How Dementia-Friendly Design Helps Manage Wandering in Residents with Memory Loss
Share Via Email
The presence of dementia or full-on Alzheimer’s disease presents a set of challenges for individuals and families. Perhaps the most frightening is the potential for wandering. Having a parent leave the premises, either on foot or in a vehicle, and not knowing if they’re able to find their way back is something no one wishes to experience. The more you know about dementia wandering — what it is, why it happens, and how professionals and memory care communities handle it — the better equipped you’ll be to rectify this issue in your own family.
A serious aspect of dementia
Clinically known as elopement, wandering occurs when a memory-impaired person loses the ability to recognize familiar places. They may even be unsure of where they are at a given moment. Emotional distress, medical conditions, or a perceived need to complete a task can precipitate an episode of wandering. They feel the urge to escape or pursue something, and can easily become disoriented and lost. There is imminent risk of falls, fractures, injury, exposure to the elements, or even loss of life.
Because the brain’s memory centers are damaged by dementia, short-term memory and spatial recall — the ability to distinguish different locations or where one place or thing is in relation to another — are lost in seniors with cognitive decline. These challenges make it harder to determine direction, find objects like keys, navigate grocery store aisles, remember a destination, or recall the reason for leaving a location in the first place.
Common triggers for wandering
Knowing why or when someone may be prone to wander is a challenge in itself. Seniors with dementia may become disoriented trying to complete daily tasks or follow old routines that once were common for them. Trying to reproduce their familiar route to work, going on a long walk, or returning to an old neighborhood often result in dementia wandering. Worrying about former chores or responsibilities like cooking dinner, caring for a child, or heading outside to the garden can lead to wandering. Any unfamiliar environment, like the grocery store or shopping mall, can cause a senior with dementia to become disoriented.
Emotional triggers like stress, fear, agitation, and frustration commonly lead to dementia wandering. Unfamiliar or crowded environments like busy restaurants, sidewalks, or even family gatherings may lead to confusion and cause people with dementia to wander. The conflicting sounds of television, conversation, traffic, sirens, and so on, may cause confusion, fear, and anxiety. This type of overstimulation may make seniors want to escape to a quieter, calmer place. The inability to express themselves effectively can also lead to frustration. When someone can’t communicate what they need, they’re more likely to initiate action on their own.
Physical challenges such as poor eyesight, hearing loss, and decreased mobility are other factors that contribute to wandering. Dementia changes how the brain processes visual information. Impaired peripheral vision can leave seniors unable to see signage or a clear path through a room or interior setting. Poor depth perception makes it difficult to distinguish two-dimensional images from three-dimensional objects. The pattern of a carpet, for example, may appear as something physically blocking a path or hallway, forcing a senior to navigate around it and become lost or confused.
Other factors that could lead to wandering
Wandering may be precipitated simply by a senior looking for someone or something they see in their mind — a former possession, a childhood friend, a room in a home where they used to live. Perceived obligations, like the need to get to a workplace, or complete some other duty or task, can cause disorientation. Even walking down to the mailbox can confuse a senior with dementia and set them wandering.
Nighttime can be especially problematic. People living with dementia often spend more time sleeping during the day, leaving them awake or restless at night. A disruption in circadian rhythm might cause them to feel wide awake and bored, searching for something to do. Physical discomfort like hunger, thirst, or the need to visit the bathroom can also result in an individual becoming disoriented and leaving the room. Waking up to search for an extra blanket can easily go awry for someone struggling with dementia.
What you can do in a home setting
There are measures you can take at home to reduce the frequency and severity of wandering, but even one episode may be one too many. First be aware of the possibility and vigilant in your supervision. In the early stages of dementia, it may be acceptable for someone to be alone for short periods, but as dementia progresses, continuous supervision will likely become necessary. Always stay with your loved one in new or changing environments, including stores, parks and restaurants.
Don’t leave any item visible, like car keys, that might trigger a wandering episode or prompt someone to think they’re supposed to go out and do something. Neutral door coverings and floor mats in front of doorways tend to reduce exit-seeking behaviors. The idea is to try to obscure entries and exits by using curtains or design elements that match the surrounding walls. Fencing or hedging to enclose a backyard can be helpful. Alarms, locks, and motion-sensing devices can alert you when your loved one is up at night or moving toward an exit. Above all, try to provide a calm, quiet environment, especially during the times you believe your loved one is most prone to wandering.
Helping individuals feel confident and calm in their environment
The goal of designers and memory care providers today is to create a setting that supports the functional delivery of care while also being psychologically supportive. For example, it’s not enough to keep residents safe and secure; they need to feel safe and secure. This can be challenging because Alzheimer’s disease often creates cognitive impairments that produce anxiety and paranoia. Such feelings are counterproductive to general health and well-being, a sense of home and comfort, the ability to concentrate, and willingness to participate in social activities.
Communities promote independence by including subtle environmental supports. These might include lockable storage spaces for hazardous materials, restricted window openings and garden fences at least 6 feet high, regulated water temperatures, nontoxic plants, nighttime lighting to highlight the path from beds to bathrooms, and many others.
Memory care neighborhoods in communities today pay close attention to spatial adjacencies to limit their residents’ exposure to active areas they shouldn’t access, and to de-emphasize entry or exit points and the visual access to them. For someone with dementia, the bathroom experience can be stressful and a trigger for wandering, especially at night, so communities provide a direct visual connection from the bed to the toilet to proactively reduce those episodes. To help create a calm, peaceful atmosphere for bathing, they may provide familiar-looking fixtures, soothing lighting, peaceful music, or aromatherapy. It’s also necessary to provide quiet, peaceful spaces to help residents feel stress-free, as well as protected spaces designed to reengage patients in safe, purposeful activities.
Unrestricted access to secure outdoor spaces in serene settings that minimize anxiety and disorientation are vital to reduce agitation and frustration, relieve stress, and improve physical fitness. Giving such access to someone with dementia may even reduce their attempts to wander. Walking paths that loop back to the building entrance and feature naturally camouflaged perimeter fencing are also part of good design for people living with dementia.
Memory care at Ridge Senior Living communities
Each of the communities in our system — The Ridge Pinehurst in Colorado and The Ridge Cottonwood and The Ridge Foothill in Utah — have many of these dementia-friendly design innovations built in. Further, our approach to memory care is built upon compassion for every individual in our care, and delivered by highly trained, licensed professionals dedicated to fulfilling the needs and enriching the lives of every resident.
Specialized programs like MUSIC & MEMORY®, Teepa Snow Positive Approach to Care®, the Montessori Approach to Dementia, and a full schedule of safe, engaging memory care activities ensure purpose and fulfillment each day. Dementia care plans at our communities are centered on warm hearted technique; innovative wellness programming; and premium services, amenities and accommodations that combine to form a holistic approach to memory care.