BEHAVIOURAL AND PSYCHOLOGICAL PROBLEMS IN THE CASE OF ALZHEIMER’S DISEASE: WANDERING

Apr
02
2009

Posted by: admin in Categories: General health.
Using Tags: General health

At some stage in their illness many people with dementia will show a tendency to wander. This can be a problem even if it is confined to the house, but some people will take to wandering, sometimes miles, away from home. Because this is potentially dangerous it usually causes a lot of anxiety and distress for the carers. It is, however, almost impossible to be absolutely certain that you could prevent a wanderer from ‘escaping’. Even in a hospital it isn’t feasible to watch someone for twenty-four hours a day.

There seem to be many different types of wandering and it is a form of abnormal behaviour that is only just beginning to be studied in detail. In some people with dementia it may result from boredom, in others perhaps it is a way of using up excess energy; on occasions it may be a reaction to pain or discomfort. In many cases it seems that sufferers are looking for somebody or something, for instance trying to find the house they lived in when they were a child under the mistaken impression that it is still their home. At a simpler level, some people wander when they have been moved into a new environment and once they become familiar with the layout of the accommodation and settle into a routine, the wandering will cease.

Another quite common cause of wandering is the mistaken impression sufferers can have that they have an appointment or that the time for an appointment has arrived when it may not in fact be for several hours, or may even be on an entirely different day.

There are various ways of trying to tackle wandering. If it is at all possible, it is worth making an effort to understand the reason behind it. This means that one has to be certain that there is no additional medical problem that is causing distress and medical advice may have to be sought. If, however, boredom seems to be at the root of the matter, then increased activity may well help. Very often all that one can do is to divert the person’s attention to some other activity that doesn’t involve wandering. When disturbed in the middle of the night, some carers suggest that the sufferer has a cup of tea before he or she leaves for wherever they imagine they are going. While the tea is made, it is often possible to divert attention away from leaving the house to something else and from there to the need to go to bed. If they insist on leaving the house, particularly if they appear to be becoming aggressive or violent, it is best to let them leave, to accompany them, and to try to divert their attention while walking so that they will eventually come round the block with you back to home.

Unfortunately a determined wanderer will sometimes escape. There is no reason why you can’t fit suitable locks and bolts to the doors, but do make sure that they are not difficult to open in case of an emergency, for example a fire. Give your relative an identity bracelet or some other means of identification, including your telephone number or that of a neighbour if you don’t have a telephone of your own. Make sure that local people, neighbours and shopkeepers for example, know of the problem so that they can alert you if necessary.

If, despite all precautions, the sufferer wanders off for some time, undetected and unseen by anybody, don’t panic. Accidents happen very rarely. I can think of hundreds of people with dementia who have wandered regularly, despite the best efforts of those caring for them, yet I only know of two or three who suffered in consequence. The greatest difficulty caused by wandering is the reluctance of day centres and nursing homes to take responsibility for a person who may disappear. This naturally increases the stress on those caring for them. Drugs are usually of little help, but may have to be tried as a last resort. It is essential though that they are only used for a short period and withdrawn very early if they don’t appear to be helping.