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Key points
- Write a plan for wandering now; no one can stay calm and think when it occurs.
- Make a stop sign for the door and consider using a door alarm.
- Have your loved one wear identification jewelry and a tracking device.
Wandering is a very serious problem that can result in disorientation, injury, and death. If your loved one exhibits wandering behavior, such as opening the front door or going outside, you should immediately work to prevent wandering. You can introduce measures that could be used to track them should they wander out of the house (or a restaurant or shop) despite your best efforts.
Here's a list of methods that can be used to prevent wandering and help return them home safely if they do.
Understand the triggers that cause wandering; resolve situations calmly
Use the ABCs of behavior change to find the antecedents that lead to wandering and work to eliminate them. Sometimes, simple visual cues are effective, such as a red, octagonal "STOP sign" banner that can be placed on a door or across a doorway, providing a visual clue to your loved ones that they shouldn't go past it.
If you catch them trying to leave the house, use the 4Rs—reassure, reconsider, redirect, and relax—to help them stay safe in the moment. If they are determined to leave the house, sometimes taking a walk around the block with them or giving them a brief ride in the car can resolve the situation with minimal conflict.
Lock the doors
One simple way to prevent wandering is to install locks so the doors cannot be easily opened inside the house. However, you need to make sure that you can open doors quickly in case of a fire. The best locks are fast and easy for you to open but are either out-of-sight or complicated such that your loved one cannot use them.
Often, simple sliding locks on the top and bottom of the door are sufficient. Or you could use a latch at eye level that requires two steps or more to unlock. Some child-proof locks will also work, depending upon the individual and their strength.
Use an alarm
From a simple mechanical bell that will ring when a door is opened (such as in a shop) to a sophisticated home alarm system using a method to signal when a door is approached or opened. It can alert you if your loved one is trying to leave the house.
There are also bed alarms that will alert you when your loved one gets up in the middle of the night—important if that is a time when they wander. Similarly, chair alarms tell you when your loved one gets up out of their favorite chair, and motion alarms can be set to sound when someone is near the door.
Provide supervision
It is simple to say that individuals who could wander should be supervised, but we know it is a much more difficult thing to do. Nonetheless, if your loved one has shown signs of wandering, it may be prudent to have someone with them all the time.
Use respite care and day programs. Enlist family and friends to spend a few hours with them each week. Speak with others in your care team to help you find solutions.
Identification jewelry; use an emergency response service
Because wandering is common in dementia and can lead to such serious problems, we recommend that all individuals with dementia wear identification bracelets or other jewelry that includes their name, diagnosis, and emergency number to call. Some programs allow you to obtain identification jewelry for yourself, which can help to normalize the wearing of such items, especially if you think your loved one may feel stigmatized by it. The Alzheimer's Association has partnered with MedicAlert to create one such service.
Consider tracking devices
We know a few individuals who seem to be magicians at getting out of the house despite their caregivers' best efforts. Some individuals are only in the mild stage of dementia and are not going to wander off but get lost quite frequently.
In either of these cases, a tracking device worn on the wrist can be helpful. For individuals who are used to wearing a watch, wearing a tracking device often feels fine, and, in fact, there are many electronic watches on the market today can be used to track your loved one through GPS (global positioning system), cellular, and Wi-Fi signals.
Some watches are made explicitly for this purpose, while others are smart watches that anyone might purchase. Other types of trackers, such as Apple AirTags, can be worn on the wrist or around the neck or attached to clothing. Some trackers allow two-way communication, and others can be easily hooked into the police system.
Write a plan for wandering, just in case.
When your loved one wanders off, staying calm and thinking clearly is very difficult. That's one reason why it is best to write a plan now, just in case it happens. You might want to include the following information in your plan:
- A list of people to call for help, with their phone numbers.
- You can give a dozen recent photographs of your loved one to police and volunteers.
- A dozen copies of their updated medical information can also be given to police and other emergency personnel.
- Areas in your neighborhood that could pose dangers, such as busy streets, forests, or bodies of water.
- A list of places that you think they might try to get to, whether it is a friend's house, corner store, childhood home, or where they used to work.
© Andrew E. Budson, MD, 2023, all rights reserved.
References
Budson AE, O’Connor MK. Seven Steps to Managing Your Aging Memory: What’s Normal, What’s Not, and What to Do About It, New York: Oxford University Press, 2023.
Budson AE, O’Connor MK. Six Steps to Managing Alzheimer’s Disease and Dementia: A Guide for Families, New York: Oxford University Press, 2022.
Budson AE, Solomon PR. Memory Loss, Alzheimer’s Disease, & Dementia: A Practical Guide for Clinicians, 3rd Edition, Philadelphia: Elsevier Inc., 2022.
