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Reduce the Risk of Wandering

February 18, 2011

By Winnie Yu

It is a major problem with Alzheimer’s disease patients: the tendency to wander off, away from caregiving loved ones or even their residential care facilities. The results can be devastating. Here’s what you need to know, and what’s being done to help keep wandering at bay.

Twelve hours after he was placed in a nursing home in California, Mardig Avadian disappeared. Dressed nicely in khaki pants and a shirt, the 86-year old man had joined a group of visitors and snuck out of the nursing home. “He began walking the streets of north Los Angeles until he hitched a ride—or so we think—and was found walking along the freeway nine miles away in the Mojave Desert,” says his daughter Brenda Avadian, MA, who went on to launch TheCaregiversVoice.com, a Web site for caregivers. “He was trying to hitch a ride to Milwaukee, Wisconsin, where he had lived for 45 years.”

Like many people with Alzheimer’s disease, Mardig Avadian had a habit of wandering, a common behavioral problem that occurs with dementia, especially Alzheimer’s. According to the Alzheimer’s Association, up to 60 percent of all patients with the disease will wander.

The most dangerous form of wandering is elopement, in which the person leaves an area and is unwilling or unable to return, says Mark L. Warner, author of A Complete Guide to Alzheimer’s Proofing Your Home (Purdue University Press) and owner of The Alzheimer’s Store. “They can walk out the door and not realize that this is their home,” Warner says.

Why They Wander

Wandering occurs for numerous reasons, says Maria Wellisch, R.N., vice president of corporate education for Morningside Ministries in San Antonio, Texas. Some nursing-home residents head out the door when they see the staff getting their coats and purses to leave for the day. Other people wander because they think they need to go to a place they left years ago such as a former home, an office or someplace to fetch their kids. Some patients wander because they’re bored, anxious or physically uncomfortable. Some may simply be confused.

For the wanderer himself, the experience is much like going out into a mall parking lot and not knowing where you parked—without knowing why he’s out there. “We all do that, but at least I know I parked outside,“ Wellisch says. “These patients don’t have the connections in their brains to find their way back or even know why they are out there. And as the disease progresses, they lose the executive function to know to ask for help.”

Who’s at Risk

Certain people are at greater risk for wandering than others. Signs of a potential wanderer include someone who:

Wandering can be very dangerous for the Alzheimer’s patient, who could fall, get struck by a car or assaulted by a stranger. For loved ones like Brenda Avadian, whose father wandered constantly, wandering can become a constant source of worry and concern. “It was like having a baby and wanting to wake up every time the baby cries,” she says. “Your ears are constantly tuned in to sounds in the night. It was absolutely exhausting. We started to show signs of impaired thinking, too.”

After seven months of having her father in her home, Avadian put him in a nursing home. He died five years later at the age of 90 in 2001.

Prevent Wandering

Simple steps can deter some wanderers or at least make it less likely they’ll go far. Here are some suggestions:

Finally, try to keep your relative occupied with purposeful tasks, which can help stave off the boredom and anxiety that may lead to wandering. “It should be something that can be done frequently, is purposeful and something they want to do,” Wellisch says. “Someone who likes to cook might want to ice cupcakes. With former nurses, I used to give them clipboards so they could make rounds with me. It should be something from their past that touches their memories.”

Silver Alert

If you have a relative who wanders, consider registering him or her in the National Silver Alert program. The free online program allows you to record vital information about that person, which can be quickly given to emergency responders in the event the person wanders off and becomes lost. The program also records a photo of the senior along with his or her vital information in an online database that is available 24/7. For more information, check out www.nationalsilveralert.org.

Source: www.ALZinfo.org. Author: Winnie Yu, Preserving Your Memory: The Magazine of Health and Hope; Summer 2010.

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