Signs of wandering behavior
- Returns from regular walk or drive later than usual.
- Tries to fulfill former obligations, like going to work.
- Wants to "go home," even when at home.
- Is restless, paces or makes repetitive movements.
- Difficulty locating familiar places or rooms in the house.
- Asks the whereabouts of friends or family.
- Acts as if doing a hobby or chore, but not actually doing anything.
- Appears lost in new or changed environment.
Steps to take before wandering begins
- Make sure the person carries ID or wears medical bracelet. Can enroll in the MedicAlert Alzheimer's Association Safe Return program.
- Let neighbors and local police know the person tends to wander.
- Label all garments.
- Keep an article of the person's unwashed clothing in a plastic bag to aid in finding the person if he or she gets lost.
- Keep recent photograph or video recording of person to help police in the search.
Tips to prevent wandering
- Never leave person with dementia unsupervised.
- Keep doors locked when caregiver is present.
- Add a keyed deadbolt, or another lock placed out of the line of sight.
- Cover doorknobs with loose covers that turn instead of the knob.
- Put signs on doors such as Stop, Do Not Enter, Closed.
- Divert attention away from doors.
- Install safety devices in windows to restrict opening.
- Install chimes or other "announcing system" on doors.
- Enclose yard with fencing and locked gate.
- Keep shoes, keys, suitcases, coats, hats and other items of departure out of sight.
Source: Alzheimer’s Disease Education and Referral Center, National Institute on Aging.
The tragic shooting of a 72-year-old with Alzheimer’s disease, after he had slipped out of his home in the middle of the night, wandered miles away and knocked on a stranger’s door, had experts in dementia knowingly shaking their heads.
It may seem an unlikely scenario, but it was all too familiar to those who work with Alzheimer’s patients and their families.
Wandering is typical behavior among individuals with Alzheimer’s and can happen at any stage of the degenerative neurological disorder.
Very often, wandering is the reason a patient comes in for an initial dementia diagnosis, said Dr. Larry Tune, psychiatry professor with the Woodruff Health Science Center at Emory University. Tune specializes in the diagnosis of Alzheimer’s.
“People typically don’t expect it to occur in the early stages of the disease, but it does,” agreed Leslie Anderson, president and CEO of the Georgia Chapter of the national Alzheimer’s Association.
“We’re seeing (wandering) more and more with people driving, and you don’t usually get people behind the wheel of a car in later stages of Alzheimer’s,” she said.
About 60 percent of individuals with Alzheimer’s will wander at some point in the progressive disease, with about half becoming lost or separated from loved ones, according to the Alzheimer’s Association.
Wandering and getting lost can be a result of the disorientation and memory loss characteristic of dementia. But it is also more complex than that, says Anderson.
For example, individuals with Alzheimer's often have trouble judging distances due to loss of spatial abilities, and that can lead to their confusion, she said. Wandering can also be a reaction to stressful situations. The Alzheimer's Association has tips on managing holiday stress at their website, www.alz.org.
“We see the result of this stress in driving, where the person has to make quick judgments and read road signs. That can cause them to become distracted, forget where they are and get lost,” Anderson said.
There are signs that indicate wandering behavior.
For example, a late return from a routine trip could mean the person got lost, even though the person might not admit it, said Anderson. Some people may have difficulty finding familiar rooms in their home. Or, they may constantly say they want to go home, even when they are at home.
“This could mean that they feel uncomfortable, or they don’t feel safe,” Anderson said.
From the initial diagnosis, family members should be prepared for and educated about wandering behavior.
Anderson recommends that families contact the Alzheimer’s Association to talk with counselors who can create a customized safety plan for the home. For example, alert devices and additional locks can be put on doors, and doorways can be disguised.
Having the patient sign up for a medical alert program, such as MedicAlert Alzheimer’s Association Safe Return, is also important. The 24-hour nationwide emergency response service requires the patient to wear a non-removable alert bracelet.
“At the very least, the patient should wear a medical bracelet, and most don’t,” Tune said.
Other things to do include keeping an updated photo of the loved one in case he or she gets lost, and knowing if the patient is right- or left-handed. Typically the wanderer will go in the direction of their dominant hand, Anderson said.
Family members should also have that often uncomfortable conversation about driving. Knowing when to take away the keys can be lifesaving.
“Family members need to get over the fact that there is a problem. Wandering is a common symptom of Alzheimer’s disease,” Tune said.
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