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How to Stop the Alzheimer’s Wandering Crisis

Jeff Anderson
By Jeff AndersonOctober 9, 2013

Alzheimer's Wandering Graphic
Last week, Google News issued 10 alerts for missing seniors with dementia. Alzheimer’s wandering is one of the biggest problem behaviors that caregivers must deal with. Memory care providers face similar challenges in terms of keeping wanderers safe.

Learn about the steps we can take to help stop the Alzheimer’s wandering crisis.

Alzheimer’s Wandering Crisis

According to the Alzheimer’s Association, six in every ten people with Alzheimer’s disease exhibit wandering behavior. It can happen on foot, it can happen while driving, and the Alzheimer’s Association says if wanderers are “not found within 24 hours, up to half will suffer serious injury or death.”

Due to America’s growing number of seniors, many of whom are afflicted with Alzheimer’s and dementia, wandering is increasing. It’s not possible to get accurate numbers on wandering trends because, as the New York Times explains, not all states track search-and-rescue incidents involving seniors.

But, some states are keeping records and their figures are astounding. For example, the Times articles notes that in Oregon, searches for lost male Alzheimer’s patients tripled between 2006-2010.

Why Do People with Alzheimer’s and Dementia Wander?

Older Man with Confused Look
Of course it’s difficult to imagine what it’s like to have Alzheimer’s or dementia, but there seem to be three primary causes of wandering in seniors with dementia:

  1. Confusion: People with Alzheimer’s and other kinds of dementia can become confused and disoriented about their location and get lost in their own home or senior community. Sometimes this confusion peaks in the evening because of a dementia symptom known as sundowner’s syndrome.
  2. Compulsion: Many of us have a friend or loved one with obsessive-compulsive disorder (OCD), or at least have seen characters with the illness portrayed in the media. Alzheimer’s and related disorders can prompt suffers to have a compulsion to just go “somewhere else.” Where that “somewhere else” is may not be clear or even known to the person with Alzheimer’s, but it can be a strong and almost irresistible urge. Family caregivers can sometimes use redirection (healthy distractions) when a senior has gotten stuck in a compulsive mindset.
  3. Going Home: Even when seniors with Alzheimer’s disease have been residing in the same house for decades, they may not feel at home (perhaps yearning for their childhood home, instead). In the above mentioned Times article, the husband of an Alzheimer’s patient, John Machett tells a classic story: “It started with five words. — ‘I want to go home’ even though this is her home.” People with this type of drive are often said to be an “elopement risk” because they will take extreme measures to get to where they think they belong (even if that place is merely illusory). Because people with this type of wandering can be so stubbornly determined to leave wherever it is they happen to be, they often require secured memory care.

If You Have a Wanderer in Your Family

Caring for a loved one who has wandering issues is one of the most difficult aspects of family caregiving. Here are some rules of thumb that that could help prevent many cases of wandering:

  • An elderly person with occasional bouts of confusion may require less supervision, but caregivers still must be careful about leaving such seniors alone
  • If a senior is at risk of wandering, enroll him or her in your local “Silver Alert” directory or a similar registry if one is available
  • Loved ones of seniors at risk of wandering can notify trusted neighbors in a block radius, introducing them to the senior if feasible
  • Seniors with serious wandering problems can’t be safely left alone and require constant supervision
  • Care teams made of visiting caregivers, family, and even kindly neighbors can help provide companionship and provide supervision to seniors who wander
  • To keep a loved one from wandering away at night, consider house adaptations such as “hard-to-reach slide bolts for doors or doors disguised with hanging towels” according to Dave Baldridge, Executive, Director of International Association for Indigenous Aging
  • Explore monitoring and tracking technologies (also discussed below), but don’t become over-reliant on them

Despite caregivers’ best efforts, the required patchwork approach to 24-7 care often doesn’t hold, especially in the later stages of Alzheimer’s when wandering may be coupled with aggression or other behaviors unmanageable by non-professionals. Many families choose memory care facilities if care becomes unmanageable at home.

Nationwide Silver Alert

Many states use an “Amber Alert” system to identify lost or abducted children, the majority of states also have so-called “Silver Alert” systems to help find seniors who have wandered off and gotten lost. Although the term “Silver Alert” has gone out fashion and been replaced by broader terms or more politically correct terms, 32 states have programs to identify missing seniors according to the National Association of States United for Aging and Disabilities (NASUAD). An additional nine states have wider-ranging programs to help find missing person but aren’t senior specific. If you live in one of these states, you can register your loved one in a directory (usually for a small fee) to help facilitate speedy recovery.

But not every state participates in Silver Alerts. For example, in Washington State there is no system to call for the public’s assistance finding missing seniors despite the fact that the state participates in the Amber Alert program for children. Silver Alert critics argue that “color coded alerts” like Amber Alerts and Silver Alerts numb the public to emergency announcements, especially when overused, and can lead to scenarios like failure to evacuate in the face of disasters like Hurricane Katrina.

Because of the variation in Silver Alert laws, directories and registries, some advocates and lawmakers have called for a Nationwide Silver Alert program. For example, in 2010 a bipartisan coalition of Congresspersons proposed a bill that would have funded a national silver alert program, but seemingly more pressing troubles occupied Congress’ time that year and the bill was never voted on.

A renewed effort to invest in such a national program could go a long way to mitigating the Alzheimer’s wandering crisis.

New Tracking Technologies

There are a wide range of technologies that can help family caregivers and senior care providers help keep wanders safe.

By in large, these devices use GPS tracking and they range from bracelets with GPS chip in them, to normal looking tennis shoes – also with a GPS chip embedded within. Of course, these devices are only effective when used in tandem with an attentive monitor. Though, even when the human monitors are attentive, these technologies aren’t fail-safe.

Seniors who wander can remove them, or get themselves into a dangerous situation before help arrives despite the tracking devices. Another limitation is that these tracking technologies are only effective in areas with solid cell-phone coverage.

Wandering and Memory Care Communities

The problem of wandering requires many families to seek dedicated, secure memory care for their loved one. Secured memory care communities use various discreet and dignified technologies to prevent seniors who wander from risking their safety. While in the old days secured memory care communities (or areas within communities) were called “lockdown units”, today the institutional sounding term is both inaccurate and passe.

Rather than locked doors, secured memory care providers may use the types of tracking technologies we described above. Some providers will have silent alarms on the exit doors of the memory care area so staff can quickly attend to a resident who has ventured too far. In other cases, the whole building is secure, requiring staff to welcome guests and walk out residents who are safe to leave the premise.

It’s imperative that residents who are potentially an “elopement risk” or “flight risk” are identified by staff beforehand so that a resident who wanders is not placed in a situation without enough supervision. This can be assured with good intake and assessment procedure by providers, and when family members are clear and open about their loved one’s needs.

Making Memory Care Feel Like Home

Residents of ‘Dementiaville’ riding a trike made for two

While residents at memory care communities may be secured, the locations do not feel like prisons. Landscape and design elements are used to cultivate a sense of freedom, ensuring that residents don’t feel trapped.

For example, at most memory care communities, residents have access to the outdoors at all times, (weather permitting), typically in a central courtyard which provides a degree of safety. Another strategy is the use of circular hallways that both prevent residents from becoming disoriented and also foster a sense of independence and freedom (for residents can walk and walk without any need to be stopped). Memory care communities often have gardens with carefully designed walking paths (also often circular) that maximize space and provide a sense of going on a journey.

Some pioneering memory care communities, like the Dutch community known as “Dementiaville” even replicate entire little villages so residents don’t feel segregated.

What’s more, at most memory care communities, residents of all ability levels are engaged in a wide range of activities. The attention and entertainment they receive from staff and visiting loved ones helps keep residents’ minds active and most residents are blissfully unaware they are being secured for their safety.

Keeping a Lookout for At-Risk Seniors

When wandering issues do occur, they don’t have to have bad outcomes. Even if you’re not a caregiver or senior care professional, you can do your part to help. If you see a senior who is alone and confused, check to see if he or she is genuinely OK and call for emergency assistance if you are in doubt. Being attentive to such scenarios can help prevent all too common wandering tragedies.

How have you and your family dealt with wandering in a loved one? Share your tips and stories with us in the comments below.

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Jeff Anderson
Jeff Anderson
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