Tips on Wandering in Alzheimer's Patients
by Edyth Ann Knox
Wandering is one of the biggest risks for individuals with Alzheimer’s Disease. In 1999, 32,000 individuals with Alzheimer’s Disease wandered away from their homes or care facilities. Wintertime or times of extreme weather conditions are some of the riskiest times for a loved one to wander off. Generally if an individual is found within 24 hours they are returned safely, however after 24 hours the survival rate drops down to 46%.
Chances are that your loved one will become separated from you at least once during the course of the disease – either at a crowded shopping center or while you are busy with chores. Though wandering remains a risk while a loved one is mobile there are things you can do to help prevent wandering and to ensure that your loved one is returned safely if they do become separated.
1. Install locks on the doors – The doors are the first place to stop a loved one from wandering. Early in the disease when they are most likely to wander off, they may still remember how to unlock the current locks. Placing hook and eye latches on the outside screen door is very effective. They are best if they are placed either very low on the door or high on the door. You can place a double key lock on the inside door, but be aware that your loved one may get panicked if they can not open the inside door.
2. Install locks on the windows – The windows are something most forget about but sooner or later many loved ones remember. Even windows on the upper levels of home or a facility should be safeguarded from an individual who may open it and crawl out. If you have windows (and doors) that slide open from side to side, often a piece of wood cut so the window can only be opened part way is helpful. Windows that slide up and down can be safeguarded by putting a nail or screw in the track so the window can only be partially opened. If the window opens with a crank, you can take the handle off when you have adjusted the window to the desired position.
3. Consider alarms – There are many types of alarms systems that can be used to let you know when a loved one is entering or leaving an area. You can equip the doors that lead outside or to dangerous areas like garages and stairs with a simple door alarm available at most electronic shops. In general, they sound an alarm when a pin is pulled or a connection lost when a door is opened. You can also get pressure sensitive mats that will set off an alarm when a loved one steps on it. This can give you the benefit of a little extra time by alerting you where they are before they open the door to go out. You can also get motion detecting alarms that can be set to let you know when your loved one gets out of bed or exits their room.
4. Erect fences and gates – Trying to keep a loved one restricted to the indoors all the time, especially in good weather, is usually not reasonable. Everyone enjoys being able to go outside on their own, including individuals with Alzheimer’s Disease. A fence can often provide them a place to go in relative safety. Chain link fences are not a good idea as most loved ones can climb those rather quickly. A privacy fence can be good but you want to make sure the side with out the brace beams are not facing in or it is a double sided privacy fence. The side braces often provide a foothold for climbing over the fence. In general, a farm fence with squares that are too small for a foothold works very well. It should be at least six feet tall to provide extra assurance that your loved one can not pull themselves over the fence.
5. A Safe Return bracelet, necklace or emergency ID card – Even with safeguards and precautions, your loved one may still become separated. A Safe Return bracelet from the Alzheimer’s Association (http://www.alz.org) is a good way of assuring that if your loved one is found when separated that they will be returned. It is best to put the bracelet on the dominant wrist so that your loved one can not take it off. Sometimes it is impossible to get a loved one to wear the bracelet or necklace. In those cases you can make sure that a label with your loved one’s name and phone number is on all their clothing. You can never depend on your loved one to carry their ID when they are separated from you and you want to be sure that if your loved one wanders they can be ID and returned quickly.
6. Dress in brightly colored clothing – Bright and distinct clothing can be spotted from a distance. A friend told me of her father who wandered off and got caught up in a fence behind their yard. His clothing blended in with the area around him and even though he was close by, he was overlooked until someone decided to walk along the old fence line and spotted him. Dressing in clothing that can be easily spotted especially in a crowd is helpful when taking a loved one out shopping or on an outing. It is very easy for an individual with Alzheimer’s Disease to become separated especially when there is a crowd. It can happen within seconds. Don’t panic if it happens.
7. Keep all keys up and out of sight and reach – An individual with Alzheimer’s Disease may still be able to recognize a key and understand its use. A loved one that gets hold of a car key and slips off can be gone miles by the time it is noticed. This does happen and it happens more often then you would think. A friend had her father discover the car key and slipped out and drove off while she was in the bathroom. They were fortunate to find him and even luckier that he did not have an accident. She had taken the keys away and had stopped his driving a long time before this event and he was fairly well along in the disease. She felt confident that he no longer remembered how to drive or had the desire to drive and had become relaxed in keeping the keys up. She was not a bad daughter nor was she neglectful or inattentive but it is easy to assume that a loved one can no longer do something or even move fast enough to get away until THEY DO.
8. Never leave a loved one alone in the car – Each year when I go to the grocery store or local shopping center I can not help but noticed the increased number of times I have seen an elderly family member left in the car while the caregiver runs quickly into the store, post office or bank. Even though the caregiver may only feel they will be gone for only a few minutes the elderly person is often left in the car for 15 minutes or longer. I know at times it can be difficult to take a loved one into the store with you but it only takes a second for a frightened or panicked person to get out of the car and be gone in a direction unknown. I have sat at a distance and watched these person that has been left in the car, and without an exception each one is nervous and frightened especially when someone passes the car they are in. One lady would reach over and flip the electronic door lock each time someone approached the car. The only problem was that she would lock the door one time and unlock it the next time.
9. Avoid leaving a loved one home alone – Determining when an individual with Alzheimer’s Disease is no longer to be left at home alone for short periods can be difficult. This makes it very difficult for someone who is the sole caregiver for a loved one with Alzheimer’s Disease. Alerting a neighbor to keep an eye out when you go out is a good idea or even recruiting a friend or neighbor to "visit" with your loved one while you go to the store is even better. Another source of assistance that is not used enough is a teen who can "grandparent sit." One of my favorite after school jobs when I was a teen was to stay with an elderly lady (she most likely had Alzheimer’s Disease though it was not a thing commonly diagnosed back then) for a couple of hours while the daughter went to the store. Many times a caregiver will loose contact with family and friends, which tends to leave them feeling that no one cares or is willing to help. This is not always true. You may have to ask around to find those that are willing to help. Try asking at area churches, High Schools, Scouts, Community Centers, Senior Citizen's Centers, local Alzheimer’s Association chapter and any other group you can uncover. When someone offers to help don't refuse it! Accept it right then and count it as a blessing.
10. Don't be afraid to be creative – Caregivers often have to be creative to keep their loved ones safe. One spouse attached a string to her toe and to her husband’s night-clothes so that if he got out of bed at night it would wake her. Many use baby monitors or motion detectors that turn on lamps or radios to alert them. Looking through the child safety center can turn up items to help you keep track of your loved one like the elastic band that a mother attaches to their hand to the child's hand can be a great help when taking a loved one to a crowded area. Hanging Christmas bells on a door can also be a useful door alarm.
Please remember wandering is a big risk factor for individuals with Alzheimer’s Disease. We can take precautions to keep our loved ones safe. Even the best caregiver or facility will have experiences with wandering. If your loved one wanders of, don’t beat yourself up for being neglectful. Take reasonable precautions, don’t panic and enlist others to help you find him/her.
© 2001 Prism Innovations, Inc. All Rights Reserved.
Edyth Ann Knox was the 24/7 caregiver for her mother-in-law, Milly, for over a decade. As an early adopter of online communities for caregivers, she has earned the respect and friendship of numerous other wired caregivers. She brings years of experience as a practical caregiver, wise mentor and easy-to-laugh friend to new and experienced caregivers alike. Edyth Ann is a Contributing Editor to ElderCare Online at http://www.ec-online.net, an online community for people caring for aging loved ones, especially those coping with Alzheimer's Disease. ElderCare Online offers a comprehensive library of practical articles, educational modules and supportive discussion groups.