Wandering (dementia)

Wandering, in persons with dementia, is a common behavior that causes great risk for the person and concern for caregivers. Although it occurs in several types of dementia, wandering is especially problematic in persons with Alzheimer's disease (AD). This is because AD frequently produces impaired memory: persons with impaired memory are likely to become disoriented and lost simply because they do not recognize where they are nor remember how they came to be there.

Elopement

Unattended wandering that goes out of bounds, a behavior known as elopement, is a special concern for caregivers and search and rescue responders. Because elopement often follows from a combination of wandering and sundowning, it typically results in the person being lost out of doors at night, dressed inappropriately, and unable to take many ordinarily routine steps to ensure their personal safety and security. This is a situation of great urgency, and the necessity of searching at night imposes added risks on the searchers.

In some countries the social costs of elopement, already significant, are increasing rapidly.cite web
url=http://www.dbs-sar.com/SAR_Research/wandering.htm
publisher=dbs-sar.com
title=Wandering and Alzheimer's overview
accessdate=2008-08-26] A SAR mission lasting more than a few hours is likely to expend many hundreds to thousands to tens of thousands of skilled man hours and, per mission, those involving subjects with dementia typically expend significantly more resources than others.

Prevention

The most effective methods of preventing wandering, particularly wandering out of bounds, are physical restraint, physical barriers, 24-hour real time surveillance, and the use of tracking devices. All of these methods have ethical issues and one, physical restraint, is widely considered to be inhumane. [PMID 16849002] Tracking devices of several kinds have been evaluated. [PMID 16107453] [PMID 15082438]

Management

To mitigate the problem of wandering, in the United States the Alzheimer's Association has developed a program called "Safe Return".

ee also

References

*PMID 15352531
*PMID 15213777
*PMID 15154224
*PMID 15014607
*PMID 14645806
*PMID 10513031