Wandering in Dementia

Wandering is one of the most frightening behaviors in dementia care. Up to 60% of people with Alzheimer's disease will wander at some point, often without warning. They may leave home in the middle of the night, become lost in familiar places, or walk for miles without understanding why or where they're going.

The consequences can be catastrophic. If not found within 24 hours, up to half of wanderers will suffer serious injury or death from exposure, dehydration, or accidents. Understanding why wandering happens and putting safety measures in place before it does is essential.

Why People with Dementia Wander

Wandering isn't random—there's usually an underlying reason, even if the person can't articulate it:

Looking for Something or Someone

• Searching for a deceased spouse (don't remember they died)
• Looking for their childhood home or parents
• Trying to get to a former job
• Following a past routine (going to church, picking up kids from school)

Unmet Physical Needs

• Looking for a bathroom
• Hungry or thirsty
• In pain and trying to escape it
• Too hot or too cold
• Uncomfortable in their environment

Emotional and Psychological Reasons

• Feeling lost, confused, or anxious
• Bored or understimulated
• Agitated and need to move
• Following a caregiver around (shadowing)
• Sundowning-related restlessness

Disorientation

• Don't recognize their own home
• Confused about time (think it's morning when it's night)
• Following an old memory pattern
• Don't understand where they are

Warning Signs of Wandering Risk

Be alert if your parent:

• Returns from walks or drives confused about where they've been
• Tries to "go to work" or fulfill former obligations
• Has gotten lost in familiar places
• Talks about needing to leave or "go home"
• Is restless, paces frequently, or tries doors
• Has trouble finding common rooms like the bathroom
• Has had previous wandering incidents
• Asks about locations from the past (old house, deceased relatives)
• Becomes more confused or agitated in late afternoon (sundowning)

If any of these apply, implement safety measures now—before an incident.

Prevention Strategies

Address Underlying Causes

• Maintain a consistent daily routine
• Ensure basic needs are met regularly (bathroom, food, water)
• Provide meaningful activity and engagement
• Reduce anxiety triggers
• Create a calm environment, especially in evening
• Treat pain, infections, or other medical issues

Make the Home Environment Safer

• Install locks that are difficult for them to operate (keyed deadbolts, childproof covers)
• Place locks high or low on doors where they won't think to look
• Camouflage exit doors (hang curtains, paint same color as walls, cover with murals)
• Place a black mat in front of exits (may be perceived as a hole)
• Use door and window alarms that alert you when opened
• Fence yard if possible; install gate alarms
• Consider pressure-sensing floor mats by the bed

Create Safe Wandering Paths

• Provide a safe area to walk or pace (secure backyard, walking loop in home)
• Remove trip hazards from these areas
• Consider a treadmill if they're capable of using one safely
• Walk with them regularly to burn energy and fulfill movement needs

Technology and Safety Devices

GPS Tracking Devices

• AngelSense: GPS tracker designed for dementia/autism; allows family monitoring
• GPS SmartSole: GPS hidden in shoe insole
• Apple AirTag or Tile: Affordable trackers that can be attached to clothing or shoes
• Medical alert watches: Some include GPS tracking
• Smartphone apps: Find My iPhone, Life360, etc.

Important: Attach trackers to items they always wear. Consider sewing them into clothing or shoes they can't remove.

Alert Systems

• Door/window alarms: Alert when doors or windows open
• Motion sensors: Detect movement in hallways or near exits
• Bed/chair alarms: Alert when person gets up
• Video monitoring: Cameras with smartphone alerts

Identification

• Medical ID bracelet: With name, "memory impaired," and emergency contact
• ID in multiple locations: Wallet, sewn into clothing, in pocket
• Labels in clothing: With name and phone number
• MedicAlert + Safe Return: 24-hour emergency response (registration program)

If They Go Missing: Immediate Steps

1. Call 911 immediately — Don't wait; every minute matters
2. Tell police they have dementia — They may not respond to their name or act normally; request Silver Alert if available
3. Provide recent photo and description — What they were wearing, distinguishing features, height, weight
4. Start searching likely locations — Former home, work, church, regular walking routes, neighbors' yards
5. Check dangerous areas first — Bodies of water, busy roads, woods, construction sites, places they could get trapped
6. Alert neighbors and local businesses — The more eyes looking, the better
7. Check inside the home thoroughly — Look in closets, under beds, in garages—they may be hiding
8. Activate any tracking devices

Where to Search

• Left-handed people tend to wander left; right-handed people tend to wander right
• They often walk until trapped or stopped by obstacles
• Check familiar routes: Path to old job, church, former homes
• Check bodies of water: Drowning is a leading cause of death in wanderers
• Look in thick brush or hedges: They may have fallen or gotten stuck
• Drive the routes they might walk
• Call their name and check behind/inside things

Preparing Before It Happens

Create a Wandering Response Kit

Have these items ready:

• Recent photo (update every 6 months)
• Physical description written out
• List of places they might go
• Medical information and medications
• Contact information for neighbors and friends
• Local police non-emergency number

Register and Notify

• Enroll in MedicAlert + Safe Return
• Register with local police department's Silver Alert or vulnerable persons program
• Alert neighbors to the wandering risk
• Give photo and contact info to local businesses

Establish Identification

• Ensure they wear ID at all times
• Sew labels with name and phone into all clothing
• Consider GPS tracking devices now, before needed

Reducing Wandering Behaviors

Meet Their Needs Proactively

• Maintain consistent routine and schedule
• Ensure regular meals, hydration, and bathroom breaks
• Provide meaningful activity and engagement
• Create opportunities for safe walking and movement
• Address pain, illness, or discomfort
• Reduce evening stimulation and confusion (sundowning prevention)

Respond to Their Reality

• Don't argue when they want to "go home" or "go to work"
• Validate feelings: "You're thinking about your mom. Tell me about her"
• Redirect: "Let's have some tea first" or "It's getting dark; we'll go tomorrow"
• Distract with engaging activities
• If they must "go somewhere," accompany them on a walk that loops back home

When Home Is No Longer Safe

Consider placement in memory care if:

• Wandering has become frequent despite interventions
• They've had dangerous wandering incidents
• You cannot provide 24-hour supervision
• Nighttime wandering is disrupting everyone's sleep and safety
• Physical aggression accompanies wandering attempts
• They can defeat safety measures you've implemented

Memory care facilities have:

• Secured perimeters designed to prevent elopement
• Alarmed exits with delay locks
• Staff trained in redirection and prevention
• Secure outdoor areas for safe walking
• 24-hour supervision

Needing this level of care isn't failure—it's a safety necessity as the disease progresses.