I recently went to a professional training to learn more about “Challenging Geriatric Behaviors”. The speaker, Anne Thomas, a geriatric nurse practitioner (and PhD, ANP-BC) spent the day discussing dementia and the medical, environmental, and personal causes of various “problem” behaviors . This month I will share with you some of the things that I learned about wandering.

What struck me most about wandering was the notion that wandering in and of itself isn’t a problem. Think about yourself (healthy and well)…when you are upset, stressed, bored, etc…how do you cope? A lot of us, myself included, walk. I walk every morning for exercise and to clear my head. I walk away from the kids when they are creating a lot of commotion or irritating me. I walk from room to room trying to get things done. I pace when I am nervous. Being able to move about my environment is something I take for granted. It is something that I, and most others, NEED to do.

Fast forward 40 years…if I have dementia, I will likely wander. My purpose may be confused, but my body will have a need to move…when I face a lot of commotion, when I am stressed, when I am happy, when I am nervous. Thought of in this context, the wandering itself is “normal”.

The issue is keeping someone safe while they do it. Obviously it is not safe for someone with dementia to wander outside of their home alone. If your loved one is someone who likes to be on the move, consider getting a Medic Alert/Safe Return* or Project Life Saver* bracelet for them. Should they ever wander away, their chances of being located quickly and safely increase significantly.

Improve your home security so that your loved can not wander OUT of the house. I have had conversations with a number of you recently about this. Some of the strategies that we have talked about include door alarms, and door locks. Door alarms can be very inexpensive and can alert you quickly and loudly if a door is opened by your loved one. Door locks can keep your loved one from opening the door at all. A Daybreak family member recently had a key pad lock installed on her door to keep her husband from wandering out. Others have used dead bolts. Keep in mind that people with dementia often loose their perception of above and below. Put locks above or below eye level and they may not even notice them. Sometimes a simple hook and eye placed high on a door is enough to keep your loved one from getting out. When considering locks, do keep in mind fire safety, and your ability to make a quick exit from the home in the event of fire

Not noticing is an important strategy that can be used to your advantage. Consider camouflaging a door so it goes unnoticed as an exit. You can purchase door murals that look like bookcases or outdoor scenes. I have seen curtain panels that are Thomas Kinkaid paintings. You can also try using a black rug in front of the door. Many people with dementia perceive a dark rug as a hole and would not walk on it, thus deterring them from going toward the door.

With your loved one safely inside your home, think about what you can do to make the wandering inside manageable. Consider putting things about the house that your loved one can do when they are moving around. A perpetual basket of unfolded towels sitting near a chair. A bowl of coins or nuts and bolts that need sorting always at the ready. A puzzle (appropriately sized for your loved ones abilities) always out on a table. An old jewelry box filled with inexpensive jewelry for rummaging through. The possibilities are endless. Think about what your loved one likes (or liked) and have safe “stations” set about the house to give them things to do while they are on the move.

Think about things that you don’t want touched, misplaced, or lost, and put them out of site. Purchase some inexpensive child safety latches to secure some drawers or cabinets, or even a room, so that your loved one wont have access to them.

If your loved one tends to wander at night, consider installing a motion detecting light inside your home. One family member has put one in the hallway outside of her mother’s bedroom door. Should her mother awake and leave her room at night, the light comes on, safely illuminating her mother’s path, and waking the daughter. Baby monitors can be useful as well. You can buy them that transmit noises, or you can splurge on the video monitor that transmits images. Put one in your loved one’s room at night and you can be alerted to them moving around.

Though I have the benefit of hearing various professionals speak about dementia and the “problems” associated with it, some of the most useful suggestions I have to offer are those that I have learned from other family caregivers. Consider joining a support group so you can share your ideas and learn from others.

Useful Resources:

Medic Alert Safe Return and Comfort Zone from the Alzheimer’s Association : www.alz.org or 1-888-572-8566

Project Lifesaver: Frederick County Sheriff’s Office: www.projectlifesaver.org

To purchase items such as door murals, confounding locks, alarms, etc:

Also check your local hardware store, locksmith, wallpaper store (murals), etc.

Christina Forbes, LGSW from the Daybreak Newsletter 1/2010