Wandering Behavior In The Cognitively Impaired

Definition
Wandering is defined as aimless or purposeless movement without regard for safety. Movement with no identified rational purpose; the individual appears oblivious to needs or safety.

Causes
Unfilled need – toileting, hunger, thirst, pain, too hot or too cold, frightened, tired, desire to go outside, security, looking for someone or something, excess energy, boredom.

1. Offer something to eat and/or drink. Don’t ask the individual if they are hungry or thirsty
   since they may not understand your question even if they answer with a yes or no re
   sponse - just provide a favorite food, snack or drink. Keep some easy to open snacks
   on the table or counter within easy reach. Use juice boxes or styrofoam cups with lids
   and a straw to prevent spills. These can be purchased very inexpensively at a ware
   house store likes Sam's Club, BJ's or Costco. (www.samsclub.com; www.bjs.com;
   www.costco.com)
   
   
2. Look for any facial expression of pain. If the individual is grimacing attempt to deter
   mine the cause of their discomfort. If the individual has a medical condition that causes
   chronic pain provide medication as ordered. A simple Faces Pain scale can be used as
   a guide. (see Faces Pain scale)



3. Direct the individual to a bathroom and motion for or assist them to toilet. Pulling at
   clothing and attempts to disrobe maybe signs of the need to toilet. Consider placing a
   picture of a commode on the door to the bathroom. This may be a cue. Use a simple
   photo in a clear sheet protector or buy a simple decorative plaque with a picture of a
   commode. Use pictures not words. (look in a Dollar store or local craft or card store for
   a plaque or cut a picture of a commode out of a magazine.)



4. Attempts at disrobing may also occur if the individual is hot - Check the room
   temperature and assist to change clothing if needed.



5. Pulling at clothing may also be a sign the individual is cold. Check the temperature and
   offer a sweater or warmer clothing. Keep a sweater, a light throw, or blanket on the
   back of a chair or sofa or in an easily accessible location.



6. Worried or painful facial expressions may also indicate the individual is frightened. Soft
   stroking of the hands or back may relieve the fear or anxiety. Quiet conversation may
   also be helpful. Consider putting on a favorite radio station or CD – quiet calming
   music is best.



7. Going to the door and playing with the doorknob may be a sign the individual wants to
   go outside. Dress appropriately for the weather and take a short walk or sit outside.
   Going outdoors is comforting and relieves the feeling of cabin fever or closeness that oc
   curs from being indoors for long periods of time. Fresh air also promotes comfort and
   may encourage sleep. Door knob covers may be installed to prevent them from leaving the house while you're not present.



8. Keep a log of the times the individual sleeps, discourage frequent napping during the
   day and encourage activity. This will help promote longer periods of sleep at night.



9. You may notice the individual appears to be searching for something or someone. This
   may result from a need for security – seeking a parent or looking for their child. Do not
   attempt to argue or explain that the person being sought is not there. Instead consider
   trying to engage the individual in reminiscence by looking at a photo album or talking
   about the individual. If they seem to become upset attempt to redirect their attention to
   something they enjoy. Never tell the individual the person is dead or grown up. It is crit
   ical to understand and accept their reality at that moment in time. (consider reading
   more about Validation Therapy – information can be found at www. )



10. Check the environment daily for any possible hazards that can result in a fall or injury.
    Remove all throw rugs, keep a clear pathway for safe wandering and try to direct the in
    dividual along the path. Try to keep furniture and personal objects in the same place to
    reduce confusion and anxiety. Clean all spills immediately.



11. Outside walkways should be evaluated for tripping hazards. Keep access to stairs lim
    ited to prevent falls.



12. Excessive energy – evaluate the amount of sugar and caffeine in the diet and limit
    intake.



13. Boredom can lead to wandering – attempt to engage in short activities (30 Minutes or
    less). Draw on past interests and hobbies. Have them accompany you while shopping or on errands.