What Are Wanderers Trying to Tell Us?
One of the many behavioral mysteries associated with dementia is the tendency to wander. The Alzheimer’s Association website claims that 60% of those with Alzheimer’s will wander at some point. However, a review of literature conducted by the Alzheimer’s Association reported that the prevalence of wandering ranged from 6% to 100%. There are many theories as to why people with dementia wander, but there is no definitive explanation for this behavior, nor has anyone figured out any one technique to prevent it.
More than One Type of Wandering?
Thomas Kitwood, the English psychologist who studied dementia, commented that all behaviors are communication. If that is the case, then it makes sense that people who wander may be trying to communicate different messages. Care givers describe different affects among patients who wander. Some seem to be seeking something, which they may or may not be able to describe. Others appear agitated and angry. Yet others seem disoriented in space and are trying to figure out where they are.
Care Givers as Detectives
Just as a crying baby may be communicating hunger, pain, fear or illness, someone with dementia who is wandering may be trying to express similar conditions. If wandering is a response to something that is wrong, it makes sense that no one response is likely to reduce or stop the behavior. Thus it is up to the care givers to be attentive to the wandering in order to decipher the message.
Wandering Due to Physical Discomfort
It is thought that much of the wandering behavior is the result of physical discomfort. Here is a basic check list to use:
- How long has it been since the person ate?
- Is the person running a fever, or displaying any other symptoms of illness?
- Does the person need to use the bathroom?
- Are there environmental factors that are causing discomfort, such as too much or too little heat, too bright or too low levels of lighting, loud noises or unpleasant smells?
Wandering as a Sign of Boredom
Some care givers report that wandering occurs when the person has no one and nothing to interact with. If there are no physical reasons for the behavior, boredom may well be the reason. Care givers have found card games, gentle exercising, a hand massage, going for a walk, helping with a meal, visiting with a pet can all sooth someone who has been restless.
Wandering in Men
Men who are now in their 80s and 90s lived in a time when they expected to be in charge. Among men with dementia who wander, there is often a need to assert their control over a situation. The more care givers try to correct or limit them, the more agitated they can get. It is important to give these men as much decision making during their day as possible.
Wandering Back in Time
Some care givers notice that people living with dementia start to wander at specific times of day, or as the result of a specific trigger. It helps to find out the past daily rhythms of that person. Often the wandering takes place at a time when the person previously went or came home from work, picked children up, or had a standing meeting. Understanding where they think they should be will give you clues as to how to best reassure and redirect them.
The solutions for wanderers are likely to be as varied as the causes for the behavior. Once care givers are satisfied that the wandering is not due to physical discomfort, they will have to think creatively of ways to engage, divert or join in with the perceived reality of the wanderer. Seen in this light, wandering is not an intractable behavior, but a puzzle to solve, with the promise of satisfaction for both the care giver and care receiver.