27 tips for preventing elderly wandering

My grandfather is somewhat of a mystery. He is usually unsteady on his feet and as slow moving as they come. But the moment I duck into the restroom, he suddenly becomes a stealthy superhuman who can exit the house and bolt for freedom faster than a speeding ticket.

 

While the notion of an elderly loved one secretly possessing a gift for absconding sounds funny at the outset, it is a much more frightening thought in reality. According to alz.org, three out of ten people with Alzheimer's will wander away from safety. Of those that do wander off, it is essential that they are found as quickly as possible and returned home before injury or worse occurs.

 

As we all know, it’s all about prevention. Although I will list some tips for what to do if an elderly person wanders off, most of these pointers will be about preventing it in the first place.

 

Why they wander

If you are serious about preventing your dependent loved one from wandering, take a moment to consider why they may wander.

• Boredom will motivate an elderly person to get up and get moving. No one relishes the idea of being completely bored all the time. When monotony sets in, they just want to find something to do. Wouldn’t you?

• Old habits can come into play. If an elderly person is suffering from confusion, they may decide that it is time to get up and go to work. Even though an elderly person may be at home, she may spontaneously decide it’s time to don a coat and head for home, wherever that may be. A more saddening scenario is when grandfather decides to go pick up grandma from work, despite the fact that she has been deceased for years.

• While getting lost is a big enough danger in unfamiliar territory, don’t forget that an impaired elderly person can become lost in his own home.

• Sundowners syndrome affects individuals with Alzheimer’s and dementia. It is characterized by a change in behavior, confusion and irritability triggered by the fading light of the evening. The added confusion and restlessness is a recipe for wandering.

 

Tips to prevent wandering

 

Keep items that represent leaving out of sight

There are a number of things that will trigger a “time to go” response from an elderly person. Be sure to keep car keys, umbrellas, coats and purses out of sight if your loved one is prone to wander.

Deal with all exits

When caring for an elderly adult who loves to roam, take a moment to consider all exits from the building. While safety is the primary concern for any caregiver, the need for dignity needs to be recognized as well.

 

Install locks above or below the line of sight.

If an at-risk person cannot open a door, he will not be able to exit the building and wander into danger. Depending on the particular individual you care for, a simple slide lock up high may do the trick. For the craftier loved one, install a deadbolt that requires a key to unlock it from the inside. Keep in mind that you should NEVER lock an elderly person in a home unless a caregiver is present with them to help with emergency egress in an emergency.

Use an electronic door alarm.

There are several different kinds of door alarms that will give a caregiver ample warning when the door is opened. Depending on the risk level, a simple chime may suffice. One the more critical end of the spectrum, some alarms make it sound like the “def-con 5” warning was triggered in a nuclear silo. Specific types of alarms will be listed below.

 

Hang bells on the doorknob.

If wires and switches are not a possibility for your particular setting, keep it simple. Hang a few bells on the doorknob or in front of the door where they are sure to foil grandpa’s best laid plans for a night on the town. As an alternative, strategically placed wind chimes will sound a gentle alarm whenever the door is opened.

Use childproof doorknob covers.

As inappropriate as it may sound, these frustratingly effective covers will prevent the elderly from getting the door open. These are usually made of plastic and slip over any round doorknob. A person lacking in hand strength (or carrying a bag of groceries plus a gallon of milk) will not be able to turn the knob. The same rule applies to this tip as to locking the door from the inside: NEVER lock anyone in a home alone.

Get tricky with doors.

Simple locks or alarms will not address an elderly person’s frustration while messing with the front doorknob. Why not make the door less inviting altogether?

• Cover exterior doors with a full length curtain so it is not readily visible.

• Full size posters can be ordered to make a front door look like a book shelf. Who would attempt to exit the house using a bookshelf?

• A large mirror on the inside of a door has often enough fooled a confused elderly person into thinking that he has encountered a stranger staring back at him. The typical response is to turn around and leave the area.

• A black throw rug placed in front of the door has been known to convince an elderly escapee to steer clear of that large “hole in the ground”. To ensure that a throw rug does not become a trip hazard, check out the article entitled 31 tips for preventing elderly falls.

• Place signs on the door that say: STOP, CLOSED or DO NOT ENTER. It sounds strange but it works quite often.

 

Remember that doors are not the only way to exit a house.

While we are talking about exiting from the house, keep in mind that grandpa may have limited mobility one moment and then be somehow able to slide through an outside window the next. If this is a possibility, install window limiters to ensure that they cannot be opened far enough to allow a person to exit. Using limiters rather than locking them shut allows windows to still be opened for fresh air.

 

Use technology

 

Sometimes it seems like an elderly loved one is obsessed. I suppose you and I would drive a caregiver to tears as well if we were not able to drive, ride a bike or come and go as we please. We need all the help we can get when caring for a loved one while still trying to give them the dignity that they deserve. This is where technology comes in. Fortunately for us, some forward-thinking geeks have set out to make our lives easier and our loved ones safe.

 

 

Use an alarmed floor mat.

Grab a pressure sensitive floor mat and place it in front of the exit or even off the edge of the bed. These nifty floor mats will send a wireless signal to the alarm box and let you know that your loved one has just hopped out of bed or is at the door trying to wander outside.

Use a door alarm.

Since we don’t want a door alarm to chime when everyone in the building uses the door, I will suggest an alternative to a normal door chime.

 

For the sake of your sanity and the effectiveness of the door warning, choose a system that only sounds an alarm if your loved one (who is wearing the wristwatch-sized transmitter) tries to exit the building. This system will cut down on the amount of false alarms and needless noise.

Use an infrared motion sensor.

For a fast, flexible solution, consider a motion alarm. This infrared motion sensor from “Smart Caregiver” will keep watch at the front door, hallway or wherever you place it. A signal is sent to the “Economy Care” alarm box to notify you of the motion event. I like the flexibility of this system. It can be used for keeping my aging grandfather safe and later be used to keep my teenager away from my Harley in the garage (And yes, I suppose it could be used to keep my grandfather off of my Harley as well).

Use a positive pressure bed pad.

If you would like to be notified the moment your loved one leaves her bed at night, place a “Smart Caregiver” pressure sensitive pad under her mattress cover. As soon as the bed is vacated, a signal is sent to the wireless monitor. You can choose an audible alarm or a silent flashing light.

 

 

Encourage healthy wandering

Take a moment to realize how frustrating it is to no longer do all the things you enjoyed in your younger years. Sometimes the restlessness and urge to wander is magnified by the simple fact that an elderly person still wants to do something with his day. If possible, create an environment at home that allows for some safe wandering.

 

Create a route to wander through the home.

Depending on the layout and size of your home, it may be possible to arrange furniture and other items to allow a circular path through the house for wandering. Bring the path past windows and an easy chair and your loved one will have a pit stop with a view as well. When arranging grandpa’s touring track through the home, be mindful of trip hazards.

 

Make a safe wandering track outside.

If you care for a wanderer, you should already be considering installing a fence around your yard. When planning the installation of an anti-wandering fence, consider creating a circular path around the house where your loved one can wander. A few benches along the way will allow for a nice rest every so often. I suggest that any chairs or benches be a bit more substantial than the average lawn chair. These are often too unstable for an inhibited elderly person to safely get in and out of.

 

It’s about physical activity.

The whole idea with creating a safe place to slake the wandering urge is about burning some of that restlessness away with increased physical activity. If a wandering path is not feasible, consider other ways you can provide opportunities for your loved one to get some appropriate exercise. This is all going to depend on each individual’s mobility and balance. Some may benefit from water exercises while others may enjoy an easy walk around the block with a caregiver. Choose what suits your situation.

When they wander at night…

An elderly person wandering in the daytime is one kind of problem, but wandering at night is a whole new kind of stress for a caregiver. It is very hard to get a good night’s sleep when you know that your loved one may get up and lock himself in the garage or leave the house at night. Be assured that there are a number of things that can be done to quell the restlessness and hazards associated with nighttime wandering.

Consider their sleep quality.

Your loved one is more likely to be up and about in the middle of the night if conditions are not conducive to good sleep. Hop in grandpa’s bed and decide if you could comfortably sleep in it. Is it warm enough in the room? Are the blankets and pillows plentiful and comfortable? Start with the conditions where your loved one is supposed to sleep and ask yourself (and your loved one) if anything needs to be changed.

 

Get your loved one on a regular sleep schedule.

This principle applies to most human beings, not just the elderly. A regular sleep routine will encourage your loved one to sleep at night rather than going on adventures. Perhaps all seven daytime naps aren’t really needed? Look for things that would interfere with a healthy sleep routine and see if you can change things to encourage a habit of nocturnal restfulness.

 

Leave a snack and glass of water by the bed.

This tip comes with one condition: consider your loved one’s access to toileting facilities. While a drink of water could be all that a wandering person is looking for, it really helps if there is a restroom that is easy for your loved one to use without getting lost. Loved ones sometimes wander and get lost in a far corner of the house when they were simply looking for a snack, drink or the restroom.

 

Provide moderate lighting at night.

Some strategically placed night lights could be all that is needed to keep grandpa from getting lost when headed for the restroom or looking to raid the slice of pie that is calling him from the fridge. Confusion runs rampant when you cannot see where you are or which door you came through. Of course, this tip will contribute to safety as well.

Reduce noise in the home.

We tend to become immune to the noise that bombards us 24/7. Consider whether the nighttime environment is too noisy for your loved one. External noises, refrigerators or heaters turning on can rustle an elderly person from bed when she could be resting soundly. Since there are some noises that you cannot control, consider checking to see if the steady background noise of a small fan may block out unavoidable noise.

 

Listen for verbal cues

This tip is pretty simple. There are plenty of times when an elderly person will give you ample warning that a wandering episode is imminent. These verbal warnings may sound like a statement that does not line up with reality:

• “I want to go home”

• “Time to go to work”

• “Let’s go visit …”

• “Where is [deceased spouse or relative]”

 

You get the idea. Just be sure to listen for a verbalization of the need to go somewhere, even if it is irrational. Gently redirect your loved one to something else and keep a watchful eye on that wandering desire you know is brewing inside.

 

If a loved one wanders off…

 

As I mentioned at the beginning of this post, sometimes our elderly loved ones exhibit a shocking ability to disappear at the slightest opportunity. Let’s wrap this up with some bonus tips on what to do if grandpa outsmarts you not only at chess but as an escape artist as well.

Bring a phone outside and be ready to use it.

If you are sure that your loved one has gone AWOL, grab a cell phone and rush outside to quickly search the immediate area. If you cannot find him in the immediate area, go ahead and let the police know that you have a missing person who is at risk.

 

Dress your loved one brightly.

This is a good tip for those that are prone to wander from the home as well as on outings. Elderly people usually won’t mind being dressed like an 80’s pop star and you will be able to scan a crowd or down the block a lot easier.

Get acquainted with your neighbors.

Be sure that your neighbors know what your keen-ager looks like. Ensure that they have your number and are aware that it is not safe for him to be wandering outside alone. Most people would be happy to pick up the phone and do a good deed.

 

They should always have ID.

Your loved one should always have identification on her, even in the home. This will let first responders or helpful bystanders identify who the mystery person is and where she belongs. Some people sew identifying labels on the inside of their loved one’s clothing. As an alternative, consider getting jewelry that also has identifying information inscribed on it.

Always have a recent photo.

In case you need to quickly show first responders what the missing person looks like, keep a current photo on hand. I have known caregivers who frequently take a cellphone picture of the person they are caring for at the beginning of a shift so that an accurate description of the clothing they are wearing can be given to the police.

 

Know their dominant hand.

Why in the world would you need to know your loved one’s dominant hand? The answer falls into the category of expert tracking tricks. When most people wander, they are likely to follow the direction of their dominant hand. This means that a right handed person will come to an obstruction and “randomly” choose to wander to the right rather than the left. Is this a hard fast rule? Of course it isn’t. But when you are frantically searching for a lost wanderer, this kind of knowledge will sway the odds of success in your favor.

 

Enroll your loved one in MedicAlert.

First responders are trained to notice a MedicAlert ID bracelet and use their 24/7 emergency response service to retrieve information on the person’s medical health and place of residence. Another useful service is the Alzheimer’s Association Safe Return system. Find information about enrollment at www.alz.com or call 1-888-572-8566. These services can be a lifeline that will connect local law enforcement with valuable information needed to get the lost home safely.

Keep their scent on hand.

I saved this tip for last because I consider it to be fairly extreme. But when a loved one is lost, you will gladly go to extremes to get them home safely. Keep a shirt that has been worn by your loved one in a Ziploc bag. In the event that your loved one goes missing, the shirt will provide a scent for a rescue dog to key in on. Every little bit helps.