Managing Wandering

The following strategies may help you manage wandering in a person with Alzheimer's disease.

Allow safe wandering

• Like walking or other forms of physical movement, wandering is often a coping mechanism for the person with Alzheimer's disease. When able to wander freely in a safe and secure environment, the person with Alzheimer's disease can enjoy a healthy outlet for feelings of anxiety, distress or restlessness.
• A fenced backyard can ensure that the person with Alzheimer's disease is able to wander safely outdoors.
• If there are doors to the outside that you do not want her to open, place locks where she cannot reach or see them. If she is able to get past the locks, a bell or alarm that signals when the door is opened is a good safety precaution. Consider camouflaging exits and providing distractions at those points (eg baskets for rummaging).
• Consider technological devices such as a sound-sensitive monitor placed in the same area as the individual that can help you keep track of her whereabouts within the house.

Look at the immediate environment

• If you notice that wandering happens consistently in reaction to the person's immediate environment, try changing those conditions (e.g., is the area too hot or too cold, noisy, isolated or dark?) This may help to reduce the person's restlessness.

Reduce the triggers

• The environment around the person with Alzheimer's disease will often trigger her wandering behaviour. It may be helpful to remove items that trigger a desire to go outside.
• Hiding car keys or items of clothing associated with outdoors, such as jackets, may help in discouraging wandering behaviour.
• Consider disguising doors to the outside by covering them or decorating them so that they don't appear to be doors.
• Anticipate events that may suggest to the person that it is time to go out (e.g. darkness falling and 'going home from work').
• Engage the person in activities or conversation to distract them. Your local Alzheimer Society can help you to request an assessment of the home environment for tips on providing a safe but comfortable setting for the person.

Provide visual cues

• Even in familiar places, a person with Alzheimer's disease can become confused or lost. However, familiar objects, furniture and pictures can give the person a sense of comfort and belonging even if they are not always able to articulate where they are.
• Consider placing labels on doors and in rooms so that she can more easily find her way through the house. For example, a picture of a bed may help her locate her bedroom.
• Disorientation at night may be reduced by leaving a light on in the hallway or providing an illuminated clock by the bed.

Develop meaningful activities

• Like everyone, the person with Alzheimer's disease may enjoy participating in activities that are meaningful and where they can feel successful. Consider involving the person in day-to-day activities, such as doing chores or helping with household duties such as peeling potatoes, setting the table or reorganizing a toolbox.
• Consider past skills and interests when presenting activities.
• Be flexible. As the person's abilities change, their interests may also change.
• Try another activity if she shows signs of becoming bored or frustrated.

Exercise

• Try to involve the person with Alzheimer's disease in a regular exercise program.
• Walking outside with her can provide stimulation as can walks in a local mall during inclement weather.
• Regular exercise can use up extra energy, and may help her sleep better.  

Keep records

• A diary or log may be helpful in understanding the wandering behaviour. A Personal Care Book (available from your local Alzheimer Society chapter) provides a record-keeping tool for storing this information in one place.
• Keep an ongoing record of times of wandering, patterns and cues.
• Make a note of any ideas you have as to why the incident occurred, how long it lasted, and what seemed to help you manage the behaviour.
• Include in your records daily notes regarding the type of clothing the individual is wearing.
• To prepare for the possibility of wandering, keep an up-to-date photo of the person handy (or in the back pocket of your Caregiver Handbook, available when you register the person with the Safely Home program). You can also use the Wandering Record section, at the back of the handbook, to record information such as the make, model and licence number of your car, as well as any credit card numbers that might be used by the person.

Establish community contact

• Let others in your neighbourhood know about the potential of the person with Alzheimer's disease to wander.
• Ask friends, neighbours, local businesses and Block Parents to stay alert to the possibility, and to call you if they suspect that the individual is disoriented.

Make the most of Safely Home

• To get the most from Safely Home®, it is important to ensure that the person with Alzheimer's disease has identification with her at all times.
• Wearing the bracelet, provided by Safely Home, is the quickest link to the program in the event that the individual becomes lost.
• The identification cards provided by Safely Home can be placed in pockets or wallets to provide backup should the bracelet become lost.
• Ensure that you have filled in the person's name and registration number on the cards.
• Police may also look for identification on the person's clothing. Labels can be attached to the inside collar of such items as jackets, shirts and blouses. All labels should include the person's name and registration number.
• If any registration information changes, contact your local Alzheimer Society or call 1-800-616-8816.