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It can be unnerving to discover that someone isn’t where you expected them to be. That’s especially the case if you have an elderly parent with dementia. Maybe they have simply chosen to spend some time in a place you weren’t expecting, such as taking a nap in that oh-so comfortable daybed in the guest room or heading out to the garden to grab a few fresh veggies – or maybe they have started wandering, and you are one step behind, unsure of where they went and terrified they might be lost or hurt.
According to the Alzheimer’s Association, 60% of those with dementia will wander at least once. Wandering can include attempts to escape a particular area, such as leaving the home – this is known as “elopement.” It can also include repetitive pacing. But the most severe and dangerous form of wandering is known as “critical wandering,” when a person makes their way outside the home and becomes lost[1]. The BMC Geriatrics journal says that critical wandering has a mortality rate of 20% - a terrifying statistic and one that makes wandering a serious problem.
What Causes Wandering?
No one knows all of the intricate reasons why a person with dementia might be prone to wandering, but there are several theories that make sense. Confusion caused by memory changes seems to be the biggest driver of wandering. Aging parents might become uncomfortable in their environment and look for ways to get more comfortable, thus they will choose to leave to get away from the discomfort they are feeling[2]. They might be in emotional distress or feel the need to complete some task. They might have a goal in mind when they leave home, but forget it along the way, or realize that their destination isn’t accessible.
Other reasons for wandering might include[3]:
· Reverting to another time in their life and following the routines of that time. For instance, they might try to drive to work, but they actually retired ten years ago. When that fact sinks in, they can become quite disoriented and upset. They might also try to handle their old chores, such as going to the grocery store, but don’t know how to get there.
· They might become lost in or around the home. In the time it takes to walk to the mailbox, they might become confused about their goal or suddenly see everything as unfamiliar, and try to get back to a familiar place.
· Physical discomforts, such as being too hot or too cold, can trigger an episode of wandering as elderly parents try to alleviate that discomfort somehow. Imagine a person who steps outside into the snow because they are feeling overly warm. While they might not remember how to change the thermostat, they do remember that snow is cold.
· They could be looking for someone or something from their past, such as their best friend or a pet from years ago. They might also be looking for a particular room or even an item from a room in a home they no longer live in.
· They might feel overwhelmed by stimuli around them, such as loud noises or crowds, and try to “escape” that situation by wandering away from it.
Spatial disorientation, combined with amnesia – both of which are common among those with moderate Alzheimer’s – can contribute to the problem[4]. To make matters worse, those who wander might not believe they are lost, so they won’t ask for help[5].
The Dangers of Wandering
A 2016 study in the International Journal of Geriatric Psychiatry found that 43% of study participants engaged in wandering and 49% of those suffered injuries, falls, and fractures as a result. The CDC reports that 20% of all falls result in serious injury, including fractures or traumatic brain injury.
Fall prevention measures, such as aging in place solutions for your elderly parent, can help alleviate the chances of falling down in the home. Consider things like grab bars in the bathroom, nonskid flooring all through the home, flat thresholds between rooms, and rocker light switches that easily illuminate an area with bright light. Medical alert technology, specifically a model with fall detection, can also provide peace of mind that if a fall does happen, help will be on the way immediately.
When someone wanders away from home, time is of the essence. Those who are found within 12 hours have a 93% chance of survival. The longer they are missing, however, the less likely they are to come home. Though some might suffer fatal injuries, they might also die from exposure to the elements. If someone is missing for 72 hours or more, there is only a 20% chance they will be found alive.
How to Keep Your Senior Parent Safe from Wandering
Obviously it is incredibly important to keep a loved one from wandering. There are some ways to get more peace of mind as your elderly parent lives with progressive dementia.
· Make sure they aren’t alone. While those with mild dementia can be fine on their own for brief periods of time, as the disease progresses they will need more attention and care. When they go out to stores or restaurants, make sure someone is with them at all times. If they begin to show signs of wandering behavior, such as pacing, it might be time to think about in-home care around the clock to ensure they stay safe.
· Invest in a home video surveillance system. If you are a family caregiver who can’t live in the home with your parent, a video surveillance system in the home can let you know they haven’t wandered off.
· Install door and window alarms. Alarms in the home that alert you to a door opening or a window sliding up can immediately let you know that your parent is trying to get outside.
· Use a medical alert device. A medical alert pendant or bracelet with built in GPS can make it easy for your loved one to get help if they need it. A medical alert system with fall detection can help them by automatically sending an alert for help the moment the tiny fall sensors in the device detect a fall. The built-in GPS allows responders to locate your senior parent quickly.
· Implement aging in place home modifications. Though wandering outside of the home can be deadly, so can pacing and other wandering activities inside the home. According to the National Safety Council, 78% of preventable injury-related deaths occurred due to an accident in the home. Among those aged 65 and older, the most common cause of death is falls. Keep your loved one as safe as possible by keep the home free of clutter, getting rid of throw rugs that can easily slip and slide, install grab bars near the toilet and bathtub or shower, and invest in non-skid flooring.
· Make it tough to leave the property. An elderly parent with Alzheimer’s might want to get in their car to go somewhere – perhaps to their former home or place of work – but that can be thwarted easily if they can’t find the keys. Those who wander outside might benefit from a tall privacy fence that will keep them inside but also obscure what’s behind the fence, making them less tempted to get over it. However, never block exits, as these are absolutely vital in the event of an emergency!
· Use soothing words and techniques. An elderly parent with dementia isn’t trying to be difficult. They are just trying to do what their brain and instincts are telling them is right at the time. So rather than correcting them, calm them instead. If they want to go to the grocery store, reassure them that you already have everything you need right there at home. If they want to go to their former workplace, ask them what they loved about work – being sure to keep it in the past tense. This sort of redirection is affirming of their memories but is also reassuring enough to hopefully keep them right there at home.
· Reduce stimuli they might want to escape from. If your senior parent really hates loud noises, keep the house as quiet and calm as possible. If they can’t handle crowds, have only one or two visitors at a time. If they are overwhelmed by something, such as the scent of dinner cooking, do what you can to alleviate it. Try to make sure they are always at a comfortable body temperature; for example, offer fans during the hottest days or extra blankets during cold nights.
· Make directions in the home clear. Label things around the house to help your loved one find what they need. For instance, labeling the cabinets with what is in them – from “dishes” to “fruit” to “cereal” – can help them stay calm and confident. Nightlights powered by motion detection can help them find their way to the bathroom with ease. Even signs on the doors that say “Emergency Exit Only” may be enough to keep them inside.
What if They Wander Away?
This is a terrifying prospect, but it does happen – so be prepared, just in case. Keep important documents in a place where you can reach for them at a moment’s notice. These should include up-to-date medical information, a few recent photos, a list of places they might go, and numbers of those friends, family members, and neighbors you can call for help. You should also have the number of local law enforcement handy.
If your loved one is wearing a medical alert watch with a GPS tracker, you will be able to locate them immediately. Make sure you know how to get in touch with the emergency call center to have them track your parent’s location.
Start looking for them immediately. Call friends, family, and neighbors for help. Remember that most individuals who wander are found within 1.5 miles of home. Many are found in areas of brush or near ponds, tree lines, and fences. Also consider whether your parent is left-handed or right-handed, as those who wander tend to generally follow the direction of their dominant hand[6].
If your parent doesn’t have a mobile medical alert system with GPS, search the immediate area for 15 minutes, then call for emergency services. Don’t wait any longer than that! Time can be of the essence when someone has wandered away from home. When you contact 911, tell them you need to file a missing person’s report for someone with dementia. If you have the Silver Alert System in your area, authorities might activate it to help find your loved one.
Above all else, try to stay calm. When it’s an emergency and time is of the essence, staying centered can help you think clearly. Take deep breaths and work methodically through your search, never hesitating to reach out for help along the way.
Alert1 is here to support caregivers and their families 24/7/365.