500,000 Elderly People Go Missing in China Every Year as originally seen in CNN
Wandering can happen to any person who gets confused or spatially disoriented. Wandering happens when a person cannot find their way back to a safe environment or “home base.” I’ve seen it mostly in dementia and brain injury cases. In fact, I heard of one of my former patients (dementia) that went wandering last summer. This particular individual wandered into Mexico and had been gone several days before he was found in a ditch, alive… barely. I had another case of a post-operative tumor removal patient who physically functioned just fine, but she would get lost in a shoe box. No joke; absolutely no spatial awareness what-so-ever. And she did wander away one afternoon. Thankfully, someone spotted her, and I got dispatched to guide her back the few blocks she’d gone.
People with cognitive impairment can get themselves in heaps of trouble when wandering. They may get into an environment the shouldn’t be: walking down a freeway, for example. They may not be clothed appropriately for the weather or climate. If they’re out long enough, may miss doses of life sustaining medication. This is serious.
Wandering can be triggered by many things. Sometimes it’s just plain boredom. Change can also trigger a need to be somewhere else… doing something else… although they’re not really sure where or what exactly. Change could be a new caregiver, new address, new routine, new physical feeling (stomach ache), etc. I had a family member tell me once that their mom had always left for work at exactly 710 in the morning every day for nearly 30 years. So at that time of the day, they had to have something scheduled to distract her, so that she wouldn’t grab the keys and walk out the door. Fear is also a huge driving factor. Maybe a big thunder storm may spur a person to seek somewhere the storm isn’t. Or I once had a patient that was petrified of women for one reason or another, so it didn’t matter what I did, he was always trying to get away from me.
People at risk for wandering may exhibit some of the following behaviors: anxiety or stressed particularly if directed at something outside their immediate surroundings, confusion, depression, hallucinations or delusions, pacing or seeking an exit, restlessness and finally verbalizing intent to leave their “home base.” If I see any of the last 3, I put my coworkers on high alert: notify my supervisor, the patient’s floor nurse, nursing supervisor and staff manning any exit points. In a home situation, I would notify any other caregivers, neighbors and also the police, so they can pass on your loved one’s description or perhaps even a photo to officers that regularly patrol in your area.
Preventing wandering is a delicate task and topic. You want to feel secure in the fact that your loved one isn’t going to end up in that ditch in Mexico, but at the same time, you don’t want them to feel imprisoned. The main idea behind everything is to put up barriers to buy time for the person to get frustrated and quit on their own, or for someone else to talk them out of wandering. For example, placing a series of different locks– think deadbolt + chain + slider– on the outside access door at either the top or bottom– where a person wouldn’t usually look for a lock. Hiding or just plain not leaving car keys in the person’s “home base.” Same thing with shoes. I have so many patients that won’t even set their feet on the ground unless they have shoes on. Make doors and door knobs hard to spot: paint the door the same color as the wall or put a curtain over it or a large potted plant in front of it. Having a routine and keeping this routine and a clock posted where the person can easily see it often decreases boredom and explains, “What now?” As mentioned in the case above, identify the times the person is more likely to wander. Maybe it goes in with sundowning? Plan activities to distract the person at that time. I’ve seen several programs in large cities that will take a sundowner that has their days and nights mixed up and stay up all night playing games and doing activities with them in a group setting. Love this idea. Sometimes wandering can be triggered by a search for a basic need: Have they gone to the restroom recently? Are they cold and looking for a blanket? Sometimes just reassuring the scared or lost feeling person that they are safe is enough. In the event none of that works and your loved one DOES pull a Houdini, I’ve made bracelets with a contact phone number for patients before, so a helpful stranger could call the lost person’s family. I’ve made them out of hospital ID bands, but I’ve seen them made for children out of number beads. On the same child thread, I’ve seen parents that are going to go to amusement park or a large even write their contact information on the child’s hand and then cover it over with liquid bandage. A medical alert bracelet or necklace may be a good idea.
If low tech options aren’t doing the trick, there are some helpful tech options out there too. Like when you go into a store and opening the door makes a “ding?” You could install those on your doors and/or windows. They’re not that expensive really. Some facilities and individuals are now using RFID (one example of several brands available, just Google) or GPS (several brands here) to track their folk. Some use bracelets or ankle bands. Some sew them into the person’s clothing. The Alzheimer’s Association is a good resource for more information.
In the event your loved one wanders, you’ll want to notify police as soon as you recognize that the person is gone. Put neighbors on high alert and call in any reinforcements you can to help with the search. Keep a list of family, friends or places the person often talks about or asks the whereabouts on or is important to them, such as old addresses, work places, favorite restaurants, places of worship, etc. They may be heading that direction. Also, know if your loved one is right or left handed as often they will wander toward their dominant hand. Keep a large, close-up, recent photo of your loved one to provide to police and anyone else helping.
If you find someone who is lost, speak calmly to them. Try to guide them to a place that is safe, appealing to those basic needs. Ask them if they’re hungry or thirsty or need to go the bathroom. They’ll be more likely to follow you if they need one of those basic things and you’re providing it. Or sometimes they don’t need those things yet and don’t care to. Focus on building a trust relationship– ask simple questions about themselves, their likes/dislikes slowly so they can process what you’re saying. And then throw in, “I feel like some coffee. You want to go get a coffee? My treat!” Or, “I really need to go to the bathroom. Can you help me find one?” and then guide them with, “I think I saw one over here.” Or something of the like. Then they may follow you. Make a call to the police as soon as you are somewhere safe.
Hopefully this helps someone out there. None of my family members have wandered to my knowledge yet, but the possibility scares me.