It is suggested that nearly 70% of people with Alzheimer's disease will wander away from home and get lost. Wandering is one of the biggest risks for individuals with Alzheimer's disease and is a common but dangerous symptom of the disease. A wanderer is someone with a disease such as Alzheimer's who has wandered away on their own free-will from their caregiver. The risk is evident in the 31,000 Alzheimer's patients who researcher Robert J. Koester estimates wanders per year. When someone with Alzheimer's disease wanders, he or she is disorientated and unable to judge potentially dangerous places and situations. People suffering from severe Alzheimer's disease are more at risk and the incidence of wandering increases.

Alzheimer's patients may suddenly walk off and become lost, frightened or confused. Generally if a patient is found within 24 hours they are returned safely, but after a longer time span the survival rate drops to nearly 50 percent, according to recent studies. It is evident that wandering behavior can be a life threatening incident.

Koester's research provides more insight into wandering in Alzheimer's patients. Those with Alzheimer's disease leave their own residence or nursing home and usually start to wander along roads. Eighty-nine percent of wandering patients are usually found within one mile from the point last seen. If the patient is not wandering along the road (14%), they are usually in a creek or drainage (28%), or caught in bushes or shrubberies (33%). But, the Alzheimer's patient is frequently found wandering a short distance from a road. Unfortunately there are some wanderers who eventually give in to the environment and develop hypothermia or dehydration (35%), or are found deceased (19%).

It is important for you to know that you can help prevent incidents of wandering even though you cannot always guarantee total prevention. If you are aware of the causes of wandering you can minimize the risks of someone with Alzheimer's disease becoming lost. Although wandering remains a risk, there are several things that you can do to help prevent wandering in an assisted living center, long term care facility or at home to ensure that the family's loved one remains safe.

1. Install locks on doors- That is the first place to prevent a wanderer from leaving. However, in the earlier stages of Alzheimer's disease it is more likely for a patient to wander because they usually still remember how to unlock the current locks. Placing hook and eye latches on the outside screen door is proven to be very effective, especially if placed either very high or low on the door. Another method is to place a double key lock on the inside door, but be aware that the patient may begin to panic if they cannot open the door from the inside.

2. Install locks on windows- In general, most people would not consider exiting a building though a window, but an Alzheimer's patient who feels the need to escape would consider. Even windows on the upper levels of a house or facility should be secured. If there are windows that open by sliding side to side, consider placing a piece of wood on the track to keep the window from fully opening. Windows that slide up and down can be protected by putting a nail or screw in the tack to prevent it from completely opening also. If the window uses a crank, consider removing the crank each time after using it to open or close the window, and then hide the crack in an undisclosed place.

3. Build fences and gates- A fence is not as restrictive and offers patients an alternative place to go in relative safety. Chain link fences should be avoided because elderly patients still have the capability of climbing them rather easily. Also, stay away from building a fence with brace beams facing into the secured area because the support beams can provide a foothold for climbing over the fence. In general, a farm fence with square openings too small to be used as footholds is a very good option. Don't forget that it is important that the fence is at least six feet tall so a patient will not try to physically pull themselves over it.

4. Use emergency IDs- Even with safeguards and precautions, patients still could break free. You can make sure that a label with the elderly patient's name and phone number is worn on their clothing at all times. This is important because you can never depend on the patient to carry their ID when they wander, but it is vital that the wanderer can be identified immediately and returned quickly if they go astray.

5. A Patient Wanderer Security System- Accutech's Wanderer Security System (www.Accutech-ICS.com) can provide an assisted living or long term care facility with the security solution needed to monitor and care for their Alzheimer's patients and to help prevent wandering. By use of a Cut Band system, a gentle band and tag is placed around the patient's wrist. Then staff is able to be notified if the band is tampered with or removed and if the patient leaves the room or facility. Such systems are a great way for facilities to help prevent an Alzheimer's patient from wandering.

6. Dress patients in bright colored clothing- It is known that bright and distinct clothing can be spotted from a distance. Dressing in clothing that is easily spotted in a crowd is helpful when taking a patient out of the home or facility and to a public area. It is very easy for an individual with Alzheimer's disease to become separated especially when there is a crowd. It can happen within seconds.

7. Keep all keys in an undisclosed place and out of reach- An individual with Alzheimer's disease may still be able to recognize a key and understand how it is used. A patient that gets a hold of a car key or is able to let themselves out of the home or facility can be gone for miles before being noticed. This does happen and it happens more often than thought.

8. Never leave an Alzheimer's patient alone in the car- According to several surveys each year the number of times an elderly patient is left in the car while the caregiver runs quickly into the store, bank, etc. has significantly increased. Even though you might only think you will be gone for only a few minutes, the Alzheimer's patient is often left in the car for more than15 minutes. You must remember that it only takes seconds for a frightened or panicked individual with Alzheimer's disease to get out of the car and quickly wander away.

9. Avoid leaving an Alzheimer's patient home alone- Determining when an individual with Alzheimer's disease is no longer to be left at home alone for short periods of time can be difficult. This makes it very challenging for someone who is the sole caregiver for a person with Alzheimer's disease. Still, there are several ways to find assistance. One, alert neighbors to keep an eye out for the wandering patient or have a neighbor visit when you are going to be gone for more than a few minutes. Two, use the idea of a babysitter and have a young adult stay with and care for the elderly patient while you are gone. Three, ask for help. Churches, high schools, Boy/Girl Scouts, community centers, senior citizen centers, local Alzheimer's Association chapters and any other group you can uncover could be willing to assist you in caring for someone with Alzheimer's disease.

10. Find other useful materials to help- You often have to be creative to keep an individual with Alzheimer's disease safe by using house hold items. For instance, baby monitors or motion detectors that turn on lamps or radios to alert if a patient is moving around or trying to leave are both items that are either easily found at home or at a store. Another idea is to look through a child safety center for more items to help keep track of an Alzheimer's patient. For example, the elastic bands mother's attach to their wrist and their child's wrist can be a great help when taking an elderly patient into a crowded area. Also, hanging bells on a door can also be a useful alarm.

The risk of wandering in individuals with Alzheimer's disease is very great. You can take precautions to keep patients safe, but even the best caregiver or nurse will have experiences with wandering patients. Take reasonable precautions, don't panic and enlist others to help you care for patients with Alzheimer's disease.

Adapted from New Research & Perspectives By Robert J. Koester M.S. Virginia Department of Emergency Management Appalachian Search & Rescue Conference,