Disorientation and losing one's way
Disorienting symptoms of dementia can cause a person living with dementia to walk away from home unattended, with the risk of becoming lost.
Overview
In itself, walking is not harmful and when done in a safe environment, it can be a simple and healthy way for a person living with dementia to exercise. But, if a person living with dementia is walking or moving about more than usual, it may mean they are experiencing pain or they need something.
Please note: We prefer to use the term “walking” or “walking about” rather than “wander” or “wandering”. "Wandering” might be viewed by some people as stigmatizing. It does not include the reason why a person might be walking, such as walking to find something or the need to be physically active.
Possible causes
- Changes in the brain that affect a person’s ability to recognize their physical environment and find their way
- Vision loss or changes in perception
- Pain, discomfort and medical conditions
- Hunger or thirst
- Feeling too cold or too hot
- Needing to use the toilet
- Trying to find a person or lost object
- Stress and anxiety
- Past experiences or trauma
- Changes in ability to recognize day or night
- Delusions, delirium and hallucinations
- Trying to move away from people, places, situations or objects that create fear or that are no longer recognized
- Changes in routine
- Feeling the need to go to work (even if they may be retired), take care of children or complete a task.
- Boredom and need to be involved in meaningful activities
- Lack of purpose or sense of belonging
- Loneliness
Tips and strategies
- Encourage safe movement and exercise to reduce anxiety.
- Maintain regular routines.
- Remove visual reminders (coat, purse, hat) from sight.
- Involve the person in productive and meaningful activities.
- Help the person connect with personal items (photos and objects that connect to happy memories.)
- Reassure the person that they are safe.
- Provide signage to assist the person in finding their way.
Example
Susan gets up and walks around the halls of the long-term care home throughout the night. They are often entering another resident’s room. This makes other residents uncomfortable.
Don't
- Request the nurse give them a sleeping pill before bed.
Do
Address potential causes and think about reasons why they might be awake and walking about:
- Are they looking for something?
- Do they need to use the washroom?
- Are they thirsty or hungry?
- Are they too hot or too cold?
- Are they lonely?
- Are they used to waking up early to go to work or look after children or animals?
- Are they in pain or have a medical condition that keeps them awake at night?
- Are they bored?
- Did they engage in exercise throughout the day to encourage rest at night?
Make the environment personalized and comforting (i.e. decorate the room with photos and personal items that are easily recognized).
Last updated: February, 2023
More information and resources
Behaviours in Dementia Toolkit by the Canadian Coalition for Seniors' Mental Health is an online library of over 200 free resources to help care partners and health care providers better understand and compassionately respond to dementia-related changes in mood and behaviour.
Shifting focus: Guide to understanding dementia behaviour by the Alzheimer Society of Ontario and Behavioural Supports Ontario is meant to help family members, friends and caregivers of people with dementia understand behaviours and actions.
Finding Your Way® by the Alzheimer Society of Ontario is a website dedicated to helping people living with dementia, their caregivers and communities to recognize the risk of going missing, be prepared for incidents of going missing, and ensure that people with dementia can live safely in the community. Note that this service is only available for people living in Ontario.