​Behavioural changes in persons living with dementia can occur as a result of changes in their brain.

The Department of Psychological Medicine from Changi General Hospital (CGH), a member of the SingHealth group, explains the common symptoms displayed by persons with dementia and offers caregivers tips on how to better manage these behaviour changes when caring for their loved ones with dementia.

Wandering behaviour in persons with dementia

Wandering is a common behaviour observed amongst persons with dementia that can put them at risk while also attributing great stress to their caregivers.

Persons with dementia who wander risk getting lost when they wander off. Getting lost can be dangerous for them as they may run into accidents or injuries.

Wandering also increases fall risk. Persons with dementia are generally at a higher risk of falling due to the damage in the brain caused by dementia.

3 Tips to manage wandering behaviour in persons with dementia

Depending on the personality of the person with dementia and how well they are able to cope, their reasons for wandering and the safety of their surrounding environment, you can consider the following management strategies.

Persons with dementia are also at fall risk as dementia can affect their gait. It is best for them to have some supervision if their gait is unsteady.

1. Take note of when wandering takes place

When caring for a loved one with dementia, identify his/her wandering behaviour by keeping records or a diary (e.g., does the behaviour show up at certain times of the day or in response to certain situations which can be carefully controlled?).

Ensure that the person with dementia carries identification such as an identity bracelet or card with his/her name, address and/or contact numbers of family members. This can be helpful when the person with dementia is found by others or by the police.

2. Remove the necessity to wander

Reduce access to objects that may prompt or encourage a person with dementia to wander (e.g., handbags, house keys).

Remove any obstacles to allow the person with dementia to move about safely such as coffee table, loose wires, toys, etc. Ensure supervision is available and that he/she has a walking aid nearby at all times.

Other common strategies include hiding the door knobs or door handles. Sometimes the door can be painted the same colour as the wall, so it is ‘invisible’, or a curtain can be put over the door so it does not look like the door.

3. Distract and promote familiarity

Engage or distract the person with dementia with a simple and quiet activity from earlier days that is familiar to him/her.

Orientate the person over the course of the day. Orientation to the time, date, place and people helps to reduce anxiety in persons with dementia.

What to do when the person with dementia goes missing

  • Remain calm.

  • Do a thorough search of the house and familiar places.

  • Try to recall what they were wearing.

  • Walk or drive around the vicinity and to other places that they visit regularly. Have someone stay at home in case they return home, or to answer any phone calls.

  • Contact the police if immediate searches yield no result. Tell them that the person has dementia and highlight any concerns you may have for their safety.

What to do when the person with dementia returns home

  • Notify the police immediately.

  • Do not scold or show any anxiety as this may confuse or frighten them.

  • Provide reassurance and get them back into their regular routines as quickly as possible.

Possible reasons for wandering behaviour in persons with dementia

  1. The inability to recall where he/she was going or why.

  2. Disorientation in the environment – the person with dementia may get lost in his/her own home.

  3. Disorientation with the past and present – when the person with dementia becomes confused and search for someone or something related to his/her past.

  4. Disease progression of dementia – the person with dementia loses the ability to concentrate and wandering keeps him/her occupied.

About BPSD (Behavioural and psychological symptoms of dementia)

Behavioural and psychological symptoms of dementia (BPSD) are neuropsychiatric symptoms and behaviours displayed by persons with dementia.

These symptoms constitute a huge aspect of dementia irrespective of its subtype, and they demonstrate a strong correlation with the degree of functional and cognitive impairment.

Learn how to manage anger and aggressionclick here.

Learn how to manage apathyclick here.

Learn how to manage inappropriate (disinhibited) behavioursclick here.

Learn how to manage hallucinationsclick here.

Learn how to manage paranoia and delusionclick here.

Learn how to manage repetition (repetitive behaviour)click here.

Ref: H24