When a senior has dementia, we often focus on how it is affecting them in their day-to-day life, but we may forget, Dementia can place a burden on family, friends, and neighbours.
According to The Alzheimer’s Association, 6/10 people with Dementia will wander. Wandering is one of the least manageable and most emotionally draining behaviours that caregivers must address. You have a million tasks on your plate, and caring for an aging loved one is stressful enough without the worry that they will get lost when you look away. Even if a senior with dementia promises to you that they will not wander away, the sad reality is that they have no control over it. As the disease progresses, their memory and reasoning skills can be so affected that they become lost in familiar places and don’t think to ask for help.
Research has not been able to provide a definitive reason why people with dementia wander, and the main reasons could be related to the changes in their memory, but the tendency to wander is also linked to unmet needs and overstimulation.
Unmet needs include hunger, thirst, being too cold or too hot, feeling tired or bored, needing to use the bathroom, and loneliness. Overstimulation is caused by activities or events that cause too much psychological or mental stimulation and leads to discomfort or anxiety.
Unfortunately, no strategy will completely stop a senior with dementia from attempting to wander. Wandering remains a dangerous mystery, but there are prevention strategies and ways to reduce the risk factors that wandering brings.
Unmet Need: Hunger and Thirst
Dementia can affect seniors in many different ways, which can cause them to forget to eat or forget when they have already eaten. Both cases can cause feelings of hunger or upset stomach that leads to seniors wandering in search of relief.
Offering food and water at regular intervals to seniors who forget to eat or drink is an effective strategy you can use to prevent excessive hunger and dehydration.
Another strategy that can prevent excessive hunger and dehydration is, to offer smaller meals throughout the day and allow for healthy snacks in between. Setting up an eating schedule on a calendar where the senior can check off their meals and snacks as they eat them promotes adequate intake and maintenance of independence. You will most likely need to remind them to check this off, but if they ask for a meal that they have already eaten you will be able to show them their calendar that is helping you both keep track.
Unmet Need: Being Too Cold or Too Hot
Body temperature of seniors is often lower than younger people and they have a decreased tolerance for changes in temperature. Since their body temperature is lower, they often prefer to have their environment warmer; sometimes as high as 90F (32C)!
In warmer temperatures, dehydration can be a concern, so consult with their doctor or geriatric care manager and consider using humidifiers to make the air less dry.
If your senior loved one is moving in with you, they will prefer having a separate living area with their own thermostat to control.
Unmet Need: Loneliness and Boredom
As seniors age, they can experience seasons of loss. Loss of mobility, friends, and loved ones. Aging can begin to feel like a time of despair and loneliness.
If your senior loved one is struggling to find joy in their life, grief counseling could help them accept a loss and move forward. A pet could also provide them with someone to take care of and a reason for them to get out of bed every morning.
Encourage your senior loved one to attend senior activity centres to continue building social connections and maintain a support system. Although a loss of mobility can prevent them from doing activities they once loved, senior activity centres can provide new accessible activities such as container gardening, arts and crafts, reading, puzzles, and writing to a pen pal.
Mavencare provides supplementary transportation services to ensure your senior loved one can get to and from a senior activity centre. Our caregivers allow your loved one to escape feeling isolated, and personal care appointments provide much needed companionship and assistance with activities of daily living.
Unmet Need: Using the Bathroom
Although going to the bathroom sounds like a simple task, some seniors with dementia may need help to use or locate the bathroom. They may be unable to communicate this with their caregiver and instead open the front door assuming it will lead to the bathroom.
Placing signs for the bathroom on the bathroom door and signs that say “Do Not Enter” on doors that exit their house can help with this issue. Another effective strategy is establishing a toileting schedule and asking the senior with dementia if they need to use the bathroom every two hours. Always ensure the senior has used the bathroom before and after meals.
If your senior loved one uses briefs for incontinence, make sure you offer to change their briefs at regular intervals. If they are feeling uncomfortable in used briefs it can cause them to wander in search of comfort.
If your senior loved one often tries to leave the house, adding locks that are out of their line of sight or a security system that alerts you to opening doors can help you keep them from wandering away from the house.
Brain activities like puzzles, physical activity, and social interaction from visitors are healthy for seniors with dementia in the right dosages. It can be difficult to measure exactly how much of each activity is right for your loved one, and some days can be different than others.
If a loved one with dementia has too much stimulation, they can become exhausted and experience sundowning, a symptom of dementia that can cause them to become very anxious or upset in the late afternoon or evening. In their agitated state they may wander in search of relief.
It is best to avoid or reduce sundowning symptoms by establishing a daily routine. To find the routine that works best for your loved one you may need to modify mealtimes, reduce caffeine intake, adjust or increase lighting, avoid naps after 3pm, and create a calming environment.
Keeping a routine of activities and avoiding overly stimulating activities just before the late afternoon is also recommended.
Dementia can cause a decline in memory, and seniors who forget where they are or what has happened in their life can wander away looking for something or someone from their past.
A regression in memory can cause a senior to relive part of their past. They may feel they need to fulfill a past obligation like going to work, or feel a strong desire to “go home” to their childhood residence.
Medication side effects and pain can also cause seniors with dementia to wander. Consult with their doctor and/or geriatric care manager to better understand what factors could be triggering your loved one to wander.
It is not always possible to prevent or eliminate triggers that can cause wandering. As such, GPS devices and emergency information plans can be helpful in the event of an emergency.
Plan Ahead: Prepare for the Worst
According to The Alzheimer’s Association, 60% of seniors with dementia will wander. For most caregivers of these seniors it is not a matter of if, but when they will wander out of sight. Putting a plan in place allows you to provide emergency response teams with the information they need as quickly and effectively as possible.
The Alzheimer’s Association has put together a comprehensive list to help caregivers plan ahead and prepare for the emergency situation if a senior with dementia wanders.
Give your loved one jewelry ID and emergency wallet cards.
Know the neighborhood: be familiar with neighbors and locate dangerous areas.
Ask neighbors, friends and family to call if they see your loved one alone.
Keep a list of these people to call on for help.
Have a map ready of the dangerous locations and areas where your loved one is likely to have wandered (eg. former homes, places of worship, favourite restaurants, etc.)
Wandering seniors tend to move in a straight line, but record if your loved one is right or left-handed and map out a possible path they have followed in the direction of their dominant hand.
Keep a recent, close-up photo, a written physical description, and updated medical information on hand to give to police.
Vehicle information if your loved one has their own car or may have borrowed a family car.
When someone with dementia is missing, it is important to search for them right away. Ninety-four percent of people who wander are found within 1.5 miles of where they disappeared.
After you have contacted neighbours, search in nearby locations for no longer than 15 minutes. If you haven’t located your loved one in 15 minutes, contact the police and file a missing persons report. Your local police force is trained for this type of situation and finding your loved one as soon as possible is imperative for their safety no matter what the weather is like outside.
A search and rescue team will ask you questions about your senior loved one to discover clues for where they may have wandered away to. If you have prepared for the emergency, you will already have this map ready to share. Questions that a search and rescue team will ask you include where your senior loved one lived at every stage of life since childhood - even if those places no longer exist - as well as the jobs they held at each location, their favourite places and people they may remember from long ago. Remain calm and answer these questions as best as you can to give them a better chance of locating your loved one. We cannot be sure what frame of time that your loved one is in when they wander away, so understanding places they know from their past is incredibly important.
Take Care of Yourself Too
The best strategy you can use to care for your loved one is to ensure you are at your best. Caregiver burnout is extremely prevalent, and it affects both you and your loved ones.
Around-the-clock active care for seniors with dementia is a home care option that means a caregiver is always with your loved one and alert. If you are the primary caregiver for your loved one you should consider respite care, which is short term care that can give you relief for a few hours at a time or as long as required.
Please reach out to us if you need help caring for a senior loved one. You can call us 24/7 at 1-800-85MAVEN, but do not call us in the event of an emergency. Always contact your local authorities to report any emergency situation.
This blog post was written to help you prevent your loved one from wandering and prepare for the emergency situation before it happens. Please reach out to us if you need more help caring for a senior loved one with dementia. We know you are doing your best, but caring for a senior loved one can be an emotionally and physically draining task.