensus that wandering describes an aimless or purposeless activity where someone leaves a safe or familiar environment and goes to an inappropriate place. Sometimes the term critical wandering is used by the emergency services and by medics. A critical wanderer is defined as anyone with dementia who has wandered away or disappeared of their own free will from their caregiver.
Wandering is quite often goal oriented despite the fact that the goal may be misplaced. For example, I frequently spent time trying to dissuade a lady with later stage Alzheimer's, of the need to catch a bus. She had no view as to where the bus would take her, but such was her motivation that she would sometimes galvanize other patients into action. I would often find a group of residents following her around the ward looking for a bus stop!
A person with Alzheimer's who is disorientated is often unable to judge potentially dangerous places and situations. It is not uncommon for the wanderer to be dressed in night clothes and perhaps have nothing on their feet. When people go missing time is critical because a life is at risk.
A research paper by Robert J. Koester, looking into the subject to help with search and rescue, presents a number of interesting insights into wandering:
- People suffering from severe Alzheimer's are more at risk than those with earlier stage Alzheimer's.
- People with Alzheimer's leave their own residence or nursing home and start to wander along roads. The person is usually located (89 per cent of all cases) within one mile (1.2 km) of the point last seen.
- If the person is not on the road itself (14 per cent), they are usually in a creek/drainage (28 per cent), and/or caught in briars/bushes (33 per cent).
- The person is usually found wandering a short distance from a road; around 33 yards. The majority of patients who succumb to the environment (hypothermia, dehydration) require evacuation (35 per cent) or are deceased (19 per cent).
- They may have a previous history of wandering.
- There are often coexisting medical problems that limit mobility.
Koester also found that people with dementia will not necessarily cry out for help or respond to shouts. They will not leave many physical clues of their whereabouts and they may attempt to travel to a former residence or wander to a favorite location.
How to Respond to Wandering
An understanding of wandering behavior in Alzheimer's, allows families, healthcare facilities, local authorities, police, search and rescue services to maximize their efforts within the most effective perimeters. Nursing and residential homes should search the building and grounds and repeat the search every few hours. The wanderer's previous home sites or places of special meaning should be searched. Bushes and briars 100 yards parallel to roadways need special attention as the person could become entangled and not be able to problem solve their way out. Trackers and tracking dog teams should also concentrate along roadways, drainage and stream areas, looking for signs along roadways and trails.
Finding that a loved one or patient has wandered can be quite upsetting, but a careful systematic search is very likely to yield positive results.
*Source: Alzheimer's Association