wandering

Wandering occurs when a person with dementia roams around and becomes lost or confused about their location. It is a common behavior that can cause great risk for the person, and is often the major priority (and concern) for caregivers. It is estimated to be the most common form of disruption from people with dementia within institutions. Although it occurs in several types of dementia, wandering is especially common in people with Alzheimer's disease (AD). People with dementia often wander because they are stressed, looking for someone or something, attending to basic needs, engaging in past routines, or with visual-spatial problems. Other times, they may wander without aim at all. Elopement Elopement, or unattended wandering that goes out of bounds, is a special concern for caregivers and search and rescue responders. Wandering (especially if combined with sundowning) can result in the person being lost outdoors at night, dressed inappropriately, and unable to take many ordinarily routine steps to ensure his or her 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. A search and rescue mission lasting more than a few hours is likely to expend many hundreds to thousands to tens of thousands of skilled worker hours and, per mission, those involving subjects with dementia typically expend significantly more resources than others. Assessment Assessment of a person's risk of wandering is often neglected. A review of medical records of 83 people with dementia living in Los Angeles found that only 8% of the records included a wandering risk assessment. Assessment can be performed by a social worker. In the United States, the Alzheimer's Association has developed a program called "Safe Return" that includes assessment tools. An assessment tool designed for use in nursing homes is the Revised Algase Wandering Scale-Nursing Home Version (RAWS-NH); this tool may be suitable for use in assisted living facilities.