By Lauren Mahakian Contributing writer. Originally published in Santa Ynez Valley News on 6/17/2021
One of the toughest challenges of caring for an aging loved one is behavioral changes. Just as everyone ages, people also will change behaviors over time. These changes can be deliberate, such as a decision to start exercising or quitting coffee drinking.
Memory issues also can be a cause of new and disturbing behaviors. These often appear as changes in what our loved ones do or say.
These changes are anything but deliberate, and they can be quite alarming.
Wandering is one of the more alarming behavioral changes I encounter in my work. It can be harmless in some cases, such as wandering around the house. We’ve likely done this ourselves on occasion, such as when anxious or bored.
Wandering also can be dangerous, such as becoming confused and wandering outside, getting lost.
Wandering, in general, should never be taken lightly if it’s not easily explained or understood.
As always, our first challenge is to understand what’s causing the behavior and then to manage it. Sometimes addressing an underlying cause can minimize negative behaviors.
Possible causes of sudden wandering are widely varied. I find there are four primary categories that I try to identify first or eliminate as possibilities: an emotional trigger, looking for something or needing something, triggering past routines, and problems with vision.
If your loved one wanders in an unfamiliar setting, emotional needs may be a cause. Our loved ones may become anxious or nervous in new situations, particularly in crowds. They may start wandering simply from discomfort, trying to escape.
Another common cause of wandering is seeking out basic needs like food or needing to use the bathroom. These are often easily discovered with a few simple questions.
Searching is another common cause. If something is truly misplaced, finding it can stop the behavior quickly. More often, a person with dementia can’t express what or who they’re seeking. With some questions, you may discover they’re looking for something long gone or someone they haven’t seen in many years.
Vision is an issue that’s often overlooked when dealing with wandering. The mind can play tricks at times, and familiar places can seem unfamiliar due to a combination of dementia and deteriorating vision and spatial awareness. Vision is a process involving the brain and is affected by dementia for the same reasons that memory begins to fail.
Routines and habits are among my favorite topics.
A person with no short-term memory may still wander outside along a familiar path and return home. However, just as routines can guide someone home safely, they can also entice someone to step into unfamiliar territory because of past routines. I’ve had several clients who routinely report to work or want to go to the store, even when it’s been more than 10 years since they’ve done so.
If we can’t manage wandering by understanding its root cause, we can still take precautions to keep our loved ones safe. A few simple steps can help. At the top of my list is removing the temptation to wander by implementing simple controls. This may be adding locks or alarms on doors that alert caregivers if a door or window is opened. Pressure-sensitive mats serve as bed alarms. In certain settings, such as my memory care homes, a wander system may be used. These sound when a resident comes within five feet of a controlled exit.
Another good approach to manage wandering is to disguise doors, hide keys and even conceal items needed to go outdoors, such as coats, shoes or a hat. Just as bathroom doors can be painted a bright color to help identify them, disguising an exterior door can remove the temptation to open it. One example is the bookshelf wallpaper on exterior doors in several of my homes that serves as a type of camouflage. I’ve also seen many communities place code locks on doors or use a simple latch system that’s out of sight but easy for caregivers to operate.
Wandering is a behavior we can’t take lightly. Understanding its causes and taking some simple steps to prevent or mitigate its triggers can help.
Lauren Mahakian is a certified care manager. Check out her free podcast, Unlocking the Doors of Dementia™ with Lauren and Free Support Groups on Zoom.
