The Wanderer

October 9, 2018

 

Wandering is very common amongst people with dementia and is quite a worry for those concerned with their safety and well-being.

I remember my dad, who had dementia, making a bid for freedom from his residential home when a visitor unwittingly let him out. He strode off down an unfamiliar road in a very determined and purposeful manner, telling the staff who were in hot pursuit “I’m trying to get away from you lot!”. The staff walked with him for a while, using gentle humour (dad was a bit of a joker himself) to validate his feelings. Eventually he forgot what was troubling him and they were able to persuade him to go back to the home, tempted by a hot drink and a piece of cake.

Wandering can be triggered by a variety of things such as insomnia, pain or discomfort, disorientation or confusion due to sun downing, boredom or lack of exercise. It is most often caused by having an unmet need of some description. A need for company, conversation, a hug, to feel useful, to have a role or something to do.

Whatever the cause there are a few things you can do to help your residents and minimise their distress.

Establish Behaviour Patterns. Look for patterns in the places they wander, the time of day. Were they engaging in any activity? For example, could they have been upset by something on the TV or by other residents shouting. Had visitors just left. Could they be bored, hungry or in pain?

Validate. What emotions are they trying to express? Are they worried, angry or upset. If the wanderer is “going to work” then recognise that they may have an unmet need to feel useful. Don’t remind them that they no longer have a job but validate their feelings by talking about the job they used to do and the importance of this. If they are “looking for their wife” then they may be feeling lonely or need a hug. There’s no point in reminding them that their wife has passed away, so steer the conversation to the old days and talk about the activities they used to enjoy together.  Let them know that you understand they are upset, worried, or feel redundant and that you will try to help.

Redirect. If the wanderer keeps saying they “want to get out!” then try to redirect by steering the conversation in a different way. Ask “Where will you go?”, “Who will be there?” “What is it like there?” Anything to get another talking point, such as interesting things about the area they used to live or what car they used to drive. Or you could try saying something like  “I know you want to go outside but let’s have something to eat first” or “lets wait for your daughter to come, she might like to go with you”. You obviously need to know your residents. The idea is not to tell lies but to diffuse the situation and find another way to meet the unmet need.

Distraction. Offer an activity that is meaningful to them. E.g. Looking through old photographs and recalling happy memories can reduce the unmet need to “go home”, sorting through coins or paperwork, helping with setting the tables or folding napkins can make someone feel useful and reduce the need to “go to work”.  Singing an old song together or just holding somebody’s hand can reduce feelings of sadness and loneliness.

It was a good outcome for my dad. It’s not always that easy but when you find that one thing that makes a difference it really is satisfying.

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Katie Farrar

Occupational Therapist

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