At 5:30 on a recent morning, Dover, New Hampshire, police were called to the site of the body of an elderly woman who was found laying on the side of the road near the home she shared with her daughter. She had wandered out the door in the middle of the night when everyone was sleeping. Just days ago, in Hanover, New Hampshire, a 91-year-old man suffering from memory loss wandered away from his independent living apartment. His body was found nearby, down a steep embankment leading to the Connecticut River.
These horrifying events are examples of the tragedy that can occur when a person with dementia wanders. It is estimated that 60% of people with dementia will wander or become lost at some point during the disease. That’s a potential for three million people per year. One in 14 of these individuals will not make it home alive. The survival rate can depend on how soon they are found, as 93% of those found within 12 hours survive, compared to a 33% survival rate after 24 hours. That percentage continues to drop with each hour that passes. It is vital that search and rescue efforts begin immediately after someone with dementia is discovered missing.
Wandering behavior happens for many reasons. The person may become confused because they no longer recognize their home to be theirs. They may experience delusions and feel a strong need to go to a place from the past (i.e, school, work, their childhood home, etc.). Agitation or restlessness due to hunger, being too hot/cold, a side effect of medication, or a need to use the bathroom, may cause them to try to escape the feeling by physically getting up and leaving. Or, they may be bored and seeking relief to use up excess energy.
Some of these situations can be addressed by being proactive; providing a safe and uncluttered environment with items that are familiar, keeping them busy with repetitive activities, understanding medication side effects, making sure that their basic needs are met, and arranging for regular physical activity. Additionally, be alert to signs they are feeling a need to leave. For example, are they talking about going to work or fretting about getting home to take care of children? Are their movements restless, are they pacing? Are they having a difficult time locating familiar places like the bathroom or bedroom? Are they acting nervous or anxious?
The Alzheimer’s Association has the following suggestions to prevent wandering:
- Have a routine and provide structure.
- Identify the most likely times of day that the wandering may occur (this is different for each individual and can be any time of the day or night).
- Be reassuring, validate their need to “go home” or “go to work.” Don’t correct the person, but rather suggest that they stay with you and go home in the morning after a good night’s rest.
- Ensure their basic needs are met.
- Avoid busy places that are confusing and can be disorienting.
- Place locks on doors that are out of the line of sight, either installing them high or low on the exterior doors.
- Use devices that signal when a door or window is opened, such as a bell or an electronic home alarm.
- Provide supervision. Never lock a person in at home or leave them alone in a car.
- Keep car keys out of sight, even if the person no longer drives. The strong urge to get somewhere, coupled with the sight of car keys, may cause them to forget they don’t drive.
The Alzheimer’s Association also suggests that a plan be in place beforehand, with the following information, to help with search and rescue efforts should they become necessary:
- Keep a list readily available of people to call for help.
- Ask neighbors, friends, and family to call if they see the person alone.
- Keep a recent, close-up photo and updated medical information on hand.
- Know your neighborhood – the dangerous areas near the home such as bodies of water, dense foliage, heavy traffic, etc.
- Keep a list of places where the person may wander.
- Provide the person with ID jewelry such as MedicAlert + Safe Return.
- Know if the person is right or left handed because they tend to follow the direction of their dominant hand.
As mentioned earlier, time is of the essence, so search the immediate area for no more than 15 minutes before calling 911 and reporting to the police that a vulnerable adult is missing. Keep in mind that most people are found within a mile and a half of their home. However, finding them can be very difficult because they are usually on foot, and they will rarely ask for help or tell anyone that they are lost. Furthermore, most will not respond to people shouting their name, and some may actually hide in fear.
A person at any stage of dementia may wander or become lost. However, being prepared and knowing the signs may prevent a tragedy.
For more information about MedicAlert Foundation and Alzheimer’s Association’s MedicAlert + Safe Return program visit: https://www.medicalert.org/safereturn