How To Stop Dementia Patients From Wandering At Night

Wandering is a common symptom and behavior of Alzheimer’s disease, Lewy body dementia, and other types of dementia. Wandering, especially at night, can be very dangerous. There are many reasons a person with dementia wanders, but it’s important for caregivers to be aware of the risk and to take steps to prevent it. 

Nursing homes and memory care facilities often have 24/7 staff to protect dementia patients. Family caregivers don’t have this option, but can still protect their loved ones from harmful wandering. 

Here, we’ll discuss:

• What wandering is
• Why a person with dementia wanders
• Tips and tools to prevent dangerous situations 

For more tips on caring for someone with dementia, check if you have free access to Trualta’s caregiver resources, support groups, forums, and more. 

Why Do Dementia Patients Wander At Night? 

According to the Alzheimer’s Association, approximately 6 in 10 dementia patients wander at least once. Many of these wander more than once, sometimes frequently. Wandering may be the result of restlessness. It can also start out purposeful, but the person gets lost or forgets why they left the home or care facility. A person with dementia may express the desire to go home if they’re in a residential facility, or even if they are already at home but confused.  

There is no single cause of wandering behavior in dementia, but it’s ultimately a result of cognitive impairment and memory loss. There can be many triggers, like:

• Hunger
• Boredom
• Pain
• Restlessness

A person with dementia might wander at any time, but nighttime wandering is common. Sleep issues, increased confusion at night, discomfort, or simply looking for the bathroom can lead to night wandering. 

Another underlying issue is sundown syndrome, a state of late-day confusion that affects some people with dementia. In sundowning, a person becomes more confused later in the day. They often become restless and engage in repetitive movements, pacing, and wandering.  

What Are The Dangers Of Nighttime Wandering? 

Wandering at any time of day or night is dangerous. A person with dementia can:

• Get lost or hurt
• Be victimized
• Get hungry
• Become dehydrated
• Suffer from exposure to the elements

Nighttime wandering is particularly dangerous because: 

• It’s easier to get lost in the dark at night. 
• Your loved one is more likely to be confused at night. 
• There are fewer people outside who are likely to notice help. 
• If you’re asleep, you might not notice they are missing until morning. 

7 Tips For Carers To Prevent Night Wandering 

Providing a safe environment for your loved one with dementia means addressing the issue of wandering, including nighttime wandering. Their cognitive decline and memory loss mean they need careful supervision. While supervision can prevent a lot of wandering, you can also address the issue with other measures, like the following. 

1. Find The Triggers For Wandering

Wandering looks purposeless to others, but there is often an underlying reason or cause. If you can find what triggers your loved one’s wandering, you can change or avoid it. Observe what’s happening, how they’re acting, and how they feel when they start to get restless or leave or attempt to leave. 

Wandering triggers include:

• Physical discomfort or pain
• Reminders of the past
• Changes in routine
• Agitation
• Distress

A night, wandering might occur because they can’t sleep or have to go to the bathroom, but then get lost. They might seem confused about what time of day it is. 

Some people wander when they get confused about past obligations. For example, They might wake up at night and think they need to get to work. When you know the cause or triggers of night wandering, you can come up with a more targeted plan for preventing it. 

2. Keep A Regular Schedule

A person with dementia benefits from a schedule and routine in many ways. They get confused easily, so changes or disruptions can be distressing. Create a routine that schedules all daily activities by the hour. When they know what to expect, dementia patients are typically calmer. 

Consider using a big wall calendar with scheduled activities that your loved one can see. Try to prepare them in advance of any upcoming changes, like a doctor’s appointment. These steps can help them feel safe and less likely to wander. 

3. Get Exercise During The Day

It’s not uncommon for a person with dementia to become agitated or restless at night, even in a familiar place. Exercise during the day, like a supervised walk outside, can disperse some of this energy and reduce the risk of nighttime restlessness. 

If it’s appropriate and safe for your loved one, take them out for a walk during the day. You should be with them at all times. If they’re prone to wandering or have risk factors for this behavior, you cannot safely leave them alone, even for a short period.

You can also ask their doctor if it’s safe for them to do a seated exercise routine. 

It may be especially helpful to get them outside for exercise. Alzheimer’s and other dementias disrupt the natural sleep-wake cycle, and sun exposure during the day can reduce nighttime confusion in these patients. 

4. Improve The Sleep Routine

Your loved one may wander at night because they can’t sleep, becoming confused, agitated, or restless and experiencing disorientation. Anything you can do to help them sleep better and more soundly will reduce the risk of wandering behaviors. 

Start and maintain a relaxing sleep routine for your loved one. Use soft, comforting music and enjoyable but low-energy activities before bed. Limit anything stimulating, like television shows or visits from friends and family. Exercise during the day can also improve nighttime sleep, as can avoiding afternoon naps, if possible. 

Your loved one’s medical team can also help. Managing their health conditions, evaluating medications, and addressing mental health concerns should improve their sleep. 

5. Plan Relaxing Evening Activities

While a relaxing, calming evening routine is important for sleep, boredom can also trigger wandering. Plan evening activities to keep your care recipient engaged but also calm. 

Easy activities include a simple game they enjoy or even chores they can do successfully, like matching socks from the laundry. A familiar movie or music can also help keep them engaged, relaxed, and calm. 

6. Catch Wandering In Its Tracks

If, despite your best efforts, your loved one gets restless and tries to leave, you’ll need to stop them. Try to determine what caused their urge to leave and address that issue. 

For example:

• If they’re too hot, suggest changing into different clothing or setting up a fan. 
• If they think they have to go to a job they haven’t had in years, try telling a “therapeutic fib” by saying something like “you have the day off today.”

You can also try to distract your loved one if they’re intent on leaving. Redirect their attention to something indoors, like a game, a photo album, or a chore they can help you with. 

7. Talk To The Medical Team

If you continue to struggle with nighttime wandering and safety, talk to your loved one’s doctors. They may be able to identify an underlying cause, change medications, or help you better manage dementia symptoms that are leading to wandering. 

Tools For Keeping Dementia Patients Safe At Night

• Night Lights. Night lights installed in the home can help your care recipient find their way around if they get up at night. They might be looking for the bathroom or kitchen and accidentally leave through an exterior door. 
• Door Signs. Clear door signs your loved one can read with adequate night lighting can also help them find their way around the house if they get lost or confused. Label the doors for the bathroom and the bedroom. Put large “stop” or “do not enter” signs on exterior doors or use safety gates as signals not to leave.
• Door Covers. Anything that camouflages or hides exterior doors can prevent your loved one from leaving the house at night. You can cover doors with curtains or use large peel-and-stick images that make the door look like a part of the wall. If windows are accessible, these should also be covered. 
• Door & Window Locks Or Alarms. For persistent wanderers, locks that they cannot access or operate improve nighttime safety. You can find special locks that are difficult to operate, or use deadbolts. When installed out of their line of sight, many individuals with dementia don’t see them. Alarms can also be useful. You can set them to signal when a door or window has been opened from inside or outside. 
• Tracking Devices. While using technology to track your loved one’s location might seem like an invasion of privacy, it can be life-saving. Read about the pros and cons here. If they get past your other barriers to wandering, a tracking app on their phone, watch, or other device can help you find them before they get lost or hurt. These technologies can also send you an alert if your loved one gets a certain distance away from you or the home. 
• Safe Return Programs. Consider enrolling your loved one in a program like the MedicAlert® + Alzheimer’s Association Safe Return®. These programs offer a nationwide, 24-hour emergency service to help find missing seniors with dementia.  

Keeping your loved one safe is a top priority as a family caregiver. Providing care from the home instead of a staffed facility can make safety more difficult. This is especially true for dementia patients who wander. Use these tips and tools to help keep them safer during the day and at night. 

Don’t forget to check if you have free access to Trualta’s support groups, forums, resources, and more. 

References

1. Alzheimer’s Association. (n.d.). Wandering. 
2. Alzheimer’s Association, Central and North Florida Chapter. (n.d.). MedicAlert + Alzheimer’s Association Safe Return. 
3. Cleveland Clinic. (n.d.). Sundown syndrome. 
4. Mayo Clinic. (n.d.). Alzheimer’s: Helping your loved one sleep better.