To get the latest experience from our website, please upgrade your browser.
As life expectancy increases in the US, due in one way or another to medical advances and changes in health care, so does the population of elderly or people over the age of 60. This in turn leads to an increase the number of people with age-related diseases such as Alzheimer’s disease and other forms of dementia. Alzheimer’s disease is the sixth leading cause of death in the US and it is estimated that 1 in 3 seniors will die from Alzheimer’s or another dementia. 1
Although Alzheimer’s disease is the most common form of dementia, other dementia-related diseases/disorders may lead to wandering as well, such as vascular dementia (post-stroke), Parkinson’s disease, Huntington’s disease, etc. It is estimated that 5.2 million Americans have Alzheimer’s disease, and the numbers are expected to triple in the coming years. 6 out of 10 of these individuals will wander at some point. 2 The patient may simply be wandering aimlessly or trying to achieve an objective such as finding a bathroom or home. In either case, the patient could wander by walking, driving, or by some other means into dangerous situations.
Anyone who has memory problems and is able to walk is at risk for wandering. Wandering, in some cases, could be a positive exercise for the elderly. It provides movement, exercise, sensory stimulation or maybe even a release of anxiety or stress as long as it is done in a safe environment and some precautions are taken. But in some cases it is, what some authors refer to as “critical wandering,” or any wandering event in which an elder leaves a home or institution and is unaware of their surroundings. This exposes the person to potential dangers such as falling, traffic accidents, and/or weather conditions (exposure). 3 4 Whatever the case may be, any wandering event is a stressful burden on the caregiver that has the potential to be prevented.
Wandering is a complex behavior and there may be many different reasons why a person may wander. For the caregiver, it could be helpful to keep a journal of these occurrences to determine what the individual is trying to achieve or what may trigger the wandering event. This may help in the future to alleviate stress and frustration that may lead to further events. Some of these reasons may include:
Other reasons for wandering include: physical needs such as using the bathroom or other basic needs, social interactions, insomnia or restlessness due to their condition or even some medications, seeking fulfillment of tasks they have routinely done in the past and feel the need to continue them, or possibly getting confused about the time of day and wake in the middle of the night believing it to be time to get ready for the next day.
Collectively, it’s important to realize that individuals suffering from Alzheimer’s and other dementia-related diseases are interested in retaining their independence, and it’s important to encourage them to do so. Of course, some degree of risk is inevitable. It is important as a caregiver to maintain the quality of life as long as possible, keeping in mind the person’s environment and safety in order to help them cope with the situation and the possible reasons they wander.
The National Institutes of Health/National Institute on Aging gives these suggestions for steps to take BEFORE the person with Alzheimer’s disease wanders: 6
There are instances where even people that are considered to be at high-risk of wandering will be left unattended and they may get up and wander. These are some tips to help PREVENT the person with Alzheimer’s from wandering away from home:
* Due to the potential hazard they could cause if an emergency exit is needed, locked doors and doorknob covers should be used only when a caregiver is present.
There are several programs in place to aid in locating individuals who wander, each of which have their pros and cons. It is difficult to research the issue because, as the authors routinely state, it is an area that is understudied. However, studies that have taken place note that individuals found in the first 24 hours usually return unharmed. Most missing person reports happen only after the 24 hour window has passed. They also note that there is a large percentage of individuals found after 24 hours who have died or require immediate medical attention once found due to falls or some other type of harm.
Safe Return +Medic Alert (http://www.alz.org/care/dementia-medic-alert-safe-return.asp) – Safe Return, established by the Alzheimer’s Association in 1993, is a 24 hour nationwide emergency response system for individuals with Alzheimer’s disease or a related dementia. The emergency responders maintain a database of information on these individuals who wear a MedicAlert + Safe Return ID bracelet. When found, citizens and emergency personnel can contact the toll-free number (1.800.625.3780) to report it. MedicAlert + Safe Return will in turn contact the listed contacts as well as provide any medical history if required in order to facilitate a safe return home.
Project Lifesaver International (PLI) (http://www.projectlifesaver.org/) – PLI is a non-profit organization with a mission to “provide police, fire/rescue and other first responders with a comprehensive program including equipment and training to quickly locate and rescue “at risk” individuals with cognitive disorders who are at constant risk to the life threatening behavior of wandering including those with Alzheimer’s disease, Autism, and Down Syndrome. Project Lifesaver has over 1,300 participating agencies throughout 47 states in the U.S., Canada, and Australia.” 7
Silver Alert – Modeled after the AMBER Alert program, the Silver Alert relies on law enforcement, the media (radio and television broadcasts), and highway signs to inform the public of information regarding missing elders and others who are cognitively impaired. Although a national legislation has yet to be put into place, several congressional members have introduced a National Silver Alert Act since 2008. 32 states already have Silver Alert programs in place along with several others that have legislation pending. Unlike Safe Return and PLI, the Silver Alert is administered at the state level and Individual registration is not required (except in Texas). People typically are required to meet certain criteria (age and cognitive function) in order to activate an alert. For more information, check with your individual state organizations on locating missing elders.
It is not difficult to see that Alzheimer’s disease and other dementia-related diseases do present a problem as our older population grows in this and other countries. Issues concerning wandering and safe return is a subject that is understudied. It is important to mention that not one program is fool-proof and each has its pros and cons and each vary in costs depending on the type of coverage and response system. Its best to evaluate the programs and determine what works best for the caregiver and loved one along with assessing the individual’s tendency to wander and cognitive ability.
National Alzheimer’s Association 2013 Facts and Figures. http://www.alz.org/downloads/facts_figures_2013.pdf ↩
Alzheimer’s Association. “Wandering and Getting Lost”. http://www.alz.org/care/alzheimers-dementia-wandering.asp. Copyright 2014. Accessed on March 3, 2014. ↩
GeronGuide. “Alzheimer’s Disease: Understanding Wandering Behavior”. Copyright 2009-2014. http://www.geronguide.com/gg/Alzheimers+Disease+-+Understanding+Wandering+Behavior. Accessed March 5, 2014. ↩
Petonito G, Muschert GW, Carr DC, Kinney JM, Robbins EJ, Brown JS. Programs to locate missing and critically wandering elders: a critical review and a call for multiphasic evaluation. Gerontologist. 2013 Feb;53(1):17-25. ↩
Alzheimer’s Society. “Factsheets: Moving and walking about”. Last reviewed: June 2012. http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=152. Accessed March 5, 2014 ↩
National Institutes of Health – National Institute on Aging. “Alzheimer’s Caregiving Tips: Wandering”. July 2012. http://www.nia.nih.gov/sites/default/files/Alzheimers_Caregiving_Tips_Wandering.pdf. Accessed on March 6, 2014 ↩
Project Lifesaving International. “Project Lifesaving Homepage: Mission”. Copyright 2004-2012. http://www.projectlifesaver.org/. Accessed on March 6, 2014 ↩