Finding Peace and Safety: Proactive Tools for Dementia Wandering

(Aging Untold) — Up to 60% of individuals with dementia will wander at least once, causing immense stress for families.

In this episode of The Aging Untold Podcast, our experts explain what happens in the brain during exit-seeking behavior and how “the feet do the talking” when verbal communication fails.

Learn why wandering is often a search for an unmet need or “home,” and discover practical, immediate solutions — from visual cues like red stop signs to tracking devices on shoes — to keep your loved one safe.

Why wandering happens

Wandering is often a sign that your loved one is trying to meet a need, according to Dr. Rhea Rogers, a board-certified physician and Aging Untold expert.

“The brain is struggling to interpret the world and meet a need and to feel safe,” she said.

One of the first areas of the brain that is affected by Alzheimer’s and dementia is the hippocampus, part of the temporal lobe that helps us to remember, orient ourselves and know where we are in a particular time and place, according to Rogers.

She said to think of it like an “internal GPS.”

“The brain, when it gets overstimulated, or there’s fear or anxiety, it just can’t explain the problem, so when people are wandering, they’re trying to fill that need. They’re trying to explain something,” Rogers said.

Wandering can be concerning because the person living with Alzheimer’s or dementia could fall or get outside and get lost, she said.

She urges caregivers to determine which need your loved one is trying to fill.

“Are they in pain? Do they want to eat, use the restroom? There’s usually an underlying theme for why they are wandering,” Rogers said.

Gerontologist and Aging Untold expert Sam Cradduck said she tells caregivers that “the feet are doing the talking.”

“Sometimes your mouth can’t verbalize, you can’t come up with the words of what’s going on. Maybe you can’t say, ‘I’m hungry.’ Maybe you can’t say, ‘I need to go to the restroom or I’m in pain,’ so your feet are what’s actually doing the talking for you,” Cradduck said.

So, the caregiver needs to anticipate what the need is and take some preparations that could help stop the wandering.

What caregivers can do

Some tips Cradduck suggests are to use visual cues, like putting a stop sign — a universal symbol to stop — on the door.

“It will literally stop some of this process,” Cradduck said.

She also recommends using a tracking device on shoes.

“Don’t put a tracking device in their pants pocket, put it on their shoes. People don’t wander off without their shoes on, usually,” Cradduck said.

Create a safety file that includes a current photo that you can provide to authorities if your loved one wanders, she recommends.

And let the people you trust in the community know if your loved one does wander.

“Let your neighborhood know because, typically, the wandering isn’t very far,” Cradduck said. “Typically, they’re not traveling five miles down the road.”

Aging expert and Aging Untold expert Amy O’Rourke shared an example of removing a suitcase from a client’s room to help stop wandering.

A client in a community she worked in had a suitcase in her room, and every day she wanted to go home to New Jersey.

“So, we took the suitcase out of the room and she stopped doing that,” O’Rourke said.

Programs exist that caregivers can look into as well.

Safe and Found is a MedicAlert and the Alzheimer’s Association program that activates a community support network including local law enforcement and hospitals to help locate the person who wandered, according to MedicAlert.

Learn more here.

Wandering could be to search for the caregiver

Sometimes the person who wanders is looking for the other person who anchors them, like a spouse or a caregiver, aging well coach and Aging Untold expert Katherine Ambrose said.

“That is very, very difficult to be anchored to, and there’s so much guilt over leaving just for a quick appointment and so that’s really a very difficult thing with caregiving,” Ambrose said.

Sometimes that caregiver does not want to let their loved one go to memory care or bring people in to help, but they might need it to protect themselves, she said.

O’Rourke also recommends having a plan when your loved one does wander.

“There’s ways to, if it happens, keep yourself protected and then you might be able to delay hiring expensive care before you need to,” O’Rourke said.

Tips to help caregivers

Cradduck provides the following tips for caregivers:

Why it happens

Start with why it happens. Here are some common triggers:

• Needing the bathroom but can’t find it
• Hunger, thirst, pain, constipation
• Boredom or restlessness
• Anxiety, overstimulation, noise, crowds
• Searching for a person, place or former job
• Sundowning (late afternoon/evening confusion)
• Medical side effectss or sleep disruption
• Discomfort due to temperature (too hot or cold)
• Keep a “wandering log” for seven days to identify patterns.

Time it happens

• What was happening right before?
• What stopped it?

Preventing exits

There are home setups that can prevent exits without making the person feel trapped

Doors and exits

• Install door alarms — simple chime ones that are loud enough to alert you.
• Use childproof doorknob covers only if they are safe and legal in your setting and the person can get out safely during an emergency. Fire safety matters.
• Add slide bolts that are high or low, typically out of the line of sight.
• Put a stop sign or “do not enter” sign on the door.
• Camouflage the door by placing a curtain over it, painting it in the same color as the wall or placing a tall bookshelf or room divider near it.
• Block visual cues. If the shoes, coat or keys are visible, it can trigger leaving. Store them out of sight.
• Consider a door mat that looks like a dark hole. Some people will avoid stepping onto it. Test it carefully because it can increase the fall risk for some people.
• Use smart locks you control such as with the caregiver’s phone, but always plan for emergencies and backup entry.

Visual orientation to reduce confusion

• Put up a big sign with arrows: “Bathroom →” “Kitchen →” Use picture prompts because words and letters become jumbled.
• Keep paths clear and familiar. Don’t rearrange furniture.
• At night, use motion-sensor night lights from the bedroom to bathroom.

ID and tracking

• Use identification that travels with them
  • Medical ID bracelet with their name, memory impairment and the caregiver’s phone number.
  • Sew an ID tag into coats and hats.
  • Put a card in the wallet, even if they don’t carry it.

Tracking tools

Use a GPS tracker, like a watch, pendant or a tag-style tracker in a shoe insert. If they remove wearables, hide trackers in:

• A shoe insert.
• Belt
• Jacket lining
• Handbag they always carry

Routine and activity: Burn the “wander energy” in the day

Wandering often drops when the day has structure.

Daily rhythm that helps

• Morning light exposure - open the curtains and outside time
• Movement every two to three hours:
  • Short walk
  • Folding towels
  • Watering plants
  • Sorting “job” tasks that are safe and simple
• Regular meals and hydration
• Limit naps after the early afternoon if nighttime wandering is an issue
• Purposeful walking is a magic trick for many
  • If they need to walk, give them a safe place to walk:
    • A looping path inside the home like a clear hallway circuit
    • A fenced backyard loop
    • A supervised indoor walking route in the community
    • Add “stations,” Chair and water, a photo wall, a basket of towels to fold

Communication scripts that stop exits without escalating

Don’t argue reality. If they say, “I have to go to work,”try:

• “Of course. Let’s get you ready. First, we’ll have a snack.”
• “We’re leaving after we use the bathroom.”
• “Your ride is running late, come sit with me.”

Redirect with dignity

• Offer two choices: “Tea or water before we go?”
• Use validation: “You feel like you need to be somewhere. That’s a hard feeling.”
• Rule: Calm voice, short sentences, gentle eye contact, open posture.

Nighttime wandering (one of the hardest)

Sleep-protection tips

• Make evenings quieter and dimmer, no loud TV or news.
• Keep the home well-lit at dusk and reduce shadow confusion.
• Warm drink or snack if it is safe.
• Bathroom schedule: Use the toilet right before bed and offer again if they wake.
• Check pain, constipation and urinary urgency.

Safety at night

• Bed alarm or motion sensor by the bedroom door
• Nightlights to the bathroom
• A gate at the stairs if stairs are present.
• Keep shoes put away to have less of a “let’s go” cue, same for a purse, jacket and keys.

Bathroom-related wandering is common

• Place a clear sign that says: “BATHROOM” with picture icon.
• Leave the door slightly open with a light on.
• Clothing that’s easy to manage reduces panic exits.
• Timed toileting every two to three hours while awake.

Community/facility tips if you’re in senior living

Ask about:

• Wander management program
• Secure courtyards and walking loops
• “Meaningful engagement” schedule. Boredom drives exits.
• Staff response protocol when an alarm triggers

Make sure staff knows the person’s:

• Common exit phrases, like “I have to get the kids.”
• Triggers, such as noise, hunger, sundown
• Best calming redirect, such as music, a snack, folding towels

Print your emergency plan

When wandering happens, speed matters.

Before it ever happens:

• Have a recent photo and update it monthly.
• Description, including:
  • clothing
  • shoes
  • height and weight
  • usual routes
• List of places they try to go, such as the:
  • old home
  • workplace
  • church
• Alert trusted neighbors

If they leave

• First search the backyard, closets, garage, familiar loops
• Call for help early if risk is high, such as weather, traffic or it happens at night
• Notify neighbors and community security
• Provide police with “memory impairment” and the last known direction

High-value “small” tips people forget

• Keep car keys hidden, not put away but hidden.
• If they fixate on the door, move their favorite chair away from a direct view of the door.
• Use calming sensory cues:
  • Familiar music
  • Lavender or a comforting scent if they can tolerate it.
  • Soft blanket/hand activity
  • Use “busy baskets” near the exit with folded towels, sorting cards, fidget items.
  • If they pace, don’t force sitting. Supervise the walk and redirect gently.

The big safety note

If you add locks or barriers, always plan for fire safety and caregiver access. You never want a setup that prevents a safe evacuation.

This program is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician. Always seek the advice of your doctor or other qualified health provider regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have seen on this program. If you think you may have a medical emergency, call 911 or go to the nearest emergency room immediately. No physician-patient relationship is created by this program or its use. Aging Untold/Gray Media, nor its employees, contractors or agents, nor any contributor to this program, makes any representations, express or implied, with respect to the information provided herein or to its use.