Drilling Down on Dementia

By Toni Lynn Davis, MHA, CNHA, FACHCA,
President/Executive Director Green Hill Inc.

Wandering

In 2012, Green Hill hosted the bill signing, with Governor Richard Codey, of the NJ Sliver Alert legislation that created the New Jersey public alert notification system requiring media outlets to broadcast information about missing senior citizens.  If the missing senior citizen is driving, the state Department of Transportation and highway authorities let the public know through the highway message boards and alert signs. A missing senior is often the result of a person with Alzheimer’s disease or dementia who has wandered.

“It is estimated that more than five million Americans currently have been diagnosed with Alzheimer’s disease”, says the Alzheimer’s Foundation of America. 6 of 10 people with Alzheimer’s will wander and not know who they are.

Persons with dementia have a progressive nuerological disease with symptoms that are constantly evolving, creating a cascade of unusual behaviors. Wandering is a common activity of people with dementia and it can have serious consequences. Wandering may appear as aimless walking to and fro with no apparent destination in mind.  A person may be looking for something that they can or cannot identify, often something lost or misplaced and not of the present time. They may have a desire to return ‘home’ to somewhere that they used to live. They could have a need to be addressed like hunger, thirst or to go to the bathroom.

Understanding the triggers of wandering at any given time in the progression of dementia is a challenging task. The old adage of ‘the best offense is a good defense’ may be one’s best tool to mitigate the wandering of a loved one suffering from dementia.

Have a clear, delineated daily schedule of activities. A routine will provide structure for the person. Try to recognize what times of day the person seems most restless and likely to wander. Fill those periods with activity. Communications strategies that we have covered in prior articles, such as redirecting the attention of the person who is wandering, can be helpful. Asking them if they would like something to eat or drink, or if they have another need can help the caregiver understand more about their needs. Engaging them in an activity that brings them pleasure, such as music, food preparation, or an art project, may bring positive diversion. Encouraging them to talk about an event or time that brings them pleasure is another approach. Exercise like walking or dancing, keeping the person active so they tire out can reduce the restlessness that dementia often stimulates.

There are also specific tools in the home that you can use to protect the person from choosing to wander, or to give the caregiver added ability to catch them wandering before they get too far. Caregivers.org and the Alzheimer’s Association suggest the following actions:

Install key locks on your doors so persons can’t open them. Check with your municipality to see if key locks are permitted. They can create a fire hazard. You may consider a keypad lock instead. You can also install child locks on door handles. Put door locks above or below eye level which will impede the processing of them as a way to exit.

Bright, clear signage like ‘Do Not Enter’ and ‘Stop’ are phrases that can impede a persons desire to go forward. The color black used as a line of demarcation on a porch or pathway is thought to impede a person’s desire to cross it.  Some home security systems include alarms or sounds that can be activated when any door is opened. There are monitored alert bracelets with GPS technology that can track a wandering person.

Do not leave your car keys in sight. If it is not too distressing, hide items such as purses, wallets, coats or any item that you notice your loved one never leaves home without. Not only will looking for the items distract them from exiting, it can give you the extra time to recognize that they are planning to wander off. Make sure you have nightlights on throughout the house and make sure your person has gone to the bathroom right before bed to reduce nighttime wandering.

If you do care for a person that wanders, have a plan. Make sure that their clothing has nametags with contact information sewn on. Let your neighbors and local law enforcement know that you have a person with dementia living with you and give them your phone number so they can keep an eye out as well. Have a recent photo of your person and a file handy with all medical information.

If faced with the emergency of a missing person with Alzheimer’s or dementia, spend no more than 15 minutes searching the immediate area and then call 911.

For more information visit; https://www.caregiver.org/caregivers-guide-understanding-dementia-behaviors