Dementia causes people to lose their ability to recognize familiar places. It’s common for a person living with dementia to wander or become lost or confused about their location.
Six in 10 people living with dementia will wander at least once; many do so repeatedly. Although common, wandering can be dangerous, even life-threatening, and the stress of this risk weighs heavily on caregivers and family.
It might seem unbelievable that older persons who are frail, slow-moving, or use a walker could get very far without anyone noticing. But it really does happen! It is important to keep your loved one with dementia safe and try to prevent them from wandering.
There are many reasons why people wander away from home. It is important to try and find out why people are wandering so that you can stop them, especially if it is dangerous for them to wander about in the area. If the person seems to become restless and tries to leave the house at a certain time every day, maybe this was the time that s/he went to work, milk the cows, feed the chickens or fetch the children from school. Maybe the person wants to visit one of her/his children, a friend or relative. Maybe it’s just to enjoy the space and freedom of being outside and not kept in the house. Some people walk just for the pleasure of walking.
Possible reasons for wandering:
1. Navigating the home and basic needs
- Sometimes, a trip to the mailbox, bathroom, or kitchen can lead to disorientation. They might be
looking for food, a toilet, or just want to get some fresh air.
2. Feeling lost
- People with dementia do not like to be moved around. They get used to the house and area in
which they live and feel safe there. - When they are moved, they may become anxious and frightened. Therefore, it is better not to
move them unless absolutely necessary. If you do need to move them, tell them about the move
just before you are leaving or whilst you are packing but always reassure them that they will be
safe. - Should someone agree to look after the person for a while, it is better for the volunteer to come to
the house of the person living with dementia than for you to take the person out of his/her familiar
environment.
3. Loss of memory
- People may suddenly forget what they were doing or where they were going. An example is that they might have gone to visit a friend and then forgotten where they were going and might also not know where they are.
- It does sometimes happen that they forget their way home. When they forget they then wander around lost and become very anxious.
4. Boredom
- Sometimes people wander because they are bored and are looking for something to do. Try giving them things to do that they might enjoy.
5. Feeling lonely
- They may be looking for something or for the companionship of a friend or someone they
were close to and while looking get lost.
6. Unfamiliar environment
- Perhaps the place is unfamiliar and the person is leaving to find more familiar
surroundings.
7. Side effect of medication
- Some medication may cause the people to feel restless or agitated. You will need to
discuss this possibility with the doctor or clinic.
8. Anxious or upset
- Something might have happened in the house, which has caused the person to become
anxious or upset, and s/he wants to get away from it. - Family arguments, shouting or too much noise (like teenagers playing loud music) can
be some of the causes. - Try to understand what the problem might be. Ask what is wrong and listen to what they
say. - Talk to them quietly; reassure them that everything is and will be all right.
9. Living in the past
- They may attempt to do former chores. Responsibilities like caring for a child, cooking
dinner for the family, or gardening can lead to wandering. Trying to find a young child or
go to the grocery store can put them in unfamiliar environments. - Talk about where they are going, and what they are going for. Do not argue with them.
An example is if someone says that he’s going to see his mother, do not say he can’t
because she is dead; rather, talk about his mother and hold his hand as he might just
feel the need for the comfort that he would have get from his mother.
10. Too dark in the room
- They may wake up during the night and think that it is daytime and so start to prepare for
the day and wander about the house.
11. Confused when it is night or day
- They may wake up during the night and think that it is daytime and so start to prepare for the day and wander about the house.
- Maybe they have wet the bed.
- They might do things which can be dangerous whilst the rest of the people in the house are sleeping. The best way to solve this is to keep them as active as possible during the day so that they will be tired enough at night.
- Try to ensure that their normal sleeping habits are being followed: If they normally went to bed at eleven o’clock, had seven hours’ sleep and then woke up at six o’clock, it is no use making them go to bed at seven o’clock because they will then sleep from seven o’clock until two o’clock and wake up thinking it is their usual time to get up.
12. Physical causes
- Sometimes, wandering is the result of physical decline of the brain. In addition to memory, dementia can affect eyesight, mobility, and spatial reasoning.
- Visual-spatial problems: Dementia affects the parts of the brain that process visual and spatial cues. Even in a familiar setting, someone may not be able to find objects like keys, navigate grocery store aisles, or understand the layout of rooms.
- Poor eyesight: Dementia changes the way eyes see and the way the brain processes visual information. Impaired peripheral vision can leave them unable to see alternate paths or signage, while incorrect depth perception — the ability to see how far away something is — can lead to them turning earlier than intended, or wandering from a
designated path. - Poor dimension perception: Vision may become limited. This can make it difficult to distinguish between two-dimensional and three-dimensional pictures or objects. For example, a rug’s pattern may come across as something physically blocking a path or hallway, forcing them to navigate around it and become lost or confused.
- Mobility: They may gradually lose their ability to walk, go up and down stairs, and transfer themselves from bed to wheelchair. They are also more likely to fall. Mobility issues can lead to disorientation, if someone needs to avoid potential obstacles, they may forget their original intentions or become lost on an unfamiliar path.
13. Physical discomfort.
- Someone may wake because of a physical need, like hunger, thirst, or a bathroom trip. While searching for a solution, they may become disoriented and leave the room.
- Being too hot or cold. Their bodies may regulate temperature differently. This is because the frontal and temporal lobes, the parts of the brain where people process temperature and pain sensations, have begun to deteriorate. Someone could leave his/her bed to find blankets and become lost, or be unable to fall asleep due to extreme heat.
- Circadian rhythms: the natural, internal processes that tell us when to go to sleep and wake often change. Because of this, it’s common for people with dementia to feel wide awake during the night. Lying in bed can be boring when you aren’t tired, and people may get up to find something to do.
CLICK HERE TO READ MORE: How to care for your loved ones with Alzheimer’s – In the Home.
CLICK HERE TO READ MORE: How to care for your loved ones with Alzheimer’s – Outside the Home
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Home – Alzheimer’s South Africa (alzheimers.org.za)
Sources: Possible Reasons For Dementia Wandering – Alzheimer’s South Africa (alzheimers.org.za)
