Understanding an Unmet Need and Dementia
The wizard Gandalf, in JRR Tolkien’s book The Fellowship of the Rings, wrote a letter to the hobbit Froto explaining the riddle of Strider or Aragon, suggesting “Not all who wander is lost.” Why would I begin an article addressing “wandering” and dementia with this quote? While the term wandering can sound negative, people living with dementia will explore to meet a need. I believe this is true when a person with dementia walks out of the house unexpectedly and possibly goes missing. The event begins with the person having a purpose, but during the journey the person can become lost due to visual-spatial difficulties that may develop with a dementia diagnosis. This of course is distressing for the family and often for the person, but understanding why a person may leave the house will be helpful in keeping your family member safe and possibly avoid any dire consequences.
When someone leaves the home, is not “escaping” “running away” or “just being difficult,” behavior but rather an attempt to meet a need. The person may need to be physically active and decides to go for a walk, with no awareness of their safety, and neglects letting someone know of their intention. The need may be to go shopping to purchase milk to help out at home, feel a need go to work, even though the person left the work force many years ago, or has the need to purchase a birthday gift for someone they love. When a loved-one walks out of the house unexpectedly, or “wanders” away from you in the shopping mall, understanding the intent is important. Perhaps this is really just “meaningful wandering” to find purpose in their day.
A person living with dementia may feel their life is turned upside down, and finding purpose is a way to make sense of a disorganized and confusing world. Thinking the grandchildren need to be picked up from school would give purpose, and grabbing car keys while heading out the door, when driving as become unsafe, is concerning.
Feeling lost and disconnected from everything around you with no purpose, or direction in life, can result in helplessness and sometime hopelessness. Being spiritually lost and not feeling grounded in faith can contribute to the restlessness a person feels when living with dementia. When providing support at home, keeping your family member safe by taking necessary precautions while honoring the need to find purpose is important.
Taking regular walks with your loved one can help meet a need to be physically active. When asked who are at risk for walking away and not letting anyone know, the answer is anyone with cognitive decline, confusion, or memory loss. There are usually no warning signs the person is more likely to walk out the house and families are shocked when it happens, explaining the person had “never done this before.” These events are unpredictable, but if a loved-one does walk out of the house or becomes disoriented and lost in the mall, consider if the person is left or right handed as wandering patterns tend to follow the direction of the dominant hand.
Look in familiar places or areas they have wandered before. If a loved-one is not found in 15 minutes, notify your local police department, and when the person is located and returns home, please do not scold, fuss, or shame them for leaving. Chances are, the person was only trying to be helpful. If the wandering event unfortunately leads to serious or even deadly consequences, know your loved-one was happy and content on their last journey, because they were fulfilling a purpose that was very meaningful to them.
If you would like more information on our Memory Ministry, Memory Café, or need tips on supporting your family member, please contact Vicky Pitner at vpitner@firstumc.org.