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Alzheimer's: Understand and control wandering
Alzheimer's causes disorientation, leading to wandering. Here's how to keep your loved one safe.
By Mayo Clinic staffAlzheimer's disease can erase a person's memory of once-familiar surroundings and make adaptation to new surroundings extremely difficult. As a result, people with Alzheimer's sometimes wander away from their homes or care centers and turn up — lost, frightened and disoriented — far from where they started, often long after they disappeared.
Three out of four people with Alzheimer's will wander at some point during the course of the disease. Wanderers who get lost outdoors may become injured or even die of exposure. This risk increases dramatically if the weather is very cold or very hot.
Why do they wander?
People with Alzheimer's wander for a variety of reasons. They may be searching for something, or trying to get away from a noisy or confusing environment. Some may even be trying to fulfill tasks from their former occupations.
Searching for something
Especially if they've recently moved to a new environment, wanderers may be searching for something or someone familiar. Or they may be trying to satisfy a basic need, such as hunger or thirst, but can't remember what to do or where the kitchen is located.
Many wanderers are looking for a bathroom. They may take medications that increase the amount of urine they produce. Elderly people are at a higher risk of developing bladder infections, which makes them feel the need to urinate more frequently.
Escaping from something
Too much stimulation, such as multiple conversations in the background or even the noise of pots and pans in the kitchen, can trigger wandering. Because brain processes slow down as a result of Alzheimer's disease, people can become overwhelmed by all the sounds and start pacing or trying to get away.
People with Alzheimer's often lose the ability to tell you when they're in pain. Instead, they may become restless or try to escape their pain by walking away.
Reliving the past
If wandering occurs at the same time every day, it may be linked to a lifelong routine. For instance, a woman who tries to leave the nursing home every day at 5 p.m. may believe she's going home from work.
This belief could be reinforced if she sees nursing home personnel leaving at that time. A planned activity at that hour could distract her from wanting to wander. Another option might be to have staff exit through a different door at the end of their shift. To reduce visual reminders of going outdoors, you may want to store coats and boots out of sight.
Tips to prevent wandering
Although it may be impossible to completely prevent wandering, changes in the environment can be helpful. For example, a woman who was a busy homemaker throughout her life may be less likely to become bored and wander if a basket of towels is available for her to fold.
People with Alzheimer's often forget where they are. They may have difficulty finding the bathroom, bedroom or kitchen. Some people need to explore their immediate environment periodically to reorient themselves. Posting descriptive photographs on the doors to various rooms, including a photo of the individual on the door to his or her own room, can help with navigation inside the home.
Offering a snack, a glass of water or use of the bathroom may help identify a need being expressed by wandering. Sometimes the wandering person is looking for family members or something familiar. In such cases, providing a family photo album and sharing reminiscences may help.
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