How do you prevent a cognitively impaired person from wandering? In facilities, they have protocols, plans, policies and education. But what do you do in the privacy of someone’s home? It only takes once for you to turn your back for just a second, and the person with dementia can be out the front door.
Wandering is the term used to describe those who are cognitively impaired who get lost or forget where they are in their surroundings. It is not unfamiliar for us to have an active silver alert in our communities, which means that an older adult has become lost. This is usually an urgent situation and alerts the local media outlets to the search, which helps to get many other eyes looking for the person who is lost. Wandering is a big problem. Nearly 60% of those with cognitive impairment will wander at some point.
There are a variety of ways a house can be adapted to try to prevent a person from wandering, and these solutions are often inexpensive and not difficult to implement. Sometimes, something as simple as covering a door or window can do the trick. Other times, placing a dark rug in front of the door will appear to the person with dementia to be a hole, and they won’t cross. Other things you can recommend include putting additional locks on doors and windows. It is often advisable to put locks high or low where a person may not think to look. Other less invasive options include putting bells or alarms on doors, gates and windows. Also, having a daily routine that includes some activity can be helpful for some who wander. If night wandering is a problem, make sure the person has restricted fluids two hours before bedtime.
Prevention is key in helping a family keep a cognitively-impaired person safe. One of the first things is to try to identify anything in the environment that may trigger the person to think they need to leave. Things like an umbrella, coat hanging on a hook, or hat can trigger someone to think they need to go out. In addition, try to identify other possible triggers, such as hunger, thirst, the need to go to the bathroom, boredom, or confusion with the current environment. Often, the person with dementia may be trying to find a way to meet their needs, but they get lost in this process.
Another line of defense is to recommend that the family enroll the person in the Alzheimer’s Association Safe Return Program (www.alz.org). If a client were to wander away, police recommend waiting no more than 20 minutes from the time the person is found to be missing to contact authorities. For every additional minute that goes by, the search area broadens. Although uncommon, wandering can be dangerous—if not found within 24 hours, up to half of those who wander risk serious injury or death.
Brad Dennis, Director for the Klaas Kids Foundation, outlines typical behaviors exhibited by a missing person with Alzheimer’s or dementia:
Will usually be found within one mile of the Point Last Seen; half found within 0.5 miles. (89%)
Will usually be found a short distance from road (50% within 33 yards)
May attempt to travel to former residence or favorite place.
When a person with dementia is insisting on going out often it is best to go with them. If they are really intent on going out, it is difficult to stop them, and often trying to do so makes things worse. Saying something like, “Oh, I was going that way too, may I join you?” can help diffuse the agitation. Another option is to try to distract the person with something. Saying something like, “OK, I know you need to go, but can you help me with something first” may work. Arguing is often not the best response to a person attempting to leave. When agitated, a person with dementia may become aggressive and then leave the residence in fear or anger, which can make them more likely to be injured.
For more information on senior or homebound care, visit www.InHomebyChoice.com or call (765) 361-0600. Home by Choice has offices in Crawfordsville, Frankfort and Lafayette and is now serving Greencastle, Lebanon, Rockville and Covington.