Wandering, or elopement, is a serious risk facing a majority of individuals living with dementia. Up to 60% of people with Alzheimer’s disease will wander away from a safe environment at least once, often with dangerous consequences. This behavior results from cognitive decline that erodes a person’s ability to navigate or discern danger. Because time is the single greatest factor in a safe recovery, an immediate response plan is necessary for all caregivers. This guide provides actionable steps, from understanding the causes of elopement to utilizing law enforcement tools for a swift and safe return.
Why People With Dementia Wander
Wandering is not aimless movement but often a response to confusion, emotional distress, or an attempt to fulfill a perceived need. Cognitive damage frequently causes a person to mentally regress to an earlier, more familiar time in their life. This can lead to a compelling need to find a former childhood home, a past workplace, or a deceased loved one.
Feelings of restlessness, boredom, or anxiety can also trigger elopement as the person tries to escape an overwhelming environment. Sundowning Syndrome, where confusion and agitation intensify in the late afternoon or early evening, is a common trigger for wandering. A person may also be seeking to satisfy a basic physical need like thirst, hunger, or the need to use the bathroom, but impaired spatial awareness prevents them from returning.
Emergency Response: The Critical First Hour
The first hour after a person with dementia is discovered missing is critical, as the risk of serious harm increases sharply. Start by conducting a rapid, thorough search of the immediate premises, including unusual places where a person may hide or become trapped. This includes closets, basements, attached garages, sheds, and dense shrubbery in the yard.
If the person is not found within 10 to 15 minutes, call emergency services immediately. There is no 24-hour waiting period for a vulnerable adult with a cognitive impairment. When speaking to the 911 dispatcher, state clearly that the missing person has dementia. This categorizes them as an “at-risk” or “vulnerable” missing person, ensuring the highest priority response from law enforcement and search-and-rescue teams.
Be ready to provide specific, detailed information to the responding officers to narrow the search area. This includes a recent photograph, a description of the clothing and shoes the person was last seen wearing, and any known medical conditions like diabetes or a heart condition. Inform the police about any known destinations the person has mentioned recently, such as a former address, or if they often wander during a specific time of day like sundown.
Utilizing Law Enforcement and Community Programs
Once the report is filed, law enforcement can activate specialized resources for missing vulnerable adults, such as a Silver Alert. Modeled after the Amber Alert system, a Silver Alert disseminates information to the public via broadcast, social media, and highway message boards. Activation criteria require the missing person to have a cognitive impairment, be over a certain age (often 60 or 65), and be considered in danger.
Many police departments utilize tracking technologies like Project Lifesaver, which enrolls individuals at risk of elopement. This program uses a small, wrist or ankle-worn transmitter that emits a unique, low-frequency radio signal. When a person is reported missing, trained officers use specialized directional antennas to track the signal. This often locates the individual in an average time of just 30 minutes, a significant reduction from the typical search time.
Unlike GPS, which can be blocked by certain structures, Project Lifesaver’s radio frequency technology can penetrate buildings, dense foliage, and concrete culverts. This is a major advantage in an urban search. Family and neighbors can also be mobilized to search specific high-probability areas, such as places from the person’s past or routes they frequently walked. Sharing the missing person’s description and photo through local community groups and media, under police guidance, increases the number of eyes assisting the search.
Proactive Safety Planning
The most effective way to manage elopement risk is to implement safety measures long before an incident occurs. Start with home safety modifications, such as installing locks high or low on exterior doors, outside the person’s line of sight. Door and window alarms or pressure-sensitive mats placed near exits can alert a caregiver immediately if the person attempts to leave.
Visual strategies can discourage exit-seeking behavior, such as painting doors the same color as the surrounding wall or placing a dark rug near an exit. This optical illusion can make the threshold appear to be a hole, which a person with dementia will instinctively avoid. It is also important to remove or hide items that signal departure, such as coats, car keys, or purses, which can trigger the instinct to leave.
Personal identification is a safeguard if the person is located by a stranger. Medical alert jewelry engraved with the diagnosis and an emergency contact number is the simplest measure. Wearable GPS tracking devices, available as watches, clip-ons, or shoe inserts, allow caregivers to monitor location in real-time and set up “geofences” that trigger an alert if the person crosses a defined boundary. Preparing a “Safety Kit,” such as the Herbert Protocol form, in advance saves time during a crisis by having all necessary data—a current photo, medical history, and list of former residences—ready for the police.