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(Ed. note: Our summer "Caregiver FAQs" feature, where we addressed issues that came up repeatedly in our support groups, received a large response, and our readers have requested that we continue it. Please feel free to share your comments or suggestions, or let us know what questions or concerns you would like for us to cover in future issues, by emailing network@memorycare.org).
My father has started walking out of the house and down the street, two or three times a day. Sometimes he comes back on his own, sometimes the neighbors bring him back, and once he fell. When I ask him where he's going, he says, "Home," but he's already at home. I'm worried but don't know what to do.
Wandering is strange and unsettling to the family, but wandering can be and often is dangerous for the person with dementia. If your father is walking down a street by himself every day, it's no wonder you're worried.
Wandering isn't as aimless an activity as you may think. There is nearly always a reason. It could be anything from "I'm hungry" to "I'm feeling lost," but it is almost always an attempt to express an emotion. Wandering can occur indoors as well as out. And it can happen to anyone - never assume that because your loved one hasn't done it yet, he won't one day decide to go off in search of his boyhood home. As one caregiver put it, "It never happens until it happens."
Many things can trigger a wandering episode. Too much stimulation or household noise, or too many people can be overwhelming and cause the person with dementia to attempt to escape. Conversely, boredom or restlessness can send them off in search of something to do. Being in a new environment, visiting in another person's home, or moving to a different residence can cause them to hunt for familiar surroundings. Being alone is often frightening, so they look for someone who can take care of them. Those who are disoriented as to time and place often seek their parents or their childhood home, or think it's time to go to work. Never mind that it's been seventy years since they lived there, or since they had that job; this is about feelings, not facts.
So how do you address this? First, don't argue or try to stop him if he's bent on going. Instead of insisting that he stay, ask where is he going and could you come along? Then try to engage him in talking about whatever is on his mind - is he afraid? Confused? Upset? Maybe he's just forgotten where he is. Maybe he's just hungry or looking for the bathroom. Maybe he's thinking about that long-ago job or home, or a long-dead family member; if so, avoid the tendency to correct or explain. Instead, try asking, "Dad, tell me more about your job. What did you like about it?" or "I wish I had known your sister Edith. Tell me what you miss most about her." As caregivers, we tend to try to avoid such topics, thinking it will upset our loved one more, but it's frequently just the opposite - many times, just talking about something can alleviate anxiety. If he seems worried and you can't figure out why, give him a hug and tell him you're there for him, and that he's safe and where he should be. When you get him home, offer a snack, a drink, or use of the bathroom - the familiar motions are comforting and can help restore his sense of calm. Provide some quiet time and see if he takes a nap. He may not be sleeping well at night, and could simply be tired. Remember, the disease has hampered his ability to express these feelings verbally, so you have to look for the reasons yourself.
Trying to keep him from leaving the house on his own might be necessary. Childproof doorknobs or locks on the doors can often help. Sometimes something as simple as putting a dark rug in front of the door, or even a large STOP sign on the door, is all that's needed to discourage potential outside wandering. Several companies offer anti-wandering door monitors and motion sensors designed to notify you when your loved one approaches. Also check out the new GPS shoes and "wristwatches" that allow families to track their loved ones using their SmartPhones (Google "personal tracking devices" to find out more). And as a precaution, you should enroll him in the Alzheimer's Association's Safe Return program (1-800-272-3900), and be sure he wears the bracelet and/or carries the identification card with him at all times.
Often, unusual behaviors such as wandering will stop as mysteriously as they began. Until then, your goal is to keep Dad as safe as possible, to keep him calm and relaxed by talking with him about his concerns, and to do your best to reassure him that he is safe and well.
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