Wandering or Searching-Curious Cases of dementia
'Mr. John, a 70-year-old, retired teacher, was getting very difficult to manage at home. He tries to open the gate and wander off, often getting lost in the neighborhood. He was diagnosed with dementia a few years back. He wakes up early, finishes his breakfast by 8:30 am, and by 9, he is restless to get out of the house. Hearing impairment made communication difficult with him. As days passed, it became difficult to keep him at home. He became increasingly angry when stopped at the door. One day, he left home unnoticed, and a few days later, he was found in another city, waiting for a bus to take him home.
'Mrs. Rajam starts searching for her kids at home every evening. She becomes panicked and calls her husband when she doesn't find them. This happens every day. Mrs. Rajam is 80 years old, her husband died 20 years back and her children, all grown up, don't stay with her. She insists to search for her kids outside when she doesn't find them at home. She argues with her maids and sometimes beats them with her walking stick when they refuse to let her go outside. '
Wandering and becoming lost is common among people with Alzheimer's disease or other disorders causing dementia. This behavior can happen in the early stages of dementia — even if the person has never wandered in the past.
If a person with dementia is returning from regular walks or drives later than usual or is forgetting how to get to familiar places, he or she may be wandering.
There are many reasons why a person who has dementia might wander, including:
Stress or fear. The person with dementia might wander as a reaction to feeling nervous in a crowded area, such as a restaurant.
Searching. He or she might get lost while searching for something or someone, such as past friends.
Basic needs. He or she might be looking for a bathroom or food or want to go outdoors.
Following past routines. He or she might try to go to work or buy groceries.
Visual-spatial problems. He or she can get lost even in familiar places because dementia affects the parts of the brain important for visual guidance and navigation.
Wandering isn't necessarily harmful if it occurs in a safe and controlled environment. However, wandering can pose safety issues — especially in very hot and cold temperatures or if the person with dementia ends up in a secluded area.
To prevent unsafe wandering, identify the times of day that wandering might occur. Plan meaningful activities to keep the person with dementia better engaged. If the person is searching for a spouse or wants to "go home," avoid correcting him or her. Instead, consider ways to validate and explore the person's feelings. If the person feels abandoned or disoriented, provide reassurance that he or she is safe.
Also, make sure the person's basic needs are regularly met and consider avoiding busy or crowded places.
To keep your loved one safe:
Provide supervision. Continuous supervision is ideal. Be sure that someone is home with the person at all times. Stay with the person when in a new or changed environment. Don't leave the person alone in a car.
Install alarms and locks. Various devices can alert you that the person with dementia is on the move. You might place pressure-sensitive alarm mats at the door or at the person's bedside, put warning bells on doors, use childproof covers on doorknobs or install an alarm system that chimes when a door is opened. If the person tends to unlock doors, install sliding bolt locks out of his or her line of sight.
Camouflage doors. Place removable curtains over doors. Cover doors with paint or wallpaper that matches the surrounding walls. Or place a scenic poster on the door or a sign that says "Stop" or "Do not enter."
Keep keys out of sight. If the person with dementia is no longer driving, hide the car keys. Also, keep out-of-sight shoes, umbrellas, and other items that might be associated with leaving home.
Ensure a safe return
Wanderers who get lost can be difficult to find because they often react unpredictably. For example, they might not call for help or respond to searchers' calls. Once found, wanderers might not remember their names or where they live.
If you are caring for someone who might wander, inform your neighbors and other close contacts. Compile a list of emergency phone numbers in case you can't find the person with dementia. Keep on hand a recent photo or video of the person, his or her medical information, and a list of places that he or she might wander to, such as previous homes or places of work.
Have the person carry an identification card or wear a medical bracelet, and place labels in the person's garments. You also might have your loved one wear a GPS or other tracking device.
Wandering. Alzheimer's Association. https://www.alz.org/help-support/caregiving/stages-behaviors/wandering. Accessed June 26, 2020.
Press D, et al. Safety and societal issues related to dementia. https://www.uptodate.com/contents/search. Accessed June 26, 2020.
Wandering and Alzheimer's disease: Your easy-to-use guide from the National Institute on Aging. https://www.nia.nih.gov/health/wandering-and-alzheimers-disease. Accessed June 26, 2020.