How To Deal With Wandering

Wandering or pacing is a common behavior of persons with memory loss and confusion (also called dementia) caused by diseases such as Alzheimer's, Stroke, Parkinsons and HIV. This is acceptable as long as the person wanders or paces during the day in a safe environment. Wandering can help relieve anxiety and restlessness and may serve as exercise. Problems occur when the person wanders away from home or wanders at night. Nearly 60% of the four million Americans with Alzheimer's disease wander off and get lost sometime during the course of the disease. Here are some suggestions for dealing with this problem:

• Photographs and clothing for police. Keep recent photographs handy and keep a piece of recently worn clothing in a plastic bag for a police to use for a search. Change the article of clothing monthly wearing plastic gloves on your own hands.

• Alert neighborhood. Ask neighbors to notify you if they see your care recipient out alone. Be aware of neighborhood hazards such as bridges, tunnels, swimming pools, bus stops, and heavy traffic.

• Safe Return Program. Have the potential wanderer wear an ID bracelet or other form of identification with his or her name and phone number. A medical alert bracelet is good, but the Alzheimer's Association nationwide Safe Return Program is better. This program provides an identification bracelet or necklace with a toll-free number that police can call to report a found person. Safe Return faxes information about lost persons to the local law enforcement department. To register by phone, call toll-free 1-888-572-8566. . The Alzheimer's Association Florida Gulf Coast Chapter (formerly Tampa Bay Chapter) also has a registration form on their web site, ((www.alz-tbc.org}http://www.alz-tbc.org)), or call their toll-free number, 1-800-772-8672. Limited scholarships are available to cover the $40.00 registration fee.

• Reducing opportunities to drive. If your care receiver tries to drive when wandering, lock up the car keys or disable the car so it won't start. Keeping keys and other trigger items such as coats, shoes, glasses, and purses out of sight may reduce wandering outside. Persons with dementia have been known to wander hundreds of miles in cars, airplanes, and vehicles that belong to someone else. For more information on resources that can provide an assessment of driving skills, see Stage One, section 7.

• Home Security. Use doorknobs that prevent your care receiver from opening the door. Place locks on windows and gates and consider electronic alarms or chimes on doors. Try placing locks at a height either above or below the person's eye level. Block access to stairs or outdoors with safety gates. Dark, solid color mats or rugs in front of doors or a two-foot painted threshold in front of the door may be perceived as a hole to be avoided. Use soft lighting at night to reduce confusion. Put a picture of a toilet on the bathroom door and use a line of colored tape on the floor to mark the path from bedroom to bathroom. Other doors may be labeled with symbols explaining the purpose of each room. Put dangerous chemicals, matches, knives, and scissors away. Move low furniture that the person may not see. A pressure-sensitive mat at the person's bedside or in front of doors with alarm heard only by the caregiver may help.

• The Complete Guide to Alzheimer's Proofing Your Home by Mark L. Warner, copyright 2000 by Ageless Design, may be helpful. Visit their Internet web site, www.agelessdesign.com, which links to www.alzstore.com. The Alzheimer's Store web site sells products such as alarms and stovetop fire extinguishers.

• Providing for needs. Monitor needs such as hunger, thirst, exercise, and bathroom use. Provide opportunities for singing, dancing, and taking a walk outside during the day. If nighttime wandering is a problem, limit daytime naps if possible and reduce fluid intake in the evening. Make sure your care receiver goes to the bathroom just before bedtime.

• Distraction. Redirect your care receiver's attention by offering a favorite food or drink, involving him or her in a conversation or activity, or joining your care receiver found wandering outside to guide him or her back home.

• Insure safe environment. Inspect the backyard. Make sure the fence is secure. Keep backyard paths clear, trim shrubs, and put yard tools and chemicals away. Make sure that there are no dangers, such as access to a pool or lake.

• Preparation for new environments. Prior to a move, help get your care recipient oriented to the new environment by making several visits. Be aware that wandering may occur in any unfamiliar place such as on trip to visit relatives. Be extra observant when in a different environment.

• Effect of medications. Sometimes medications cause restlessness. Check with your care receiver's doctor. Also, if needed, ask the doctor about medications to help someone with dementia relax.

• Being objective. Don't take your care receiver's wandering behavior personally. He or she may be trying to make sense in a world that no longer seems predictable. This could mean trying to meet former obligations involving a job or home, friend or relative. Sites and sounds may be misinterpreted. Some patients are affected more at certain times of the day. Some are more confused in the evening, a symptom called "sundowning". Changes in the weather, drinking alcohol, and feeling useless or helpless may also contribute to wandering.

More Resources

• Alzheimer's and Related Disorders section of the Senior Helpline's Senior Resource Directory or online at www.agingcarefl.org/caregiver/alzheimers has articles you may find helpful. Topics include legal considerations, financial assistance programs, clinical evaluation and research, progression of the disease, residential care facilities, community services, caregiver support, and a Caregiver's Checklist with tasks that need to be done by category. The Senior Resource Directory is available free to Pinellas and Pasco County caregivers and seniors who call The Senior Helpline at 1-800-96-ELDER, (1-800-963-5337). For inquiries from outside of the area call 727-217-8111.
• See Stage One, section 7: Driving Assessment in this Handbook for help in making the decision of whether to take away the keys.
• Call the Senior Helpline for transportation options and resources. Find "Transportation Options" online at www.agingcarefl.org/aging/transportation.

To access the services or programs described in the Handbook, call The Senior Helpline at 1-800-96-ELDER, (1-800-963-5337). For inquiries from outside of the area call 727-217-8111.