Who Are Individuals with Access & Functional Needs (AFN)?

Persons with Access and Functional Needs are those individuals with function-based needs (related to a restriction or limited ability to perform activities normally considered routine) that may require assistance before, during, and /or after a disaster or an emergency. This may include, but is not limited to:

• People with disabilities

• People who live in institutionalized settings

• Elderly

• Children

• People from diverse cultures

• People with limited English proficiency/non-English speakers

• People who are transportation-disadvantaged

Alzheimer's - Wandering

Wandering

Alzheimer’s disease causes people to lose their ability to recognize familiar places and faces. It’s common for a person living with dementia to wander or become lost or confused about their location, and it can happen at any stage of the disease. Six in 10 people living with dementia will wander at least once; many do so repeatedly. Although common, wandering can be dangerous — even life-threatening — and the stress of this risk weighs heavily on caregivers and family. Click any of the bullet points below for more information.

• Who's at risk?

• Plan ahead

• Reduce the risk of wandering

• Take action when wandering occurs

• Prepare your home

Who's at risk for wandering?

Everyone living with Alzheimer’s or other dementia is at risk for wandering. Common signs a person may be at risk of wandering include:

• Returning from a regular walk or drive later than usual.

• Forgetting how to get to familiar places.

• Talking about fulfilling former obligations, such as going to work

• Trying or wanting to “go home” even when at home.

• Becoming restless, pacing or making repetitive movements.

• Having difficulty locating familiar places, such as the bathroom, bedroom or dining room.

• Asking the whereabouts of past friends and family.

• Acting as if doing a hobby or chore, but nothing gets done.

• Appearing lost in a new or changed environment.

• Becoming nervous or anxious in crowded areas, such as markets or restaurants.

 Reduce the risk of wandering

The following tips may help reduce the risk of wandering and can bring peace of mind to caregivers and family members; however, these actions cannot guarantee that a person living with dementia won’t wander.

• Provide opportunities for the person to engage in structured, meaningful activities throughout the day

• Identify the time of day the person is most likely to wander (for those who experience “sundowning,” this may be starting in the early evening.) Plan things to do during this time — activities and exercise may help reduce anxiety, agitation and restlessness.

• Ensure all basic needs are met, including toileting, nutrition and hydration. Consider reducing – but not eliminating – liquids up to two hours before bedtime so the person doesn’t have to use and find the bathroom during the night.

• Involve the person in daily activities, such as folding laundry or preparing dinner. Learn about creating a daily plan.

• Reassure the person if he or she feels lost, abandoned or disoriented.

• If the person is still safely able to drive, consider using a GPS device to help if they get lost.

• If the person is no longer driving, remove access to car keys — a person living with dementia may not just wander by foot. The person may forget that he or she can no longer drive.

• Avoid busy places that are confusing and can cause disorientation, such as shopping malls.

• Assess the person’s response to new surroundings. Do not leave someone with dementia unsupervised if new surroundings may cause confusion, disorientation or agitation.

For individuals in the early stage of the disease and their care partners, the following strategies may also help reduce the risk of wandering or getting lost:

• Decide on a set time each day to check in with each other.

• Review scheduled activities and appointments for the day together.

• If the care partner is not available, identify a companion for the person living with dementia as needed.

• Consider alternative transportation options if getting lost or driving safely becomes a concern.

Prepare your home

As the disease progresses and the risk for wandering increases, assess your individual situation to see which of the safety measures below may work best to help prevent wandering.

Home Safety Checklist

Download, print and keep the checklist handy to prevent dangerous situations and help maximize the person living with dementia’s independence for as long as possible.

   Download

• Place deadbolts out of the line of sight, either high or low, on exterior doors. (Do not leave a person living with dementia unsupervised in new or changed surroundings, and never lock a person in at home.)

• Use night lights throughout the home.

• Cover door knobs with cloth the same color as the door or use safety covers.

• Camouflage doors by painting them the same color as the walls or covering them with removable curtains or screens.

• Use black tape or paint to create a two-foot black threshold in front of the door. It may act as a visual stop barrier.

• Install warning bells above doors or use a monitoring device that signals when a door is opened.

• Place a pressure-sensitive mat in front of the door or at the person's bedside to alert you to movement.

• Put hedges or a fence around the patio, yard or other outside common areas.

• Use safety gates or brightly colored netting to prevent access to stairs or the outdoors.

• Monitor noise levels to help reduce excessive stimulation.

• Create indoor and outdoor common areas that can be safely explored.

• Label all doors with signs or symbols to explain the purpose of each room.

• Store items that may trigger a person’s instinct to leave, such as coats, hats, pocketbooks, keys and wallets.

• Do not leave the person alone in a car.

Plan ahead

The stress experienced by families and caregivers when a person living with dementia wanders and becomes lost is significant. Have a plan in place beforehand, so you know what to do in case of an emergency:

• Consider enrolling the person living with dementia in a wandering response service.

• Ask neighbors, friends and family to call if they see the person wandering, lost or dressed inappropriately.

• Keep a recent, close-up photo of the person on hand to give to police, should the need arise.

• Know the person’s neighborhood. Identify potentially dangerous areas near the home, such as bodies of water, open stairwells, dense foliage, tunnels, bus stops and roads with heavy traffic.

• Create a list of places the person might wander to, such as past jobs, former homes, places of worship or a favorite restaurant.

Take action when wandering occurs

When someone with dementia is missing 

Begin search-and-rescue efforts immediately. Many individuals who wander are found within 1.5 miles of where they disappeared.

• Start search efforts immediately. When looking, consider whether the individual is right- or left-handed — wandering patterns generally follow the direction of the dominant hand.

• Begin by looking in the surrounding vicinity — many individuals who wander are found within 1.5 miles of where they disappeared.

• Check local landscapes, such as ponds, tree lines or fence lines — many individuals are found within brush or brier.

• If applicable, search areas the person has wandered to in the past.

• If the person is not found within 15 minutes, call 911 to file a missing person’s report. Inform the authorities that the person has dementia.