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 • What causes wandering?

Note: This article has been localised for an Irish audience.

Wandering is a problem for Alzheimer's patients and carers. As the disease progresses, your loved one may experience increased disorientation with regard to time and space. He or she may slowly lose the ability to recognise places and even familiar faces.

This may be due to a combination of memory impairment and disorientation or as a way of reducing stress. To carer and family, wandering can be frightening or simply exasperating, but this behaviour can almost always be traced to an underlying cause.

Wandering may occur because the person is seeking out familiar people and surroundings - and gets lost even in his own neighbourhood. Often he will wake up in the night, not recognise where he is and wander out to find "home."

Theories for the causes of wandering are legion. The causes may include the side effects of medications that cause confusion or restlessness. The person with AD may be trying to avoid an isolated and seemingly dangerous spot, or trying to escape noise, tension, or stress inside the home or residential setting. He may be acting on past routines, such as going to work and seeing friends, or trying to escape from something frightening, whether real or imagined. He may be trying to escape pain. He may be looking for something that is lost, trying to find the bathroom or get something to eat, or - like many of us - feeling the need to move around and get some fresh air. He may feel useless and abandoned, or be trying to make sense of his new surroundings. He may feel frustrated or upset with a caregiver; he may also be suffering from delusions, agitation, or paranoia. Or he may simply be bored and want to see something new.

The best approach to wandering is not to discourage it, but to control it as best you can. If, for example, a circular wandering path can be created in the home, this can help control a loved one's restlessness and should be encouraged. And much wandering is not aimless; in some homes and residential settings, a person who appears to be wandering may actually be following the same path each time, taking the opportunity to look out the window, get water and seek social contact.

However, because wandering can be dangerous - and even result in death due to exposure or accidents - carers shouldn't become complacent. Wandering can begin without warning and experts recommend the following "do's" to manage this difficult behaviour:

•Be prepared for wandering, even though it may not happen.

•Try to figure out why the person is wandering: Did anything happen just before the episode that could have caused it? Is there a time-of-day pattern to it? Does the loved one appear to have a goal?

•Get your loved one a thorough medical evaluation, particularly if wandering begins abruptly.

•Let your loved one wander where it is safe, but keep an eye on him.

•Take your loved one for walks around the neighbourhood to satisfy the urge to move about.

•Set a structured program of exercise and movement as part of a daily routine, especially if your loved one was active before AD. Some people with AD enjoy gardening or just digging in the soil.

•Use double-key locks and other simple devices affixed to doors. In some cases, placing a towel over door handles is enough to deter someone from wandering; due to brain damage from the disease, the person will not know a doorknob with a towel over it is part of a door.

•Install door alarm systems that sound an alarm if the person opens the door.

•If you're deprived of sleep because the patient routinely gets up to walk around at night, consult your general practitioner or a specialist about ways to control the wandering.

•Look around your home for hazards such as high balconies, steep stairways, dense foliage, and nearby motorways; you may want to install fences inside and out to reduce risks.

•Install night lights and gated stairwells camouflaging at all exits.

•Affix clothing labels and an identification bracelet or necklace that display your home phone number.

•Reassure your loved one frequently about where she is and why.

Here are some "don't's" in managing wandering:

•Don't argue with your loved one or physically restrain him, as these may lead to further agitation and aggression.

•Don't secure the home with bolts you can't readily open.

•Don't panic when you can't find your loved one; the majority return on their own.

•Don't rush out on your own; call the police. If the wanderer returns and you aren't home, she may go out again.

Wandering can be managed to a good degree -- it simply takes careful planning and education. And no matter how scared you are when the person disappears, don't get angry with him when he returns.

Useful Resources

Alzheimer Society of Ireland

Alzheimer House

43 Northumberland Road

Dun Laoghaire

Co Dublin

Telephone 01 284 6616

Fax 01 284 6030

Alzheimer National Helpline 1800 341341

www. alzheimer.ie

West of Ireland Alzheimer Foundation

Main Street

Ballindine

Co Mayo

Telephone 094 936 4900

Fax 094 936 4946

www.westernalzheimer.ie

Alzheimer Support Group / Dementia Support Group

Highfield Hospital Group

Swords Road

Whitehall

Dublin 9

Telephone 01 837 4444

Fax 01 837 9013

www.highfieldhospital.com

This article has been revised by Vhihealthe for its audience and may contain, among other things, information or medical practices that are unique to Ireland. Neither Consumer Health Interactive nor the original author make any warranty as to the accuracy of the article as revised, and assume no responsibility for modified content.

First published May 27, 2004
Last updated February 14, 2007
Copyright © 2004 Consumer Health Interactive

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