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    Dementia Symptoms & Caregiver Strategies: Managing Wandering and Getting Lost

    A person with cognitive impairment may not remember his or her name or address, and can become disoriented, even in familiar places. For people with cognitive impairment wandering can be dangerous, but there are strategies and services to help prevent it.

    Who is at risk of wandering?
    Anyone who has memory problems and is able to walk is at risk for wandering and/or getting lost. It's important to plan ahead for this type of situation. Be on the lookout for the following warning signs:

    • Returns from a regular walk or drive later than usual
    • Tries to fulfill former obligations, such as going to work
    • Tries or wants to "go home," even when at home
    • Is restless, paces or makes repetitive movements
    • Has difficulty locating familiar places like the bathroom, bedroom or dining room
    • Asks the whereabouts of current or past friends and family
    • Acts as if doing a hobby or chore, but nothing gets done (e.g., moves around pots and dirt without actually planting anything)
    • Appears lost in a new or changed environment
    Tips to prevent wandering
    Wandering can happen, even if you are the most diligent of caregivers. The following strategies may help lower the chances:
    • Try and identify the most likely times of day that wandering may occur.
      Plan activities at that time. Activities and exercise can reduce anxiety, agitation and restlessness.
    • Reassure the person if they feel lost, abandoned or disoriented.
      If the person wants to leave to "go home" or "go to work," use communication focused on exploration and validation. Try not to correct the individual. For example you can say something like, "We are staying here tonight. We are safe and I'll be with you. We can go home in the morning after a good night's rest."
    • Ensure all basic needs are met.
      Has the person gone to the bathroom? Are they hungry or thirsty?
    • Avoid busy places that are confusing and can cause disorientation.
      This could be a shopping mall, grocery store or other busy venue.
    • Put door locks out of the line of sight.
      Install them ether high or low on exterior doors, and consider placing slide bolts at the top or bottom.
    Home Safety Checklist
    • Camouflage doors and door knobs.
      Camouflage doors by painting them the same color as the walls, or cover them with removable curtains or screens. Cover knobs with cloth the same color as the door or use childproof knobs.
    • Use devices that signal when a door or window is opened.
      This can be as simple as a bell placed above a door or as sophisticated as an electronic home alarm.
    • Provide supervision.
      Never leave the person with severe cognitive impairment alone at home or leave him or her in a car without supervision.
    • Keep car keys out of sight.
      A person with cognitive impairment may drive off and be at risk of potential harm to themselves or others.
    • If night wandering is a problem:
      Make sure the person has restricted fluids two hours before bedtime and has gone to the bathroom just before bed. Also, use night lights throughout the home.
    Make a Plan
    The stress that is experienced by families and caregivers when a person with cognitive impairment becomes lost is significant. Have a plan in place beforehand, so you know what to do in case of an emergency.
    • 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 to give to police.
    • Know your neighborhood.
      Pinpoint dangerous areas near the home, such as bodies of water, open stairwells, dense foliage, tunnels, bus stops and roads with heavy traffic.
    • Is the individual right or left-handed?
      Wandering generally follows the direction of the dominant hand.
    • Keep a list of places where the person may wander.
      This could include past jobs, former homes, places of worship or a restaurant.
    • Provide him or her with ID jewelry.
      Enroll the person in MedicAlert® Safe Return http://www.alz.org/care/dementia-medic-alert-safe-return.asp
    • Consider having the individual carry or wear an electronic tracking GPS device that helps manage location.
    When someone with cognitive impairment is missing:
    • Begin search-and-rescue efforts immediately.
      A vast majority of people who wander are found within 1.5 miles of where they disappeared.
    • If the individual does wander, search the immediate area for no more than 15 minutes.
      Call "911" and report to the police that a person with cognitive impairment - a "vulnerable adult" - is missing. A Missing Report should be filed and the police will begin to search for the individual. In addition, a report can also be filed with MedicAlert® Safe Return (http://www.alz.org/care/dementia-medic-alert-safe-return.asp) at 1.800.625.3780. First responders are trained to check with them when they locate a missing person with cognitive impairment.


    Cognitive Impairment can have many causes. The patient’s doctor should be consulted to determine a specific diagnosis and treatment options. But whatever the cause, the symptoms are often alike, and the Caregiver Strategies are often similar.

    The information in the resources listed above was compiled by the Ray Dolby Brain Health Center through clinical experience and commonly available published materials. For information on additional Caregiver Strategies, go to: cpmc.org/brainhealth.