Memory loss associated with Alzheimer’s disease and other types of dementia often causes seniors to become disoriented, confused and afraid. These conditions can erase memories of once familiar people and places and may result in dementia patients wandering away from home. In fact, the Alzheimer’s Association estimates that 60 percent of Alzheimer’s patients will wander at some point. The unpredictability of this dangerous dementia-related behavior can weigh heavily on caregivers and family members.
How to Keep Alzheimer’s Patients from Wandering
When caring for a senior with Alzheimer’s at home, it is very challenging to completely prevent wandering. Fortunately, there are steps that dementia caregivers can take to minimize the risk of elopement. Explore the following wandering prevention products and strategies to keep a dementia patient safe at home.
Install Door Locks for Dementia Patients
Specialized locks and escape prevention devices can be installed on doors, windows and gates. These products require complex maneuvers to open entrances/exits, making it difficult for seniors with moderate to severe cognitive impairment to leave. Keyless electronic locks can also be used in this manner. Be aware that dementia presents differently in each person. Some individuals, especially those in the early stages, may still be able to reason well enough to unlock some of the “dementia-proof” devices on the market.
Another option is to install sliding bolt locks out of a senior’s line of sight—either up high or down low on door frames. These can be used on their own or in conjunction with other locks to serve as a back-up method for securing doors.
Never lock a person with dementia in the home by themselves. Proper supervision is required to ensure their safety, and doors should only be secured when another person is present. Otherwise, the dementia patient could be trapped in the event of an emergency, such as a fire or urgent medical issue.
Install Anti-Wandering Alarms
There are many types of wandering alarms for dementia on the market that can alert caregivers to possible elopement. Options include motion sensors, pressure-sensitive mats that can be placed on floors, seats, or beds, and door and window monitors. When triggered, all these devices sound an alarm, notifying others nearby that the dementia patient has either entered a certain area of the home, gotten out of their chair or bed, or opened a door or window.
Some of these wireless wandering alarms feature remote receivers that can be placed in a certain room of the house, such as a caregiver’s bedroom for added security at night. Some receivers are even portable, meaning a caregiver can take it with them as they move around the home and even outside, depending on the device’s transmission range. A traditional hardwired or wireless home security system featuring contact sensors on exterior doors and windows can also be set to chime when any entrance/exit points are opened.
Disguise Entrances and Exits
It may seem like an odd approach, but camouflaging doors and windows can sometimes prevent a senior with dementia from finding a way out of their home. Studies have shown that conditions of the brain, such as Alzheimer’s disease and other forms of dementia, can have a pronounced effect on eyesight. While most people only think of the brain and spinal cord as the components of the central nervous system (aka the “command center” of the body), it also includes the retinas and optic nerves. It isn’t yet known exactly how Alzheimer’s disease and the sense of sight are related, but damage to brain cells seems to interfere with the way the eyes receive stimuli, how information is communicated to the brain and how it is processed there. Furthermore, Alzheimer’s disease mainly affects older adults who are prone to age-related eye diseases like macular degeneration, cataracts and glaucoma.
Caregivers might consider painting doors and doorframes the same color as walls or hanging curtains on windows that match the color of the walls. This will help exits blend in with surroundings and make them less “visible” to loved ones living with dementia. Another optical trick that some dementia caregivers have used is placing a dark, solid colored doormat in front of doors leading outside. Something about the visual effects of dementia may cause care recipients to perceive the mat as a “hole” in the floor, thereby deterring them from using the door.
Provide a Safe Space for Wandering
Flexibility is key in Alzheimer’s care. Dementia-related behaviors are the product of a “broken brain,” which cannot be fixed. Confusion and disorientation can make seniors with dementia scared, anxious, angry and even aggressive. If your attempts to thwart wandering fail to address a loved one’s restless behavior and compulsion to move about, you may need to adjust your approach.
Instead of preventing a senior from wandering, provide a safe and supervised place in the home or yard for walking or pacing. Going for walks together during the day may also help curb the impulse in the evenings when many dementia patients experience symptoms of sundowner’s syndrome and try to elope. Not only will this help a senior maintain their mobility but it will also help them work off excess energy and feel more control over their movements.
Use Visual Cues for Reorientation
People who have Alzheimer’s often forget where they are, even inside their own homes. Visual reminders can provide clues and trigger memories that help reorient dementia patients to their surroundings. For example, post descriptive photos on the doors to various rooms, such as the bathroom and kitchen. Another approach is to post stop signs for dementia patients on doors that they shouldn’t open or areas of the home that would be dangerous for them to gain access to.
Look for Patterns in Dementia Behaviors
Many people with Alzheimer’s disease have a pattern to their behaviors. Watch for triggers, such as a certain time of day, activity, person or setting. For example, if a senior tends to wander at the same time every day, a planned activity at that hour or just before could distract from wandering or ensure they don’t have the energy to pace around afterwards.
Hide Car Keys and House Keys
In addition to wandering on foot, people with Alzheimer’s might attempt to drive. Getting lost while driving not only endangers the dementia patient but also the public. Be sure to store keys to all vehicles and exterior doors in a secure place. Coats and shoes may trigger a dementia patient’s desire to go out or resume deeply engrained routines like running errands, picking up kids from school or driving to work. Keeping these items out of sight may help deter them.
Warn Neighbors and Authorities
Caregivers often don’t know their loved ones are missing before someone finds them. If neighbors are made aware of the situation, they can be on the look-out in case a senior wanders outside and around the community. It’s also important to notify the local police about your loved one’s tendency to wander. Many law enforcement agencies have developed voluntary registries for caregivers to submit information about and photos of loved ones with dementia to ensure they are returned home safely. Police officers and other first responders then have access to this information and can use appropriate dementia-friendly protocols in the event they encounter a senior who is lost or involved in an emergency situation.
Use a GPS Tracking Device
If your loved one wanders, a wearable tracking device can help emergency personnel find him or her quickly. With most Alzheimer’s tracking systems, the senior wears a personal transmitter—usually a bracelet, anklet, necklace or clip-on device—that is detectable using GPS technology, radio frequency identification (RFID) technology or online location management services. Many communities have implemented a program called Project Lifesaver to track and locate dementia wanderers. Check with your local police station to find out if this program or something similar is available in your area.
Some personal medical alert devices also include GPS capabilities and wandering alerts that allow caregivers to program “safe” geographical areas and receive notifications when a senior moves outside of these zones. However, tracking devices are only useful if a dementia patient is wearing their bracelet or pendant while wandering.
Consider Emergency Medical IDs
A lower-tech contingency plan is having a dementia patient wear some sort of medical identification. The Alzheimer’s Association partners with the MedicAlert Foundation to operate a nationwide identification system called Safe Return. The person with Alzheimer’s wears a piece of medical ID jewelry that is engraved with critical information and a phone number to call if they’re found while wandering. Their caregiver can contact the 24/7 emergency response team to report them missing.
Prepare for the Worst-Case Scenario
Many seniors with dementia do not show any indication that they are prone to wandering before they start. If your loved one were to elope despite your best efforts to keep them safe at home, what is your game plan? In addition to considering the anti-wandering products and strategies listed above, be sure to add a recent photo and detailed physical description of your care recipient to their emergency medical file (along with information about their vehicle if applicable).
You can find some of the security, safety and fall prevention devices mentioned above and other useful caregiver supplies in the Senior Care Products Directory.
Sources: Alzheimer’s Association: Wandering (https://www.alz.org/help-support/caregiving/stages-behaviors/wandering); Eye conditions provide new lens for screening for Alzheimer’s (https://newsroom.uw.edu/news/eye-conditions-provide-new-lens-screening-alzheimer%E2%80%99s); Association of Preclinical Alzheimer Disease With Optical Coherence Tomographic Angiography Findings (https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2697402); Safety: Technology 101 (https://www.alz.org/help-support/caregiving/safety/technology-101)