Carers' Corner

How to handle the problem of getting lost in elders with dementia?

According to a local telephone survey conducted in 2007, about 30% of elders with dementia living in the community have a history of getting lost. The consequences can be fatal. Wandering can put elders in dangers as they may experience starvation and dehydration, falls, traffic accidents or exposures to extreme weather conditions. The following strategies may help to minimize the problems of elders getting lost.

Correct approach to manage wandering

Due to cognitive decline, elders with dementia may become disorientated once they leave their familiar environment. Therefore, many carers apply restraint to restrict their activities. However, inappropriate use of restraint will jeopardize the relationship between elders and carers without solving the problem. Restraint can also cause further functional and cognitive decline which in turn may lead to greater confusion and agitation of the elders.

Getting started

To manage the wandering behaviour which may end up in the elder getting lost, carers need to look into the reasons behind it. For example, does the elder need to go to the washroom? Is the elder hungry, bored or confused? By finding out the underlying causes, effective measures can be devised to reduce the triggers of wandering. Structured daily routines and environmental aids are useful strategies.

1. Establish structured daily routines Minimize any change in the environment and daily routines of elders to increase their sense of security. Involve elders in familiar and manageable activities. This helps to reduce afternoon nap and night-time wandering as well as the intention to go out. Accompany elders for a walk to provide a healthy outlet of energy and emotions. Alternatively, choose a safe and enclosed walking path where the elder can walk freely.
2. Use appropriate environmental aids Use visual cues such as pictures or labels to help the elders to orientate (Figure 1). Paint the doors with the same color as the walls, or cover it with a cloth to camouflage the exits. Door chain may be considered but safe escape in case of emergency has to be ensured. onsider alarms such as motion sensitive alarm, bed monitor or beeping monitor to alert carers when the elder wanders off (Figure 2)
	Figure 1: use picture and label to indicate the location of toilet	Figure 2: beeping monitor
Elders with dementia may wear bracelets, necklaces or clothing with imprinted name and contact information label for easy identification and contact with carers. Carers may also inform neighbours or security guards about this potential problem. Keep recent photographs of the elders to help with identification in case of need (Figure 3).
		Figure 3: name tag with name & contact information

Conclusion
To minimize the chance of getting lost, effective communication, understanding their needs, and removing the causes of wandering behaviours are crucial. Carers may contact health professionals for further advice.

Related topics

Dementia - Daily Living

Activity Program for Persons with Dementia

Behavioral Management in Persons with Dementia

Dementia (communication skills)