About 60 percent of dementia patients wander out of their homes or institutional facilities, or get lost driving, shopping, or even going for a walk. Just close your eyes for a moment: Imagine that you don’t identify who, or where, you are, the time, day or, in some cases, the year. Someone who you don’t remember is speaking to you and asking you to do things. They are trying to assist you with daily living skills or other routine yet personal activities, but you don’t understand why. Thus, you become anxious and frightened.
To relieve your anxiety, stress and confusion, you try to move about and begin to pace to help relieve some of your apprehension with the circumstances as you see them. If you are being supervised, especially during the day, it may not cause you any harm and the exercise may relieve your anxiety. Conversely, one day a door is left unlocked and while unsupervised, you just walk out, thinking your actions are going to lead you to the person you are looking for ? maybe a mate who passed on many years ago, or a job you once held that you need to get back to.
But you are disoriented and don’t respond to shouts or ask for help, and rarely do you leave any physical clues behind. Keep in mind that a person with Alzheimer’s/Dementia has no control over often-annoying repetitive behavior. The disease leaves one unable to judge potential dangerous places and situations. Confusion and restlessness occur because the brain can no longer sort out cues in the environment.
Fortunately for so many, wandering seniors are found and returned safely to their homes or other living arrangements. But wandering is expected to grow as the aging population increases. We will need resources for more than 30,000 or more incidents of “critical wandering” in the coming years. [Koester] Wearing a Medic Alert bracelet and being enrolled in a Safe Return Program is also recommended.
Statistics have shown that while all wanderers may appear to behave similarly, two distinct sub-populations exist.
The first group is those who have always been physically active and always “on the go.” These individuals may wander because of a compulsion to stay busy; they have an impaired concentration; they may have traveled and were highly mobile in their lifestyle, and they are feeling anxiety or boredom. There can be other external factors, stimulants or medications as well.
The second group is comprised of individuals who wander because of their emotional states. Their emotional state compels them to get out of their environment. They either feel unsafe, persecuted, lost, disoriented or anxious. We need to keep both types of individuals safe and secure!
The goal of their wandering is to return to a place and time when things made them feel very secure and safe. Koester’s research shows that a person who wanders is usually located (89 percent of all cases) within one mile of the point last seen. Time is critical whenever a life is at risk. Those suffering from severe Alzheimer’s are more at risk and the incidence of critical wandering increases.
Because six out of ten people with dementia (the most common, Alzheimer’s disease) will wander, it is important to watch for some of the triggers: stress, agitation and restlessness, etc., It is also important to prevent a wandering incident by: always keeping all doors locked; having a recent photograph of your loved one to help police and neighbors should he/she get lost; installing keyed deadbolts in your home or condo; using safety latches up high, or down low, on doors that lead to the outside; covering door knobs with cloth, or painting them the same color as the wall. This makes them less noticeable and makes it less likely that AD patients will try to get out. Getting enough sleep and exercise is also important.
The 2009 Report from the Institute of Medicine notes that the overall health care workforce is inadequately trained to care for older adults, which is expected to reach 80 million by 2030. Today, the current health care work force has little geriatric training and our country seriously lacks physicians who specialize in elderly care – Geriatricians. A majority of our older adults are suffering from several chronic diseases, and rely on health services far more often than other segments of the population. With one person being diagnosed every 70 seconds with AD, the U.S will face a serious shortage of physicians and nursing staff, specifically those with a vast amount of elder care training.
Keep things simple! Caregivers, because you provide the majority of AD care in the U.S., knowing how to keep your loved one safe is of utmost importance. Make sure they have plenty of supervised activity to channel their energy. If they are intent on wandering, redirect them to another simple task such as folding clothes, rolling a ball of yarn, or stacking magazines. Any busy repetitive work may prevent them from being moody, withdrawn, or angry as well as keep them from following you from room to room.
Paula Camposano Robinson, RN, is co-founder and owner of Sanitasole Senior Health Services. This is an information-only column and is not intended to replace medical advice from a physician. Email me at firstname.lastname@example.org or visit www.sanitasole.net for more information. Phone: 239.394.9931.