Late Stage Symptom: Wandering
As Alzheimer’s disease progresses, symptoms can change and become more pronounced at each stage, particularly the behavioral symptoms. While the physical and cognitive changes can be challenging, the behavioral symptoms can be particularly distressing. While there are treatments and strategies to help manage behavioral symptoms, there is no cure, and no treatment will fully stop the symptoms or slow down the progression of the disease. The aim of these treatments is to help mitigate symptoms, and various lifestyle modifications can help minimize disruption and improve quality of life.
Wandering, or even getting lost, can happen at people with Alzheimer's disease. Reasons vary among individuals. Taking certain steps early on can help keep everyone safe. Wandering can happen during any stage of Alzheimer’s disease, but may become more severe as time goes on.
Approximately 6 out of 10 individuals with Alzheimer’s will wander.1 During this time, they might not know their name, can become disoriented, and may not know their address.
There is no one official clinical definition of wandering, and in the general population, people may interpret it as walking off or getting lost. It is typically understood to be aimless or disoriented ambulation, and may include repetitive behavior like lapping.2 It’s often thought of as walking, but those in wheelchairs or using assistive devices can also “wander.”
Causes of wandering
There is no one main cause of wandering in Alzheimer’s disease, and the reasons can vary among individuals. Reasons for wandering can include:3
- Following routines of the past: the person might believe you’re going to work or running errands
- Boredom: the person might be seeking stimulation
- Stress or fear: the person might be reacting to an overstimulating or overwhelming environment, they don’t understand what’s going on, or they need relief from crowded spaces
- Looking for something: the person might be looking for something you misplaced
Keeping yourself safe
It’s important to keep a person with Alzheimer’s safe in case they start wandering, or in case of an emergency. The person can wear an ID bracelet so that if they get into an emergency situation, first responders have any pertinent information, including the diagnosis.
Risk factors for wandering
Anyone with memory or cognitive problems is at risk for wandering, even if the disease is in the early stages.1Some signs that you or someone you love may be more at risk for wandering or getting lost include:1
- They forget how to get to familiar places
- They want to “go home” even though you’re already at home
- They’re restless or pace a lot
- They get lost in your own home
- They start asking where old friends and family are
- Increased anxiety in public or crowded places
There are some steps your partner or caregiver can take to help prevent wandering or getting lost. This is especially important if you wake up earlier than other people and are alone in your environment for a time. Preventative measures can include:1,3,4
- Locking doors, preferably with a keyed deadbolt or a latch that is out of reach
- Using doorknob covers like those for babyproofing
- Installing an alarm or chime system that goes off when doors or windows are opened
- Avoiding busy or overwhelming places that may cause anxiety or agitation
- Making sure all basic needs are met (ie, hunger, thirst, toileting)
- Keeping car keys out of sight and in a safe place
- Consider wearing a GPS or tracking device
If a person with Alzheimer’s disease has a history of wandering or are showing signs of wandering, partners or caregivers should have a discussion about supervision needs, in order to keep them safe. Put together a plan if the person does wander off and a list of local people to call. Find ways to modify the home environment and its surroundings in order to keep the person as safe as possible. This might also mean choosing a residential facility for the person with a higher level of security, in order to ensure their safety.