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Not All Who Wander Are Lost... And Yet

Not all who wander are lost is a statement that promotes flexibility for the individual seeking a different path. The individual with dementia is just as driven as any seeker but not as able to express why he/she is wandering. Their passion for the different path is every bit as valid. The difference is the individual with dementia has an extraordinary need to have safeguards so their reduced cognitive capacity does not result in becoming lost.

Why does an individual with dementia wander? 

They may be searching for someone or something. They may be searching for security, often expressed as a wish to go home or they may be expressing a long-term coping skill. The long-term outdoorsman will continue to seek the outdoors as his dementia symptoms increase.

The disease of dementia lowers the individual’s stress threshold resulting in inadequate coping and management resources.  External stressors like noise, change in routine, and internal stressors like pain and fatigue may result in combativeness, night wandering and agitation. 

The holiday party or the family dinner may have tipped your loved one’s stress threshold.  Behavioral manifestations may occur up to 36 hours later. Wandering may be one of these manifestations. Wandering reduces caregiver stamina due to the increased need for vigilance. Because wandering often begins at night, caregivers no longer have a restful night of sleep.

Another precipitator of wandering behavior for an individual with dementia is unmet need. In particular lack of activity and boredom are often triggers for the behavior. A study conducted on modifying wandering behavior found that engaging the individual in activities was key to changing the behavior.

But My Loved One Never Has Wandered

Sixty percent of those with dementia will wander during the course of their disease. Once an individual has wandered, he/she is 75% more likely to wander again. Couple these percentages with the fact that one of every seven individuals diagnosed with Alzheimer’s lives alone translating to a higher wandering risk. Of those who wander, the longer the individual is gone, the higher the mortality rate. Only one third of wanderers with Alzheimer’s disease survive if lost for 24 hours. 

Wandering is one of the two most common reasons for placing an individual with dementia in a care setting. You may think that any care community will protect your loved one from wandering. Yet wandering is the number one reason a resident is transferred out of regular assisted living to a memory care unit.

Why not simply start at a regular assisted living and let them move my loved one to the memory unit if it becomes necessary?

There is increasing research evidence that individuals with dementia are subject to stigmatizing behaviors when placed within regular assisted living. The demands to perform often result in isolation and further cognitive decline. In a multi-tiered care community, this change in involvement precipitates a management decision to move your loved one.

There are many reasons that memory units and average memory communities minimize your loved one’s quality of life and cognitive performance. Top among them are the training, design and implementation of dementia-specific benchmarks. Arden Courts understands the rights of an individual with dementia. Arden Courts understands that behavioral manifestations of dementia are examples of unmet need. They are committed and trained to re-direct in order to best meet the individual’s need.  This is done not only with a larger staffing ratio than the average memory care community, but with a larger amount of dementia-specific training. 

If the unmet need is a need for engagement, Arden Courts has the programming staff and the expertise to engage the individual in activity. Not just any activity, but dementia-specific programming that is tailored to the individual. Cognitive performance is prolonged when the individual with dementia is engaged in meaningful activity. A quality benchmark for dementia care is activity programming that is seven days a week, including evenings.  This is the standard at Arden Courts. 

 Individuals with dementia have the right to be safely outdoors. Arden Courts’ outdoor space was designed with wandering in mind. Each community has a web of intersecting paths with benches and specialty areas to allow the family and individual with dementia a variety of settings as well as places to rest. Access to the outdoors is the standard for Arden Courts. Memory units and other memory communities are more likely to have very limited outdoor area access, if any at all. 

Arden Courts indoor living space likewise offers a central square of walking paths with different porch settings to encourage sitting down when tired as well as encouraging exploration in a “just right” stress level.

Natural and bright light environments have been shown to deter wandering because of the light’s impact on the sleep-wake cycle. Each Arden Courts setting was designed to include natural lighting. This is one of the many environmental features of Arden Courts that contributes to the reduction of wandering. 

Research validates that visually complex environments with subtlety in barriers promotes well-being for the individual with dementia. Arden Courts Memory Community offers the right blend of visual complexity both in and outdoors with a vigilant regard for safety. 

Arden Courts Memory Community is committed to excellence in dementia care. Why not wander into one of our communities to see for yourself. 

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