Coping with Wandering and Exit Seeking in Dementia Patients
People with Alzheimer’s, or another form of dementia, often exhibit symptoms of the disorder that are known as wandering or exit seeking behaviors.
What is Wandering?
Anyone with memory issues, but is still mobile enough to get around on their own, can be prone to wandering. The term wandering makes it sound like an aimless act, but this is often not the case.
Wandering can be caused by confusion or disorientation, but sometimes wandering is just the person’s way of showing others they are still capable of independent activity. Whatever the reason may be for your loved one wandering, it can be very dangerous if not properly monitored and managed.
Early Warning Signs of Wandering
It is helpful to know the telltale signs of the early stages of wandering so it can be handled before it gets out of control.
Some signs to look out for, may include:
- Taking longer than usual on routine walks or errands
- Problems with navigation in familiar areas
- Restless, anxious, nervous, or repetitive behavior
- Retired people may talk about having to get to work
- Talk about visiting deceased friends or family like they are still alive
- Says “I want to go home”, even when at home
- Trouble remembering where various rooms are in the house
- Tries to perform daily tasks and routines, but nothing gets done
These are symptoms that are generally associated with the early stages of dementia, wandering behaviors are frequently soon to follow.
How to Prevent Wandering in Dementia Patients
If you find your loved one is beginning to wander, and you are concerned for their safety, there are a few things you can try to help manage the situation.
To help prevent wandering, it is usually a good idea to:
- Create an organized and structured routine
- Identify wandering triggers
- Determine what time of day wandering typically occurs
- Make essentials are taken care of
- Provide reassurance
- Provide supervision
- Avoid problematic locations
- Car keys and locks
- Notification alarms
One of the best ways to help prevent confusion in dementia patients is by creating and following an organized daily schedule. If activities, tasks, and meals happen at the same time every day, it leaves less room for disorientation.
People with dementia that are prone to wandering are usually set off by certain triggers.
Some common wandering triggers in dementia patients, are:
- Delusions or hallucinations
- Hunger, thirst, need to use the bathroom
- Onset of evening – sundowning
Time of Day
Many dementia sufferers exhibit a symptom referred to as sundowning. This is also known as late day or early evening confusion. For most individuals with dementia, it is extremely demanding and exhausting just getting through the day. By the time evening comes around, regular mental and behavioral processes may not be working as they should.
Try to determine what time of day wandering typically occurs, and arrange an activity or rest time for those periods.
Dementia patients that have their essential needs taken care of, like food, water, toileting, and rest, are less likely to wander.
If the person becomes confused and starts to panic, a little reassurance that they are safe and everything is OK, can really help.
Sometimes the only solution is constant supervision. This is particularly true for dementia patients outside the home, or in unfamiliar surroundings.
Try to avoid crowded or noisy places that are likely to set off an episode.
Car Keys and Locks
Don’t make it easy for your loved one to wander. Make sure car keys are kept out of sight, and inside the house door locks are not easy to open (or locate) to get outside.
If the issue becomes frequent, you may want to install devices or alarms that go off when a door or window is opened.
What is Exit Seeking?
Exit seeking is another common symptom of dementia that is very similar to wandering. Also called elopement, exit-seeking is basically just a more purposeful or driven form of wandering. Exit seekers are not trying to hide their intentions or behaviors and may even get agitated and cause a scene when the impulse comes to make a swift exit.
Stay Calm and Don’t Argue
When dealing with exit seekers, it is extremely important to stay calm and not be argumentative.
Try putting yourself in the patient’s shoes. Imagine you are trying to leave a place to deal with some important business. As you are leaving, someone stops you and says “No, you can’t leave. You have to stay here”. Now you are being detained and you are not sure why. This situation can escalate in a hurry.
Look for a Reason or Trigger
Try to figure out what has sparked this immediate need to leave, and that may help with a solution for the present situation and future episodes.
Exit Seeking Prevention
Steps to prevent exit seeking are quite similar to those used to inhibit wandering, but maybe with a bit more authority.
- Avoid overstimulation – crowds, noise, bright lights, clutter
- Avoid under-stimulation – boredom is often a good reason to bolt
- Install signs in the home for easy navigation
- Disguise exit doors
- Install notification alarms
- Inform neighbors and friends to be on the lookout
- Make sure dementia patients always have ID and address on them
- Medical alert bracelet