Wandering

Many people with dementia will wander, and others will abscond or demand to leave. A risk assessment may be needed to determine their safety outside, for example assessing road safety and their ability to find their way back home.

First exclude causes of agitation. Ensure that the patient has plenty of opportunity for physical exercise and is encouraged to take walks. Identify any motivation that may be driving the wandering behaviour, for example the belief that they must get back to work, or that their family is in danger, or a craving for alcohol. At home additional locks or safeguards may be needed, A 'Stop!' sign on the front door may be effective. Some units have number entry locks which the patient with dementia cannot use. Identification bracelets or tagging systems which sound an alarm if the patient leaves the unit are perhaps a last resort. An inpatient or residential unit will need both an absent without leave policy, which will include the protocol for informing family and police, and a locked door policy which must take into account what happens if there is a fire. Detention under the Mental Health Act 1983, or its equivalent, may need to be considered.

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