What to Know About Alzheimer’s Wandering

Alzheimer’s wandering is a common but dangerous side effect of Alzheimer’s disease and other types of dementia. Researchers estimate it affects 6 in 10 people with the disorder, causing them to become confused and disoriented. 

Wandering occurs at various stages of the disease and for various reasons, but it’s particularly stressful for caregivers tasked with keeping their loved ones safe.

Fortunately, there are a number of preventive measures you can take to secure your home, minimize your loved one’s symptoms, and lower the risk of an accident or injury.

Anyone living with Alzheimer’s disease or another type of dementia is at risk of wandering. 

Even though wandering is defined as “traveling aimlessly from place to place,” that isn’t entirely accurate when describing wandering associated with neurodegenerative disorders. Instead of having no purpose, Alzheimer’s wandering is often a form of communication. 

Bryan Reamer-Yu, Executive Director at The Memory Spa in Fullerton, California, says that “people who wander are typically doing so for a reason. Part of the job of the caregiver is to determine what they’re trying to communicate.”

He continued, “attempt to figure out what they are trying to tell you through movement and help them find a solution. Once you understand what it is they’re trying to tell you, it’s possible to mitigate the risk.”

Alzheimer’s wandering occurs for a variety of reasons, including:

• Stress or fear

• Searching (Ie: Looking for an object or an acquaintance.)

• Basic needs (Ie: Hunger, exhaustion, a need to use the toilet.)

• Following past schedules or routines

• Visual-spatial problems 

Other times, “it’s part of a pattern of agitation, psychosis, or depression and thus amenable to treatment,” said Mark D. Rego, MD, Assistant Clinical Professor of Psychiatry at the Yale University School of Medicine in New Haven, Connecticut.

“But in fact, most of the time, patients walk around or try to leave because it’s what they’ve done all their lives. If the patient is generally calm and merely wandering around (as is the case most of the time) there is no need for direct treatment. Nor should they be prevented from walking around. Rather, the environment must be made safe.” 

You may not be able to stop Alzheimer’s wandering entirely, but there are steps you can take to prevent it from resulting in an emergency. Common tactics experts recommend include:

Keeping your loved one busy throughout the day. People with Alzheimer’s and other types of dementia benefit from a set schedule. A routine provides structure to the day, helps reduce agitation, and can even improve their mood. 

If your loved one tends to wander during a certain time of the day (like the mid-afternoon or evening) try to plan activities during these times. Preparing a meal, going for a walk, or playing a game may help eliminate feelings of anxiety or restlessness.  

“I had a caregiver who told me her husband always tried to sneak out of the house on the weekends around 4:00 PM,” said Reamer-Yu. “After some discussion, we decided that she would take him for a walk every day around 3:30 PM. They both enjoyed the exercise and he stopped trying to leave the house.” 

Attending to your loved one’s basic needs. As previously mentioned, wandering is often a way to communicate through movement. If your loved one is hungry, thirsty, or needs to use the bathroom, they’re more likely to get up and move around.  

It’s possible to minimize confusion by:

• Eating meals and snacks at the same time every day.

• Encouraging proper hydration with water or nutritionally enhanced beverages.

• Gently remind your loved one to use the toilet every two to four hours.

• Reducing fluid intake two or three hours before bed.

If your loved one is incontinent, change their diapers as soon as they’re soiled and/or monitor their catheter regularly.

Determine how your loved one reacts to different surroundings. Certain environments, like the grocery store or a busy mall, can exacerbate feelings of anxiety or confusion. Observe your loved one at home and in public to determine where they’re most comfortable. If you determine that certain activities or locales trigger wandering behavior, try and avoid them in the future.

Using a wearable tracking device. If your senior is in the early stages of Alzheimer’s disease or another type of dementia, it’s important to encourage their independence. Investing in a wearable device, like a GPS tracker or Apple Watch can provide peace of mind without limiting your loved one’s mobility. Electronics can be especially beneficial for long-distance caregivers who are unable to provide in-person monitoring at all times.

There are several things to consider when preparing your home to accommodate a loved one who wanders:

Eliminate trip hazards. There’s no way to prevent wandering entirely, so it’s important your home’s interior encourages safe risk-free movement. Clear all hallways and walkways so they’re easy to navigate. Remove cords or wires that could cause your loved one to trip and tidy up clutter like stacks of books or boxes.

Increase lighting throughout the home. Dark or poorly lit areas increase the risk of a slip-and-fall. Poor lighting also makes it difficult to recognize faces or surroundings. By installing warm, bright lighting throughout your home, it’s possible to minimize feelings of confusion or anxiety, while allowing for increased mobility.

Install locks and motion sensors. Never leave someone with Alzheimer’s disease or dementia alone at home, but do take steps to prevent them from leaving on their own. Experts recommend installing deadbolts outside their line of sight or covering door knobs with pieces of cloth that match the door color. You might also want to install motion sensors. These small, electronic devices set off an alarm if someone opens a door, leaves a door unlocked, or exits the home unexpectedly. 

Safety-proof the kitchen. “I usually recommend that controls be taken off the stove and large knives are put away, especially if the patient was a cook,” said Rego. “This isn’t about preventing aggression, but about what patients have done before but can’t anymore because it’s no longer safe.” 

Hide keys, wallets, and other personal items. Personal items like a wallet, purse, or set of keys can trigger an individual’s memory of leaving the house for work or to run errands. Store these items in a drawer or lockbox where they aren’t visible or easy to access. 

Set up an area for playing music. Listening to music is a wonderful way to relax, but it may also minimize the risk of wandering behavior. “I have seen many times the entire patient population of a nursing home, including many patients I was treating for agitation, sit perfectly still for a long concert of live music,” said Rego. “This goes for any level of dementia. Of course, you must use the music of their era, or play artists they liked when they were younger.”  

Caring for someone who experiences Alzheimer’s wandering isn’t always easy, but with planning, education, and a willingness to try different approaches, it’s possible to develop a care plan that meets your loved one’s needs.