Q. My mom, who has Alzheimer's, has begun to wander around the house. I am worried that she will go outside when I am not looking and get lost.
Wandering around the house may be irritating to the caregiver, but not necessarily unsafe for the patient. In this case, you may need to adjust your anxiety level about wandering. On the other hand, some wandering can be dangerous and must be prevented: going into areas of the house that are off-limits, especially stairwells, decks, hot tubs, and swimming pools; leaving the house alone via a window or door to go outside; or leaving your yard or property.
You can prevent many instances of wandering by carefully selecting child-safety devices for your home that effectively restrict adults. Some caregivers have "outsmarted" the person who has a desire to escape with novel solutions, such as hiding items like purses, shoes, or glasses that the person would always take with them if they left the house. Or, you may want to acquire comfortable chairs that are difficult for the Alzheimer's patient to get out of! Bean bag chairs and recliners are pleasant to sit in, yet restrict movement out of the chair.
Two characteristic precursors to wandering are restlessness and disorientation. Redirecting behaviors, distracting, orienting, and encouraging physical exercise therefore, serve to reduce the incidence of wandering. Some suggestions are:
• Immediately redirect pacing or restless behavior into productive activity or purposeful exercise.
• Make sure mom gets plenty of exercise and movement. Even consider singing and dancing! Indoor shopping malls are vast walking opportunities protected from the weather. If you walk outdoors, make sure that you both have clothing that shelters from cold, rain, and sun.
• Make sure she is involved in many productive daily activities, such as the simple chores of folding laundry or washing vegetables for dinner.
• Reassure her if she appears disoriented.
• If wandering tends to occur at a particular time of day, distract her at that time.
• Reduce noise levels and confusion. These can disorient her.
Disorientation can be a result of medication side-effects, drug interactions, or over-medicating. If disorientation is becoming a problem, consult the doctor.
If you are moving mom to a new environment, reduce disorientation by acclimating her ahead of time with several visits.
Another smart preventive measure is to sign her up for the Alzheimer's Association's Safe Return Program, which is an identification system to help rescue lost Alzheimer's patients who have wandered away. It is available through the Alzheimer's Association at http://www.alz.org.
NANCY TURNEY received a bachelor's degree in social work and a certificate in gerontology. If you have a specific question you would like answered in this column, e-mail it to firstname.lastname@example.org or call Turney at the Crescenta-Cañada YMCA, (818) 790-0123, ext. 225.