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, Parkinson’s 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.
Anyone who has memory problems and is able to walk is at risk for wandering. Even in the early stages of dementia, a person can become disoriented or confused for a period of time. It’s important to plan ahead for this type of situation. Be on the lookout for the following warning signs:
Wandering and getting lost is common among people with dementia and can happen during any stage of the disease.
- Returns from a regular walk or drive later than usual
- Tries to fulfill former obligations, such as going to work
- Tries or wants to “go home,” even when at home
- Is restless, paces or makes repetitive movements
- Has difficulty locating familiar places like the bathroom, bedroom or dining room
- Asks the whereabouts of current or past friends and family
- Acts as if doing a hobby or chore, but nothing gets done (e.g., moves around pots and dirt without actually planting anything)
- Appears lost in a new or changed environment
- 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.
- 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.
- 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 outside 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 “sun-downing”. Changes in the weather, drinking alcohol, and feeling useless or helpless may also contribute to wandering.