People living with dementia can display many behavioral traits that are difficult to manage, one of the most common and challenging is wandering.
Dementia-related wandering can be described as aimless meandering, repetitive locomotion or purposeful locomotion that causes a social problem such as getting lost, leaving a safe environment or intruding in inappropriate places.
Wandering is a common behaviour in people living with Alzheimer’s disease and other forms of dementia. As the illness progresses, clients feel a compulsion to move, walk, and wander. Most wandering seems confused and aimless but this is not always the case.
Purposeful wandering - People with dementia who wander are often trying to get somewhere for a specific purpose - it’s just that the reason doesn’t tie in with where they should be at that current time. They will often resent anyone trying to stop or interrupt them. Purposeful wandering may arise from things like:
Aimless wandering - This type of wandering is characterized by a lack of focus or no apparent direction. Reasons for aimless wandering may include:
Safe wandering - Not all wandering is harmful and sometimes, intervention is not necessary. Staff monitoring is always required as a lack of sound judgment may lead the person to unsafe situations. For safe wandering, the following conditions must apply:
Risky wandering - On the other hand, risky wandering should be prevented with interventions tailored to each client. Clients who tend to wander with potentially dangerous consequences are those that:
Boundary transgression (BT) is when wandering leads the client to out-of-bounds or hazardous situations. Wandering is a serious behaviour that may lead people to become lost, trapped or exposed to the elements. It can result in injury, violence and even death.
Most care facilities have an Identification Kit for residents prone to wander, to assist police if a resident goes missing. The kit should have the resident’s name, preferred name, photograph, and description of general appearance. There are also several styles of IDs available that can be worn by residents including bracelets, necklaces, and watches.
Fortunately, adverse outcomes are rare. Most care facilities have policies in place to manage wandering behaviour and prevent dangerous situations from arising.
It is more common for a wanderer to walk into the space of another resident and upset them; a bedroom or toilet for example. Such cases are successfully resolved with caring staff and suitable distractions and activities.
Channeling wandering into safe activities can start by recognizing triggers. It is useful to keep a record of patterns and cues to figure out ways to manage the situation.
Step 1 - Observe what is happening:
Step 2 - Frequency and time of day:
Step 3 - Consider the background and other underlying causes:
We'd love to hear your feedback!
What strategies have you found to work well with wandering behaviour?