Prevent Wandering in Dementia by Understanding Its Common Causes

Alzheimer’s disease, in its middle stages, can present some very challenging behaviors for the individual and loved ones. One of those challenging behaviors is wandering. Up to 60 percent of individuals with dementia will wander at some time during their disease.

A man leading an older man with a walker

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Is Wandering Preventable?

Some wandering can be proactively prevented, especially if you can determine the motivation for the behavior.

Searching for a Bathroom: If you think your loved one may not be able to find the bathroom, taping a large picture of a toilet on the bathroom door can sometimes assist with this. You might also simply try to lead them to the bathroom to see if this is why they're walking around.

Hunger: If hunger could be the cause, try offering small, healthy snacks more frequently to make sure this need is met.

Attempting to Go to Work: For some individuals, the practice of going to work every day is so ingrained in them. After all, they may have done that daily for 45 years. This person may benefit from a more structured day, such as an adult activity program or being given specific tasks to do. For example, you could provide them with a few folders or files with papers in them if they worked with a lot of documents prior to the onset of dementia. Or you could offer them a basket of clothes to fold if this task was part of their regular duties. Thinking about what your loved one’s routine consisted of prior to dementia can help you know what types of activities would be meaningful to them.

Restlessness: Give adequate opportunity to exercise. If your loved one already has had a long walk, it’s less likely that they'll want or need another long walk right away. Your goal is to anticipate her needs.

Discomfort or Pain: Sometimes, people wander because they're experiencing physical pain or discomfort that is relieved by walking. Being alert to signs of pain is crucial to ensure that your loved one is properly treated and as comfortable as possible.

Distressing Hallucinations or Paranoia: If the wandering occurs when the person with Alzheimer’s is upset and seeing or hearing things that are not there, they may be experiencing some psychosis. Psychosis such as hallucinations or paranoia is when an individual is out of touch with reality. The individual’s physician should be notified of these behaviors. Sometimes antipsychotic medications may be appropriate.

Searching for Home: Wandering for people living with dementia is sometimes triggered by a desire to find their home. Keep in mind that "home" in dementia might mean their actual current or most recent house, their childhood house, or simply something that looks and feels familiar.

Boredom and Loneliness: Sometimes, boredom and loneliness can trigger wandering. Offering engaging and meaningful activities can improve the quality of life and may decrease restlessness and wandering.

Other Wandering Prevention Tips

Locks on Doors: Install a deadbolt lock on the exterior door. You may want to install it at a higher or lower level than you usually would so that it is not near eye level. Ensure that someone with dementia is not locked in a home alone in case of an emergency.

Mirrors on Doors: Place a full-length mirror on doors you do not want them to go through. The image often stops someone with Alzheimer’s from proceeding through the door.

Stop Signs on Doors or Areas: Place stop signs on doors you don’t want them to go through. The usual response to a stop sign is so ingrained that it often continues to evoke that same response.

​​Alarms: You can install an alarm on the exterior doors so that if, for example, you’re sleeping at night, it will sound if someone tries to exit the door. Alarms that automatically trigger home protection services can be installed. Or you can use a door chime or bell that makes a non-threatening sound and would simply alert the caregiver at home about an opened door.

GPS Monitoring Service: You can consider a Global Positioning System service. These are available through several online companies and offer different options. They usually have an initial cost and often an ongoing monthly cost as well. The device is wearable as a necklace, bracelet, belt, or shoe attachment. In addition to real-time tracking, they can offer proximity alerts if a loved one exits the designated safe area (even at their day program) as well as 2-way voice communication function on some devices.

Enroll in the Alzheimer’s Association MedicAlert + Safe Return program: This program provides you with an ID bracelet or pendant with information about your loved one, as well as a 24 hours/day emergency response system including law enforcement notification if your loved one is missing.

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  • Alzheimer’s Association. Wandering.

  • Disability Online. Dementia and Wandering.

  • U.S. National Institutes of Health. Wandering and Alzheimer's Disease.

By Esther Heerema, MSW
Esther Heerema, MSW, shares practical tips gained from working with hundreds of people whose lives are touched by Alzheimer's disease and other kinds of dementia.