By Janette Foley
Administrator of Dementia Services at Chicagoland Methodist Senior Services (CMSS)
Long before the sun rises each morning, Mr. Banks wakes up and gets dressed for work. A retired postal worker in his 90s, Mr. Banks hasn’t worked for years. Dementia causes him to fall into his old routine of rising in the early morning and preparing to leave for his job—behavior that causes his family to worry that he may wander. If Mr. Banks leaves the house on his own, what could happen to him? If he became disoriented, the dangers that await could be life threatening.
Why are those with dementia prone to wandering? Dementia works backwards on a person’s memory, so those affected typically lose their most recent memories first. Problems with short-term memory loss often cause confusion and disorientation, which can lead to a person being unable to recognize where he is or remember why he is there. In those cases, the natural inclination is to go in search of somewhere familiar, whether that’s a specific location like their former workplace or a more general place like their old hometown.
Any person with dementia, no matter how advanced, has the potential to wander. Everyone who wanders has a first time, so friends and family of those suffering from dementia should be on alert even if they don’t think their loved one has wandering tendencies.
The tendency to wander can be a dangerous behavior for those with dementia—and a frightening situation for caregivers. Once an affected person goes missing, the possibilities of becoming lost, injured or otherwise endangered are alarmingly high. The good news is there are a number of things you can do to prevent wandering from occurring.
Recognize the signs.
If someone seems restless, anxious or uncomfortable, it could be a sign that he wants to leave and go somewhere more comfortable. The person may even talk about needing to go somewhere specific. For example, many people affected by dementia will say they need to pick up their children or go to work, referencing old routines from some point in the past. They may ask questions, such as “What time is it?” or “When are we leaving?” and they might look for a jacket in preparation to go somewhere. Being observant and aware of these signs will help you recognize that someone is likely to try to wander.
Understand the possible cause for wandering.
When a person with dementia displays signs of wandering, it’s crucial to figure out where he wants to go and why. Sometimes, the person will directly state these things, but if it’s not clear, think back to his past and where he may have regularly needed to go. When you have that information, you can work to solve the issue and put the person’s mind at ease.
Rather than argue that what he believes is simply not true, provide reassurance. For example, if a person thinks he needs to pick up his children from school, but in reality, the children are now grown and live on their own, you could try explaining that another person is picking them up today so there is no need to worry. It may take some time to uncover the motivation to go somewhere and find a way to reassure the person, but once you do so, this approach can be quite effective.
Engage the affected person in enjoyable activities.
Keeping someone with dementia active and engaged is an important way to prevent wandering. If a person is fully engaged in an activity, he won’t be as preoccupied with whatever is causing him to want to wander. Consider what the person was interested in or enjoyed doing in the past, such as a certain hobby or work experience, and make time for activities that involve those interests. In addition, look into day programs or care services that provide social engagement. The more grounded in the present a person is, the less likely he is to wander into a mindset and place from the past.
When wandering happens:
Of course, the best-case scenario is to prevent occurrences of wandering in the first place. But it’s a good idea to put systems in place to help when someone with dementia does go missing. In those cases, every minute counts. Establishing larger-scale procedures to spread word of a missing person to the surrounding community, such as issuing a Silver Alert or similar broadcast message, would be ideal.
As a proactive measure, caregivers can put some form of identification in the affected person’s coat pockets—even something as simple as a slip of paper with the person’s name, address and an emergency contact. If the affected person is willing to wear an ID bracelet or pendant, that type of identification helps ensure that the information is visible to others.
Caring for someone with dementia, especially a person who is inclined to wander can be a daunting responsibility. For those who don’t have access to 24-hour care and supervision, a commitment to awareness and engagement on the part of their caregivers is key. Look for the signs, get to the root cause and do all you can to keep the affected person engaged in the present.
Some peace of mind for all:
Strategies like these helped prevent Mr. Banks, the retired postal worker, from wandering. Out of concern, his family and caregivers had tried everything. They put bolts on the doors and had someone stay awake with him overnight. They tried to tell him he didn’t work anymore, but in his reality, he was still employed. So finally, they tried a different tactic. While Mr. Banks couldn’t believe that he was retired, his caregivers could convince him that he had the day off. Accepting this statement, he could relax and settle in for a nice, quiet day at home.
Preventive measures, rather than reactive actions, have a greater potential to save lives. Beyond building a higher level of awareness among caregivers, better access to 24-hour care and day programs will supply the necessary supervision and engagement that those with dementia often require. Making strides in preventive efforts like those can keep people like Mr. Banks safe. We should do all we can to prevent wandering for those affected with dementia now, not only for Mr. Banks but also to ensure a more secure future for our families and ourselves as we get older.
Janette Foley is the Administrator of Dementia Services at Chicagoland Methodist Senior Services (CMSS) and the Director of The Hartwell, a residential memory care facility run by CMSS. She also provides guidance in dementia care for Wesley Place, Covenant Home of Chicago, and the Home Care divisions of CMSS. Janette credits her educational background and personal experiences with aging family members as influences on her lifelong devotion to senior care. She is a Licensed Nursing Home Administrator (LNHA), holds a bachelor’s degree in psychology from Northeastern Illinois University and is certified in Dementia Care and Programming.