No matter how carefully you’ve prepared a safe and secure home for your loved one with Alzheimer’s, they may throw you into a panic by disappearing without warning. You may find yourself frantically calling family members, fellow caregivers, and even the police — and wondering what you could’ve done to prevent your loved one from leaving.
Wandering is a widespread behavior among people with Alzheimer’s, especially as the disease progresses into its middle stages. And while this behavior can be frightening (and frustrating) to deal with, a clear understanding of its causes will help you reduce the risk of it happening — while a few simple security steps can often prevent it from getting out of hand.
Here, we’ll take a closer look at some common triggers for wandering behavior, and discuss some helpful tips for preventing it — or handling it effectively when it does happen.
The most frequent triggers for wandering are anxiety, confusion and discomfort.
Although wandering might seem like an inexplicable behavior, it often starts with a specific trigger. Since Alzheimer’s affects everyone differently, it may take some time to pinpoint your loved one’s triggers — but even so, it’ll help to get familiar with the most common categories.
Noise, crowds and unfamiliar people can all be extremely stressful for people with Alzheimer’s. Many wandering episodes begin in busy environments, which your loved one may be eager to escape. Even a family gathering can trigger wandering behavior, if the buzz of activity and conversation becomes overwhelming. What’s more, a person with Alzheimer’s may not always recognize family members and other caregivers, and can sometimes become upset about these “strangers” in their home.
Unfamiliar sights and sounds can also frighten a person with Alzheimer’s, who may misinterpret what they’re seeing and hearing. Some people become intensely fearful in the disease’s later stages, and may try to run away when they believe they’re in danger. Sounds of wind and rain, creaky pipes, or animals in the yard can be all perceived as threatening, and cause your loved one to attempt to flee.
Tiredness and boredom can both serve as triggers for wandering. Many people with Alzheimer’s experience what’s known as “sundowning” — an intense restlessness that begins around dusk, and may persist throughout the night. Another common cause of wandering is physical discomfort due to hunger, thirst, a need to use the restroom, or a feeling that the room is too hot or cold. Even trips to the sink or bathroom can be disorienting for a person with Alzheimer’s, and may lead to wandering around the house — or the neighborhood.
Moving to a new residence can often trigger wandering behavior, too. Your loved one may become confused about where they are, and try to find their way “back home.” If their daily routine changes, they may believe they need to get to work, go shopping, or keep an appointment. And in some cases, your loved one may simply step out onto the porch when no one’s looking, and wander off in search of some time alone.
You can help by keeping things calm, sticking to a routine, and securing the home.
As important as it is to help your loved one enjoy an active and stimulating life, it’s equally crucial to know where to draw the line for their own safety. If your loved one is easily upset by noise and crowds, you can help prevent many wandering episodes by limiting social gatherings to just a few people who your loved one recognizes — and sticking to quiet areas when you visit restaurants and other public places.
If sudden noises or unexpected visitors tend to frighten your loved one, it may be helpful to remove alarms and other noisy items from the home environment, put up “No Soliciting” signs, and cover windows and glass doors with curtains after sundown. You may want to consider adding soundproofing to windows, doors and walls, too.
You can help reduce wandering at sundown by limiting caffeine intake, and keeping daytime naps to a minimum. Daily exercise can significantly reduce evening restlessness, if your loved one feels up to it. They’ll also find it easier to fall asleep if their body clock is accurate, so make sure they get plenty of sunlight during the day, and dim the lights in the evening. At bedtime, a night light can make a dark room more comforting, and ease your loved one into sleep.
Keeping a predictable schedule will avoid many wandering triggers. A consistent daily routine will minimize the chances of your loved one becoming confused and distressed — plus, it’ll make it easier to plan engaging activities for sundown and other restless times. If your loved one does get disoriented or agitated, reassure them that they’re safe at home, and try to redirect their attention to an activity they enjoy.
Create a plan for where to search, and who to call, if your loved one wanders.
When you realize a person with Alzheimer’s is missing, it can be tough to keep a clear head. To maximize your chances of bringing your loved one home safe and sound, you’ll want to put together an action checklist now, before they wander off.
If you haven’t done so already, show your neighbors a current photo of the person you’re caring for, and give them your number to call if they see your loved one wandering alone. Make sure they always carry identification and/or wear an ID bracelet, and consider signing up for the MedicAlert Safe Return program. It’s also useful to make a list of familiar places your loved one might wander to — as well as dangerous locations such as busy roads and overpasses.
The moment you notice your loved one has wandered, start calling neighbors and searching the surrounding neighborhood. Many individuals who wander are found within less than two miles of the place they were last seen. Bushes and dense foliage are frequent hiding spots, so search those areas especially carefully. If you’re not able to find your loved one within 15 minutes, call 911 immediately and file a missing persons report with the police.
In certain cases, the only surefire way to keep your loved one safe is to prevent them from leaving the home unaccompanied. That may mean installing additional locks on doors and windows, moving deadbolts out of sight, and/or replacing mechanical locks with keyless pads that require a combination to open. Many caregivers also find it’s effective to add visual barriers in front of doors, by placing black tape or “stop” signs at eye level. These can all be hard decisions to make — but sometimes they’re for the best.