People living with dementia, whether living at home or in nursing homes can often be engaged in wandering behaviour. When not identified and managed it can be associated with significant financial and human costs. Professor Beattie recently provided a snapshot of this important phenomenon in an excellent presentation “Assessing and Responding to Wandering in Residential Care – What is the Evidence Base?"
How is wandering defined?
“syndrome of dementia related locomotion behaviour having a frequent, repetitive, temporally-disordered and/or spatially-disoriented nature that is manifested in lapping, random, and/or pacing patterns, some of which are associated with eloping, eloping attempts, or getting lost unless accompanied” Alagase, D.L.et al, 2009.
There are important dimensions to wandering identified by researchers:
- Contributing Factors
- Adverse Events
A data-based typology of the behaviour has been developed. Data suggests that respiratory and cardiac status is poorer in those who walk the most.
Five major goals for responding to the person who is experiencing wandering as a behavioural symptom of dementia are:
- Promote safety within the context of negotiated agreement on acceptable risk
- Aid navigation to support retained wayfinding ability
- Provide physical and emotional comfort to reduce unmet need-driven activity
- Encourage engaging social interactions consistent with personality and preference
- A multi-level approach is requiring to minimise negative immediate and cumulative outcomes:
- Using a framework to think through assessment
- The pre-admission wandering history
- Ongoing assessment using both simple behavioural charting and validated behaviour-specific tools
- Systematic re-evaluation
Professor Beattie’s presentation provides an excellent summary of practical tools and methods for implementing the multi-level approach to achieve the five major goals. Read More
Watch for Part Wandering Part 2 in the September Dementia Research News.