Wandering from Nursing Homes

Many patients in nursing homes suffer from Alzheimer’s or dementia, and wandering around the home, and out of the home, is often a cause for injury for these patients. A study from 2006 showed that 20% of patients suffering from dementia will have a “wandering incident” at least once. When they are out of the safe confines and away from the watchful eyes of the staff, injuries and even death can occur.

Why Do Residents Wander?

Patients with Alzheimer’s and dementia are very likely to wander, especially those who are just starting to suffer from the conditions and those who are new to the facility. This is because it is a strange environment, and they are often looking for a familiar and safe place. Other things that can cause wandering can be changes to a routine or changes in medication. If the resident is thirsty or hungry, or needs to use the bathroom, wandering can occur as well. Sometimes, patients are trying to find their home or any familiar surroundings. These incidents can be traumatic for the resident, and they may feel trapped when guided back to their rooms.

Types of Wandering

There are names for different types of wandering that occur in the nursing home, and it’s important for the staff to be able to understand the various types of wandering that happen.

Agitated Purposeful Wandering

When a patient feels agitated for some reason, it may cause them to wander, and they may be upset when they are doing it. The reason for the agitation can be real or it can be something that they imagine, but they are a disrupted emotional state. They may be aggressive and unwilling to cooperate. If the issue that caused the agitation is not remedied, these episodes will likely continue.

Elopement

This is a very dangerous type of wandering, and it refers to when a patient leaves the nursing home and wanders outside. They can be injured and even die in these cases. Many different things – all of the other elements of wandering – can cause them to want to leave. It’s important for staff to be especially watchful of patients who have done this in the past.

Environmentally Cued

In some cases, the environment, such as a hallway, will cause the patient to want to wander. Different environmental factors can trigger the wandering behavior.

Fantasy

Fantasy wandering happens when the patient is no longer away of their actual surroundings. They wander through an imagined environment, typically something from the past, such as their old home. It can be hard for the patients to understand that they are not in that other environment and that they are in fact in a nursing home.

Recreational

Sometimes, a patient merely wants to walk and to get more exercise. This causes them to wander around the facility. The staff can remedy this by ensuring the resident has more exercise and time to explore the area.

How Should the Staff Respond?

The staff needs to evaluate all of the patients they have in order to get an idea of the risk of wandering that each has. Most of the time, the first incident of wandering will occur within the first two days of coming into the facility. Locking doors that are not in the resident’s safe areas can help to cut down on injuries. The patients need freedom, but they also need to be safe, and the staff needs to maintain this balance.

Whenever there are incidents of wandering, it is important for the staff to let family members know right away. Help from the family can sometimes assist in preventing wandering with some residents. In some cases, changing the environment, or removing the resident from the home, is the only way to keep them safe.

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