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She has had dementia for 2 years. Yesterday afternoon I noticed the back door was open, and she was outside, with no winter clothes on. Fortunately, she didn't go to far, but i'm nervous because we live on a busy street.

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This is scary! Common, but scary!

"Memory Care" facilities (often units within assisted living or nursing homes) are set up to be secure, that is, so that the residents cannot easily leave the premises. Exits are locked, and even elevators require a pass code. Some of the more creative escape artists wear ankle bracelets that broadcast their whereabouts.

For Grandmother to continue to live with you safely you'll have to set up your place as a security unit. Locked doors for starters. Perhaps alarms. Maybe a tracking device on GM. Search this site and others and you'll find suggestions for dealing with wandering.

This is a serious dementia symptom. It can be hard to deal with. Know that this is Not Your Fault, and certainly not something Grandmother can control. And, as far as I know, there are no treatments that reduce the urge to wander.

I sincerely hope that you can put enough practical measures in place to enable you and GM to continue to live together. If/when it is time for a care center, realize it will have to be a secure facility.
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It sounds like her dementia has definitely worsened. I would read up on this using the various articles on this site which I've linked to below.

https://www.agingcare.com/search.aspx?searchterm=dementia+and+wandering
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I agree that there is so much to be aware of when your loved one has dementia and especially if they begin to wander. It can not only be scary, but can pose a real risk to your loved one.

I was very surprised when my loved one began to wander. She already had significant dementia, was in an Assisted Living facility AND was in a wheelchair when she started. Plus, she was a real indoor kind of person, but it didn't matter. She would roll herself out into the parking lot and try to get into various cars, believing they were her car. She had no regard for safety or even where she was. I had to place her in a Secure Memory Care facility for her own protection.

Since your grandmother is in your home, you may want to find some ways to keep her safe and secure there. I know I have read some good ideas on this site before. Some involve alarms. I do know that it's challenging, because it's a 24/7 responsibility. They can even get up during the night, so it's really tough.

Do you have someone who can stay with her all day?
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Thank you everyone. This is helpful, I guess I will investigate ways to start "locking down" my home. Alarms will be helpful. Someone is usually in the home with her all day, but not always in sight. She does NOT want to go to a facility, and we don't want her to either...
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So far we haven't dealt with MIL wanting to wander, but we did with FIL while he was still living at home. They installed dead bolts up higher than usual and they were the kind that had to have a key on both sides. The key was hung on a nail nearby for safety, but he didn't know that. That kept him in the house.

To keep him out of a bedroom that was being used for storage, just a change of doorknob was all it took. They installed a keyed doorknob and kept that room locked. Too much extra furniture and boxes and stuff sitting around for him to try to walk around.

I have heard that a "stop" sign will work too. The red and white kind, it can be homemade. They see it and stop.
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Just have to ask, does she wander throughout the house as well, or just to the outside? Perhaps, if this was unusual, there was something outside that caught her attention. Maybe a bird or squirrel or something. IOW (in other words), maybe this isn't the start of a trend, but just an isolated incident. No less scary, I'm sure.
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Yes wandering is scary. My mother 81 has dementia and a few weeks ago she wandered off and was lost for 4 hours. I was beside myself with worry. Thankfully a man drove her to the local shops where her hairdresser spotted her and contacted me. She was so dehydrated (it was a very hot day) and sunburnt that she was hospitalised for a couple of days.
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