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Do You Know Why Those With Dementia Sometimes Wander Off?
There are various reasons a person with dementia walks about or wanders. Once you understand and identify a particular person’s needs or reasons you can start to discover ways to help meet them. Keeping a journal for a few weeks may help identify someone’s specific triggers.
The following are a list of possible reasons —
Habit or Routine
As much as possible after developing dementia people want to continue with their regular habits or routine. Walking is just one example. You may find that a person wants to take more walks at times of the day when they used to regularly be out. For example, when they might have gone to work or walked their dog. Try to accommodate this for as long as you can. If you are unable to accompany the person yourself, you should ask relatives or friends to help.
Many people with dementia often walk about to relieve boredom. They may also have previously participated in activities but now are no longer feeling fulfilled. Having something to do gives us a sense of purpose. Those people suffering from dementia are not an exception to this. Try to find ways to keep the person mentally engaged and/or physically active. This might be by playing games or engaging in hobbies.
Need for Physical Activity
Constant wandering may also indicate that the person feels the need for more regular exercise. There are many simple ways to incorporate more exercise into a daily routine without making big lifestyle changes. Good examples including the use of an exercise bike, walking to town rather than driving, taking the stairs rather than using an escalator or elevator or maybe doing some gardening.
Encouraging the person to leave the house at least once a day for some fresh air can also help address the issue. Observing regular routines around the neighborhood such as the garbage being collected, mail being delivered or children going to school can also help to orientate them.
Pain and Discomfort
People often walk when they are in pain, in an attempt to ease their discomfort. In the case of arthritic or rheumatic pain, walking actually helps. Alternatively, some people believe they are trying to escape from the pain. If you think this might be the case, it is best if you raise your concerns with the person’s doctor. If you notice a sudden change in a person’s walking/wandering habits and restlessness, contact their doctor who can examine them for any underlying physical illness.
Other sources of possible discomfort might include needing to use the toilet, and ill-fitting shoes, clothing or dentures. The person may also be responding to an uncomfortable environment. You may need to go through a process of trial and error to figure out the cause of their restlessness. For example, if the reason was not connected with the person needing to go to the toilet, try adjusting the temperature.
Some people wander when they are agitated, stressed or anxious. This could be a response to the issues noted above. A less common reason is that the person may be responding to hallucinations or other issues with visual perception. This is a common symptom of some types of dementia. Encourage the person to tell you about their anxieties, and do your best to reassure them in whatever way you can.
New surroundings often trigger feelings of uncertainty in people with dementia. Common examples include when respite care has been arranged, when the person moves to a new house or when they are attending a new day center. If the person’s living environment has changed, showing them familiar items, such as photographs or clothing, can assure them that they belong in this unfamiliar place.
The person may need additional assistance to find their way about. They may also be confused about the layout of their own home when they return to it. This disorientation might disappear once they become familiar with their new environment. However, as the dementia progresses, the person may fail to recognize familiar surroundings, and may even come to consider their own home as unfamiliar. You might have to make up signs, for example for the toilet, even in the person’s own home.
Restlessness and Agitation
People who tend to wander might also feel agitated, fidget, tap their fingers or practice other repetitive movements. Collectively these behaviors are known as restlessness and are sometimes a symptom of the physical changes in the brain caused by dementia.
The need to walk about can sometimes be a side effect of certain medications (such as some antipsychotics). Again, ask the person’s doctor to check whether their prescription could be causing this behavior. There is also a medical condition called ‘restless leg syndrome’ which causes an overwhelming, irresistible urge to move the legs to prevent unpleasant sensations – mostly when sleeping. This condition can result in someone getting up and walking about during the night. If restless leg syndrome is suspected please bring them in for a doctor’s visit.
A person with dementia might embark on a journey for a specific purpose, with a particular goal in mind, and then forget where they were going and find themselves lost. This can be an upsetting experience. The person could also be searching for something that they have lost or believe to be lost. Keeping personal possessions on view may help prevent this.
Alternatively, they might forgot that their caregiver has told them they are going out, and will start looking for them. This may lead to the person feeling extremely anxious, and they will need a great deal of reassurance in return. In the earlier stages, it might help if the caregiver leaves notes to remind the person where they have gone and when they will return. These should be securely placed in a location where the person will see them, such as on the fridge or on the inside of the front door or maybe right next to where they usually sit.
A Focus on Past Events of People
As someone’s dementia progresses, they may try to seek out someone or something from their past. Encourage them to talk about this, and show them that you take their feelings seriously. Avoid correcting what the person may say. It is important to focus on their feelings instead of the accuracy of their comments. For example, if the person is looking for their mother, ask them what they miss about her and maybe bring out some old photographs if they are available. This may help them deal with their emotional needs.
Confusion about the Time
People with dementia can often become confused about the time of day. They can wake up in the middle of the night and get dressed, ready for the next day. This confusion is especially understandable in winter when it is common to go to sleep and then wake up while it is still dark outside.
Having a large clock that shows am and pm, and keeping it by the person’s bedside might help. Some clocks also show the day of the week and the date. However, if the person’s body clock is seriously out of sync, you should probably seek professional help.
If night time walking is a particular issue, the person may be having trouble sleeping. Simple measures that may help include avoiding daytime napping and not consuming caffeinated drinks such as tea, coffee or energy drinks late in the day. Drinking alcohol, smoking or eating a large meal should also be avoided closer to bedtime. Taking dementia medication in the morning may be helpful if nightmares or vivid dreams are a problem, but check with their doctor. Exercise may also be helpful in addressing this.
If you are interested in help with these issues check out the Memory Care facility available at Platinum Communities Larson House in Columbus.