Wandering is a common behaviour in people with dementia. They may walk excessively, pacing up and down, walking outdoors in a seemingly random manner or even frequently return to previous homes or workplaces because they think they still live or work there.
Around 60% of people living with dementia wander at least once, with around 20% doing so on a fairly regular basis.
Wandering can pose risks to people with dementia. They can get lost, risk accidents and even break the law if they walk onto private land or even other people’s homes and gardens. They can even lose too much weight, particularly if their restlessness also limits how much they eat.
Caring for someone who wanders can be exhausting, but there are ways to help the person with this behaviour and minimise the risks involved, while still enabling them to reap the rewards of regular walking.
Signs of wandering in people with dementia
Wandering behaviour can present in a number of different ways. Some people may wander on a daily basis, while for some it’s a once in a blue moon occurrence. Behaviours include:
- Pacing or walking in a loop
- Forgetting their way or feeling disorientated when walking in familiar places, sometimes including within their own home
- Forgetting where family and friends live. This can include exaggerations, such as believing a friend lives miles away when they’re actually just round the corner
- Feeling lost or disorientated suddenly while out
- Walking to places from their past, but not in a nostalgic way. For example, someone who still drives might drive to the shop, come over confused and walk back to their old house, having forgotten their new home and the car
- Walking to see someone who died or moved away a long time ago
- Leaving the house at strange times to walk, such as during the night
- Leaving the house without meaning to
- Acting as if they’re doing an activity, but not actually doing it. An example could be they walk aimlessly round the garden for a while and keep going into the shed, then tell you they have mown the lawn and done loads of gardening when they haven’t
Why do people living with dementia wander?
Physical causes of wandering
- Cognitive decline. People with dementia can have problems with memory and processing information. This can prompt wandering off as they become confused about where they’re supposed to be and where they’re going. It can also affect visual-spatial awareness, leading to them feeling lost even in familiar surroundings. They may no longer recognise their home as where they live, or have false memories that they need to go somewhere that they don’t.
- Poor eyesight, caused by dementia or not, can increase how much they get lost.
- Discomfort and frustration. They may become agitated if they need the toilet, a shower or are hungry, without recognising or being able to express their discomfort, so instead expressing it by walking about.
- Restless legs. Restlessness can be an effect of any damage to the brain, including dementia. A 2020 study from the American Medical Directors Association also found that night time wandering in people with dementia can be a manifestation of Restless Legs Syndrome. This can happen to people at any age but is more common in women. It is an overwhelming feeling of having too much energy in your feet and legs, almost like a pot boiling over. It usually happens at night. It is very uncomfortable and only alleviated by moving them quickly.
Emotional causes of wandering
- Anxiety is a common symptom in dementia and a person may walk to alleviate stress or because they feel overwhelmed and disorientated by their surroundings. People with dementia are known to be more likely to wander if anxiety or delusions are part of their symptoms.
- Boredom, particularly at night due to the disruption that dementia causes to the body’s natural circadian rhythms. They may sleep more during the day but feel wide awake and want to go out at night.
- Stress or fear about being in an unfamilar place.
How to prevent someone with dementia wandering
To help someone with dementia to stay safe, you could:
Work out patterns
Think about whether there are any patterns in when your loved one wanders or where they are when it begins. Do they only start to wander in unfamiliar surroundings? Or do they experience sundowning? Spotting patterns in their behaviour could help you to prevent it and so reduce their risks.
Get to know their routes
If they often leave the house and get lost, get to know where they go. They might often end up in a particular pub or café, or even follow an old routine, such as going to pick their children up from school. You could have contacts in these places to let you know they’re there.
Support them to fill their day
Help them to keep busy with hobbies and involve them in daily activities they enjoy like gardening or housework.
Be there when they wander
Create a routine of spending time with them at times they usually wander.
Help them to exercise safely
Walking has huge benefits for physical and mental wellbeing, so it’s not that they need to stop, but just to do so in a safer manner. Try helping them to exercise safely, whether it be arranging for a family member or carer to go for a walk with them each day or buying exercise equipment for their home, such as a mini exercise bike.
Look into lifestyle changes
If they show signs of Restless Legs Syndrome, lifestyle changes including making time to exercise in the day and quitting smoking can greatly help, along with adopting a night time routine to help wind down. More severe cases may be caused by iron deficiency, so see your GP about testing and supplements.
Use technology
Consider assistive technology to find out where they are if they get lost. While it’s essential to respect their freedom and privacy, it may be appropriate to use a pressure-sensitive mat by the door to alert you to when they leave the house, or to track their location using an app, device or GPS in their car. You can buy dementia tracker bracelets online, that have the person’s name and a contact number, and link to your phone so you know where they are and you can be called in case of emergency.