Wandering 101 – Prevention, Tracking and Tools

An estimated 6 in 10 individuals with dementia will wander or “elope” at some point. Whether they’ve gotten lost in a store, walked away from home or taken the car for a drive, wandering puts a highly vulnerable person in a potentially dangerous situation. We strongly encourage you to consider the following suggestions to reduce the chances of wandering and increase the likelihood of a safe outcome if it happens.

“Alzheimer’s disease usually first damages the hippocampus, leading to memory loss and disorientation. Hippocampal damage can also cause amnesia and an inability to form new memories, specifically those regarding time and location.”

Understanding Wandering

Wandering isn’t a conscious choice, so attempting to rationalize the behavior with your loved one is unlikely to help for long. While we can’t fully understand exactly why our loved ones wander, recognizing some common causes can help caregivers adapt routines or become more vigilant when they occur:

  • Anxiety, fear and stress can make us want to get away from it all. Is there a safe space your loved one can go to be alone instead? A designated quiet space can be a calming haven to someone feeling upset or over-stimulated. Ideally, this space will have familiar objects and possibly soothing music or other sensory tools to help your loved one relax.
  • If you’re not at home, be extra attentive about leaving your loved one out of your immediate line of sight. If they can’t see you, they may think you’re lost and wander away to find you.
  • Being overly stimulated or tired can motivate people to want to flee. Be sure to provide plenty of opportunities for rest and down time – especially if you’re out of the home or running errands.
  • Those experiencing sleeplessness also tend to wander, so be sure to talk with their doctor if your loved one is experiencing trouble sleeping. A good bedtime environment and routine can also help, so consider limiting caffeine, using the restroom before bed and keeping a cup of water on the nightstand.
  • Someone with excess energy may want to go for a walk without realizing their limitations, so try to build time into your routine for your loved one to burn off energy
  • Those who wander often believe they’re on the way to work or home. Are there tasks you can give them at home so they feel purposeful? Providing meaningful activities can help curb boredom related wandering.
  • “Sundowners syndrome” can make the transition from afternoon to evening an especially challenging time for caregivers and their loved ones with dementia. Staying home during these hours, monitoring caffeine intake, adjusting the lighting in your home and other tricks can help minimize the chances of wandering during this time of day.
  • Being in an unfamiliar setting can lead your loved one to try and return home or to another place they feel safe. (Keep in mind, what may have once been familiar to your loved one may no longer be familiar to them, so even if they’ve been there 100 times in the past, they may no longer remember.) Carefully planning trips and being vigilant when away from home can help.
  • Lay out your loved one’s clothes daily for them or take note of the clothes they put on in the morning so you can quickly describe them if needed.
  • Use your phone to take a head-to-toe photo of your loved one every time you leave your home. By making this a routine habit, you’ll always have a current photo, showing exactly what they’re wearing that day, which you can easily share with others if you are separated.
  • Even if you are not close with your neighbors, it is a good idea to alert them about your loved one’s diagnosis – neighbors can help if they see the person with dementia wandering alone.
  • Consider installing an alarm system like SafeWander or the Simple Door Alarm Sensor to alert you every time your loved one gets out of bed, opens a door or passes a motion
  • Many caregivers use video home monitoring systems like Ring, Blink or Nest to let them check in on their loved ones. Some versions allow two-way communication, alerts and other features.
  • Make the best of the visual perception challenges that frequently come with dementia by making minor home decor modifications:
    • Placing black mats in front of exterior doorways – many individuals with dementia will see these as holes and avoid them.
    • Painting doors the same color as the walls or cover knobs with cloth that’s the same color as the door. Without sufficient contrast in colors, the door or knob can almost seem invisible to someone with dementia.
    • Covering doors with removable wallpaper that resembles a window.
  • Rather than simply putting a note on the exterior doors, use something more attention- getting and familiar – a large, red octagon with the word STOP on it in white letters.
  • If you have a garage, use only that door to enter and exit the house and be sure to keep the overhead garage door closed. If your loved one becomes accustomed to only using that door, they’ll be most apt to use it to wander, and the sound of the overhead garage door opening will alert you to their exit.
  • If you’re a FaceBook or NextDoor user, make sure you’re familiar with the groups for your neighborhood. If your loved one disappears, this can be a great way to get the word out to folks to be on the lookout.
  • Install a chain lock at the very top or very bottom of the door – where it’s out of eyesight and the immediate line of vision for your loved one. Keypads, combination locks or other “baby proofing” tools can also make it harder to wander. These locks should only be used when your loved one is in the home with another responsible adult. Never lock someone inside alone; in case of fire or medical emergency, a locked door can be a matter of life or death.
  • To prevent your loved one from driving alone, hide any car keys in a secure location and disconnect the battery, if necessary.

In too many cases, wanderers become so disoriented during their journeys, they’re unable to recall their own names – much less their addresses, phone numbers or those of their loved ones – making it difficult for others to help them find their way home. Medical IDs with your loved one’s name and diagnosis along with your address and emergency contact information can help. There are dozens of bracelets, necklaces and similar products available online, including various styles and sizes for men and women, as well as non-removable bracelets if your loved one is apt to try to take it off.

  • Alzhiemer’s Association MedicAlert with Wandering Support
  • MyMDLife Medical Alert Bracelet
  • American Medical ID
  • Medical ID Fashions

(If you use a GPS tracker, an ID band can still be helpful if your loved one gets lost without their GPS tracker, their GPS battery dies or they enter an area without reliable cellular service.)

To notify you if your loved one wanders away and to help ensure a safe outcome, we highly recommend caregivers use a tracking device with GPS and cellular technology. (If your loved one consistently carries a smartphone, that may be sufficient – just be sure they always have it with them, keep it charged and be sure to turn on the location services or use an app like Life360 to track their movements.) For those who can’t keep up with or operate a phone, another discreet device may be a better option to help locate your loved one and easily communicate with them if they wander away. Watches and other small trackers often require the initial device purchase, plus a monthly or annual service fee –-many of which can be incorporated into your existing mobile plan

Apple AirTag – Device costs $29. No ongoing fee.

    • Small token that can be inserted into a wallet or shoes or worn as a pendant.
    • If the token is within range of any online Apple product (iPhone, iPad, Mac), you can locate it’s last known location using the “Find My”

Tile – Device prices start at $25. No ongoing fees for basic

    • Small token or card that can be inserted into a wallet or shoes or worn as a pendant.
    • If the Tile is within range of a device with Bluetooth, you can locate its last known location using the app.
    • Range varies depending on device.

Lil Tracker Senior Watch – $149 device + monthly data/voice plan via cell phone carrier.• GPS, alerts for falls and for leaving pre-set area, medication reminder.

    • One touch SOS button and two-way communication for up to 12 pre-set numbers.

AngelSense – Free device + subscription starting at $33/month.

    • Non-removable device that easily attaches to clothes, belt, or shoes.
    • Includes three security pins that require a magnetic key to unlock.
    • Allows communication with individual, ability to call

Gabb Wireless – Devices start at $149 with monthly plans $18+.

    • Watches or smartphones that have real-time tracking with GPS and limited communication options, but no apps or internet access.

Jitterbug – flip phones and smartphones available, with optional data.

RazMobility – smartphones with picture-calling insert.

GPS Smart Sole – $300 for tracking device +$15-25/month.

    • Water-resistant shoe insole.

iTraQ – $130 for device + $15/month or $60/year.

    • Small device to tuck into a pocket or purse.
    • Offers precise location information based on predetermined reporting.

Project Lifesaver – Free service offered by the Charleston County Sheriff’s Office.

    • The CCSO provides a free tracking device that attaches to a wrist or  ankle.
    • CCSO creates a personal profile with the family’s assistance. If a loved one wanders, CCSO can use a receiver to track the location.

While high-tech devices with games and other features may be tempting, be sure to select a product that’s simple enough for your loved one to use without instruction. If it’s overly complicated, uncomfortable or too easily removed, your loved one may hide it or refuse to wear it.

There’s a 50% chance of serious injury or death for someone who wanders and is not found within the first 24 hours.

Finally, some folks may be resistant to a tool they consider a “babysitter” or similar device to limit their independence, so consider one or more of these options based on what you think your loved one will be most receptive to:

  • Wrap it up as a gift for a special occasion and tell them it’s from someone they hold in high regard (child, grandchild, friend, former colleague, etc.).
  • Emphasize the security and independence/freedom it gives them by allowing them to contact you whenever they’d like.
  • Present it to them as a watch, health monitor (Fitbit or heart rate monitor), medication reminder or other device, without mentioning the tracking feature.
  • Let them help pick it out or pay for it to encourage pride and ownership.

If you use an electronic device for your loved one’s security, make sure to charge it regularly.

  • If your loved one wanders off, immediately call for help. If you’re in a public place, notify management and request that all exits be closed.  If you’re at home or have reason to believe your loved one is outside, call 911 ASAP. Time is of the essence.
  • Be sure to let public safety officials know your loved one has dementia and be prepared to send them the most current photo you have of them.
  • Understand wanderers won’t necessarily respond when their name is called because they may not have the cognitive function to realize they’re lost.
  • Common tendencies among wanderers include
    • Following the direction of the dominant side.
    • Traveling with tunnel vision, unable to turn around and continuing until they get stopped.
    • Traveling in a relatively straight line, with few turns.
    • Unlikely to ask for help because they don’t know they’re lost.
    • Unlikely to respond to rescuers calling their name (only ~1%).
    • Found within 5 to 2 miles of home or where they started their journey.

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