"Wandering" in Individuals with Alzheimer's and Dementia

The California Department of Aging recently released a very informative webinar discussing the issue of wandering in individuals living with Alzheimer’s disease and other forms of dementia.

Wandering is a complex and often distressing behavior that can put individuals at risk of injury or getting lost.

It is a common yet under-discussed symptom of dementia that affects both individuals and their caregivers.

Understanding its causes, types, and possible preventative measures can help families and healthcare providers create safer environments and reduce associated risks.

What is Wandering?

According to Barbara McLendon of Alzheimer’s Los Angeles, wandering (specifically for those with a cognitive impairment) refers to having a strong urge to leave their current location or separate from their caregiver. It is not aimless. It is with a goal in mind. Types of Wandering

There are different types of wandering behaviors.

Exit-Seeking Wandering

• Individuals attempt to leave a facility or home.

  
  

• It may be driven by curiosity or a desire to explore the outside world.

  
  

• They may feel distressed and want to return home.

  
  

• Some believe they have a responsibility elsewhere and feel compelled to leave.

Roaming

• More commonly associated with Frontotemporal Dementia.

  
  

• The person may walk, bike, or drive the same route repeatedly.

  
  

• This behavior is compulsive and can be triggered by restlessness, stress, or an unmet need.

Causes of Wandering

Wandering is not aimless—it is driven by specific factors, including:

1. Searching for something – A familiar home, food, or a person.

2. Escaping from discomfort – Anxiety, stress, or overstimulation (e.g., loud noises, crowded spaces).

3. Reliving the past – Visiting a former workplace, childhood home, or other meaningful places.

4. Self-soothing – Walking may help relieve anxiety or agitation.

5. Medication side effects – Certain drugs can cause anxiety, leading to wandering.

6. Lack of stimulation – Boredom can contribute to wandering behavior.

7. Confusion due to Sundowning – Disorientation that occurs in the late afternoon or evening.

Risks of Wandering

Individuals may wander when traveling, increasing their risk of getting lost.

If not found within 24 hours, 50% of people who wander will suffer serious injury or death.

How Caregivers Can Reduce Risks

Since wandering can happen unexpectedly, preparation is key. Here are strategies to enhance safety:

1. Ensure constant supervision – Whenever possible, have someone with the person. Caregivers should be aware of respite services that can provide assistance.

2. Use monitoring devices – Door alarms, motion sensors, and GPS technology (such as AirTags) can help track movement.

3. Provide visual cues – Post signs, notes, or photos around the home to help with orientation. Remove objects that may trigger the urge to leave, such as coats or keys.

4. Create a calming environment – Reduce noise and clutter to prevent overstimulation and anxiety.

5. Engage the community – Inform neighbors about the situation so they can help if they see the individual wandering.

6. Encourage physical activity – Exercise during the day can reduce agitation and the urge to move.

7. Address unmet needs – Offer food, hydration, and comfort to minimize wandering triggers.

8. Give them a sense of purpose – Assign simple tasks to help them feel engaged and valued.

9. Use familiar music – Playing music they recognize can have a calming effect.

10. Register with local authorities – Some police departments offer registries for individuals prone to wandering.

11. Label clothing – Sew or write their name and contact information in their clothing in case they get lost.

Wandering is a significant concern for individuals with Alzheimer’s and other dementias, but understanding its causes and implementing preventative measures can greatly reduce risks.

By fostering a safe and structured environment, utilizing technology, and engaging with the community, caregivers can help ensure the safety and well-being of their loved ones.

Planning ahead and staying informed are crucial steps in managing wandering behaviors effectively.

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