Wandering and dementia

What is wandering?

For people living with Alzheimer's disease and other dementias, wandering is a common behaviour. As a result, people living with dementia may not be able to find their way back home and become lost. For caregivers, wandering can lead to stress as well as safety concerns.

Wandering is a direct result of physical changes in the brain and:

• Is more common in the middle or later stages of dementia, although it can occur at any point during the disease.
• Can cause a person with dementia to become confused and disoriented, even when they are in a familiar place.
• May occur at any time of the day or night.
• May lead the person with dementia outdoors, which can expose them to dangers such as traffic or dangerous weather conditions.
• May occur on foot, by car or public transportation.

Whether or not a person living with dementia wanders, it is a good idea to take proactive steps to understand this particular behaviour and reduce the risk of the person becoming lost.

Reasons for wandering

Figuring out why a person living with dementia wanders can be difficult. Every person living with dementia is unique; however, there are some common reasons:

• The person may be too hot or too cold.
• The person may be agitated due to medication side-effects, too much noise, or other forms of over-stimulation.
• They may be experiencing delusions and hallucinations due to dementia or medication side-effects.
• They may be in discomfort. For example, the person may be hungry, in pain, or may need to use the toilet.
• They may be bored and be seeking stimulation.
• They may not have enough of an outlet for their energy.
• Restlessness or changing sleep patterns can lead to confusion between night and day.
• They may be experiencing a common phenomenon called sundowning - read more about sundowning here.
• The person may believe they need to leave the house in order to go to work, or take care of their children.
• The person may be continuing a long-standing habit. For example, perhaps the person has always enjoyed long walks.
• New environments may increase disorientation. Moving to a new neighbourhood or a new home may increase someone's risk of wandering.
• They may not recognize their own home and may want to go somewhere that is more familiar. Read more about wanting to go home below.

Wanting to go home

It's very common for people living with dementia to become fixated on wanting to "go home" – even when they are home. This can be very stressful, both for the person and for the caregiver. Often, this is a phase that will eventually pass, but in the meantime, caregivers will need to find coping strategies that are both creative and tactful.

The reason for wanting to go home varies from person to person. Understanding the root reason for people wanting to go home can help you to manage this behaviour.

Possible reasons for wanting to go home:

• They may be unable to recognize their current home.
• They may have recently moved to an unfamiliar place.
• They may be depressed.
• They may want to go to a childhood home or see a loved one from the past.
• “Home” might mean a time when life was more comfortable.

Coping strategies

• Try to determine the emotion being expressed (anxiety, fear, insecurity) and respond to that ("I'll take care of you" or "Are you feeling lonely?").
• Try to determine why the person expresses the need to go home.
• Remove objects that might be reminding the person to go home (coats, hats, purses).
• Distract or redirect the person’s attention to a different activity. Try looking at photos and reminiscing together or going for a walk.
• Try not to contradict the person’s wish to go home, instead reassure the person.
• Give the person a reason to stay longer. For example, offer them a cup of tea or their favourite dessert.

Reducing the risk of wandering

No one thing is going to prevent a person living with dementia from wandering. Multiple strategies are recommended to reduce the risk.

When it is at all possible, it is important to find solutions that honour the person's independence and freedom. The precautions you take will depend on what is appropriate for the individual you are caring for, as well as the features of the person's physical environment. For example, what will work for someone who lives in a small town may not be suitable for someone in a large urban centre.

• Keep a diary of when and where the person tends to wander. Look for a pattern - this may give you clues as to what is triggering the behaviour.
• Keep objects associated with the outdoors (car keys, jackets, shoes) out of the person’s view.
• If possible, re-locate door locks above eye level or where the person can’t see them.
• Try disguising doors by decorating or covering them with posters, wall hangings or mirrors.
• Consider purchasing alarms which will alert you when a door or window has been opened.
• Consider purchasing door mats that set off an alarm when stepped on.
• Anticipate the times the person may wander, or has wandered before like approaching nightfall (often associated with sundowning).
• Review the person's medications with their doctor. It may be possible to switch to drugs which are less likely to cause confusion or delusions. As a last resort prescription medications may be appropriate for some people who wander. Speak to their doctor about the options.
• Encourage the person to engage in regular physical activity. This can reduce agitation and provide an outlet for their energy. Walking with a caregiver or a friend, or spending time outside in a secure area may be a safe option for a person who tends to wander.
• Tell neighbours, nearby businesses and your local police or RCMP detachment about the situation. They may be able to recognize if your family member appears disoriented and be able to help.

Become prepared

• Fill out an identification kit now. This tool can help organize vital information about the person you are caring for. If the person goes missing, you will have valuable information on hand to assist police. You can find an Identification Kit on page 9 of Wandering and dementia: A guide for caregivers

If a wandering incident occurs

It’s not easy to remain calm and think clearly when a person living with dementia is lost. Keep in mind that you are not alone and others are there to help. When a person living with dementia goes missing it is an emergency – the most important thing is to not delay your response. The following strategies may be helpful if the person living with dementia wanders away from home:

• Quickly search the vicinity of where the person was last seen.
• Check for car keys, luggage, or other items that may indicate where the person may have gone.
• Contact the police. Dial 9-1-1.
• Notify the police of any locations that the person may wander to, such as a former workplace, previous address or favourite shop.
• If the person may be in a vehicle, share vehicle information with police.
• If the person may be using public transportation, share information about any transit routes they may have used in the past.
• If the person’s credit cards are gone, inform police and consider notifying credit card companies. Tracking credit card use may help to locate the person.
• Alert friends and neighbours to the situation.
• Have someone stay at home in case the person returns.
• After an emergency situation, some caregivers choose to re-evaluate the person living with dementia's living situation. The Alzheimer Society of B.C. is here to help with these decisions.

We can help

The Alzheimer Society of B.C. can assist people with dementia and their families to explore a variety of practical strategies to minimize the risk of wandering and to be prepared if wandering does occur. Contact your local Alzheimer Resource Centre or the First Link^® Dementia Helpline at 1-800-936-6033.

More useful links and resources

To learn more, download our guide for people living with dementia. This version includes forms and worksheets you can fill in online and print. (Instructions for use: Once you have opened the document, go to “File” and select “Save as” to save it on your computer. This will allow you to continue adding and editing information. To write directly in the PDF, use the cursor to click on a section with lines. This will open a text box where you can type in your answer.)

To learn more, download our guide for caregivers. This version includes forms and worksheets you can fill in online and print. (Instructions for use: Once you have opened the document, go to “File” and select “Save as” to save it on your computer. This will allow you to continue adding and editing information. To write directly in the PDF, use the cursor to click on a section with lines. This will open a text box where you can type in your answer.)

Access a print version of the guide for people living with dementia: this can be printed and filled out by hand.

Access a print version of the guide for caregivers: this can be printed and filled out by hand.