Identified Factors Leading to Wandering in Individuals with Dementia
Wandering is a common and challenging behaviour observed in individuals with dementia. Changes in routine or environment can trigger this behaviour, leading to a range of negative outcomes, including injury, death, and stress for caregivers.
In a comprehensive study, researchers delved into the issue of wandering in dementia, focusing on articles, chapters, and books published since 1975, using keywords like 'wandering,' 'behavioural and psychological symptoms,' 'dementia,' 'nursing,' and 'elopements.'
The study aimed to understand why people with dementia wander and how to help them and their caregivers deal with this challenging behaviour.
Effective strategies to prevent wandering in dementia patients involve a multifaceted approach that combines environmental safety measures, routine and engagement, personalized care, and monitoring technologies.
Securing the environment is a crucial step in preventing wandering. Installing door and window locks placed out of sight or reach, adding alarms that alert caregivers if exits are opened, removing hazards in the home, and creating clear, clutter-free walkways help prevent accidental or purposeful wandering outdoors. Fencing yards for safe outdoor access can also be helpful.
Maintaining a consistent daily schedule reduces anxiety and restlessness that often lead to wandering. Ensuring regular meals, hydration, toileting, and sleep patterns addresses basic needs that can trigger wandering.
Engaging the person in meaningful activities keeps them purposefully occupied and decreases boredom-driven wandering. Providing personalized tasks, such as folding laundry, watering plants, reminiscence activities, or walking in safe indoor/outdoor spaces, can be beneficial.
Monitoring and tracking is essential to ensure the safety of the individual. The use of discreet GPS-enabled wearables such as bracelets, watches, or shoe inserts allows caregivers to locate the person quickly if they wander despite preventive measures. Sensors, alarms, and motion detectors on doors and exits are additional tools for timely intervention, especially in care facilities.
Understanding and addressing triggers is key to proactively preventing wandering. Keeping a log of wandering episodes can help detect patterns and triggers, such as anxiety, hunger, pain, toileting needs, or feelings of overwhelm and confusion.
Communication and redirection are essential components of caregiving. Calmly approaching and reassuring the person during wandering episodes, using validation techniques that align with their reality, reduces anxiety and makes redirection more effective.
Care environment adaptations can also help deter wandering. Using visual cues like signs on doors, low-contrast rugs, or camouflage thresholds can gently deter exit attempts. Memory care communities provide specialized supervision, secure environments, and staff trained in dementia care to reduce wandering risks.
These strategies, when combined and personalized to the individual’s history, preferences, and risk factors, form an effective prevention plan that respects the person’s dignity while maximizing safety.
It's important to note that wandering can be triggered by various factors, such as confusion or memory loss, fear or anxiety, unmet needs (e.g., hunger or thirst), side effects of medications, feeling lost or disoriented, desire for independence, sleep disturbances, boredom or lack of stimulation, and unfamiliar surroundings.
In some cases, simple solutions can make a significant difference, such as ensuring the availability of favourite music, wearing glasses, or maintaining a comfortable living environment.
In summary, wandering prevention in dementia requires securing exits, maintaining routines, engaging activities, monitoring technologies, and empathetic caregiving to address underlying needs and triggers. By implementing these strategies, we can help improve the quality of life for individuals with dementia and their caregivers.
Science has unveiled that maintaining the health-and-wellness, particularly mental health, of individuals with dementia is crucial in managing the challenge of wandering. Effective monitoring and tracking, such as using discreet GPS-enabled wearables, play a significant role in ensuring the individual's safety and addressing the issue of wandering. Additionally, adopting a personalized approach to care, which includes engaging the person in meaningful activities, understanding and addressing triggers, and communicating and redirecting with empathy, can significantly reduce wandering incidents.
