Those living with dementia show a wide range of symptoms including the urge to wander which can leave them lost and at risk.
Anyone who has supported an elderly parent in their final years knows how stressful it can be. Calls in the night to respond to emergencies, continuing poor health, requiring multiple hospital appointments, trips to A&E following a fall or other accident, unwanted unexpected visitors appearing at the door, financial issues or attempted fraud and other similar events can all combine to put stress and strain on the most hardy of us.
Those living with dementia show a bewildering array of symptoms and behaviours. The condition affects everyone differently – no case is the same. Elderly spouses, family members and other care givers see constantly shifting patterns of behaviour at varying rates, with good days and bad days. Seeing such changes in a loved one or long-supported client can be distressing and stressful. Such behaviour combined with all the common challenges we face in old age, can make life very hard indeed.
Many of those living dementia (6 out of 10) will wander from home and go missing. For reasons no one really knows, they will show a constant restlessness and urge to go out. In some cases, they do not recognise their home as home. They will say “I need to go home now”. Once out of the house, they often wander the neighbourhood, asking for directions, getting on buses or trains, talking to strangers and generally act confused and anxious. This can occur at any time night or day.
Theories for this behaviour include habit; boredom; pain; memory loss; confusion; anxiety and looking for someone. A recent study from the National Center for Biotechnology Information USA suggests that navigational difficulties can be a precursor to cognitive impairment diagnosis, as dementia damages the hippocampus, the part of the brain responsible for forming new memories specifically about time and location.
Whatever the reason or cause, it is sad seeing someone apparently lost and unable to find their way home.
For family members and care givers supporting the person living with dementia it can be very upsetting not knowing where the person has gone. Clearly when out the home alone, the person is at high risk of getting lost and possibly injured from a fall or walking into the road. They are also at risk from missing medication, exposure to extreme cold or heat, and strangers looking to take advantage of vulnerable people. As the person wanders, family members and carers face frantic searches of the local neighbourhood with the awful constant worry that the person is serious risk with whereabouts unknown. Further underlying health conditions and old age may mean the person is at high risk of coronavirus infection.
When supporting someone with dementia, we aim to help them remain independent for as long as possible, maintaining their quality of life and dignity. Where a client begins to wander, acting in the best interests of the client, we have to judge whether or not it is safe to continue the service and/or whether alternative arrangements can be put in place to allow the client to remain safely in their own home. Sadly, sometimes in extreme cases this is not possible, in which case, home care is invariably no longer suitable.
