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What's the best way to keep someone with dementia safe who wanders?

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I think that depends on whether they are more apt to wear the watch or the shoes. Nothing is foolproof, people have been known to leave the house in slippers or barefoot, people can reject a watch (especially if it is big or "ugly") or to take it off at night and leave without it.
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Does this person (not sure if you are asking for your husband or your ex) have a cell phone?
A cell phone also has the capability to be tracked and if this person does not leave without the phone that is great.
If they always have keys on them you can put a tracker on the key ring.
There are no fool proof 100% reliable tracking devices because we are dealing with humans.
they can leave without shoes
they can leave without a watch
they can leave without keys
they can leave without a cell phone.
The only way is to keep them within your vision. Trust me I KNOW all to well that is impossible. I wore my house keys around my neck for 5 years. I NEVER took them off. My Husband STILL managed to "escape" 3 times.
If it becomes a danger then you might really have to consider placement in Memory Care. (even then there have bee reports that residents have managed to escape)
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tshoug, instead of those items, if your hubby tend to wander at night, put down a black throw rug in front of the exit doors at night only. Since hubby has Alzheimer's/dementia, he may think there is a large hole in front of those doors. Hope that works.
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jacobsonbob Jan 2021
Excellent answer; I recall having seen this suggestion in the past. Maybe a rug can be designed such that it will look like a well or pit, with what appears to be a progression of rocks on the side that shrink to provide the perspective of going farther away as if down a hole (or maybe a brighter area in the middle that looks like light reflecting from water).
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When my uncle started wandering we thought of all the great tracking products that could help. In the end we decided on a camera focused on his door, we had it set to alert 3 family members when he left the house. Whoever was closest would go and intercept him. This wasn’t a perfect solution and I think a combination of the shoe tracker and camera would have been better. But it definitely gave us a sense of comfort.
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At the nursing home, my father wore some kind of "ankle bracelet" that notified staff if he got too close to an exit door. (It could not be removed by him.) He did not even notice it. You might look into this.

I have a phone app called "Kasa" that I use for my pet parrots. The camera can be pointed towards any particular area you wish - such as towards the front door. When I am out of town, I am able to check on my parrots remotely. Something like this is an inexpensive solution to monitoring the front door.
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Have a certain safe area for them to wonder in
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The best way to keep a "wanderer" safe is to have a safe environment and to have a person who is watching him/her. Memory care units are usually locked so that their charges can not wander off the premises. These facilities also tend to disguise doors as walls or bookcases to keep wanderers from lingering at the doors in wait of an opportunity to escape.
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In my mother's memory care facility they have alarms that go off if a resident gets close to the door. I think they work in conjunction with the ankle or wrist bracelet. My mother tried to cut off the ankle bracelet. That's when they took away all sharp objects in her apartment.
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Whole wondering is a fear, there are drawbacks to both. Shoes are not worn all the time so I would probably suggest not going with that option. As far as a watch style as long as the patient is used to wearing something on their wrist and leave it on, it will hopefully keep the loved one to be able to be found easier should it have GPS capability. The problem is by the time you know the family member has wondered, any number of things can happen. It is IMHO best to have safeguards in addition to the watch style unit. Things such as window and door alarms, make sure they are ones that are loud enough to hear through your home if that is were you are planning on keeping your loved one. Dementia care/living centers are set up to prevent their wondering. Gardens have no ability for them to wonder, but allows them to get fresh air.
Good luck
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Problem with watch trackers is they need to be recharged for a period of hours every day. If you feel comfortable that the wandering only is a danger during a portion of the day or night that's fine. For my father, this was not an option. We just put a cowbell on the front doorknob.
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My mother constantly fidgets with her watch, rings, necklaces, etc., so it's impossible to keep any type of tracking device on her. So instead we've installed an additional lock on the top of every door (the sliding bolt kind) and we have an alarmed mat next to the bed so we know when my mom gets up. Even if mom avoids the mat when she gets up (which has happened on occasion!), there's no way she can get out of the house.
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We put a slider lock on the front door for my father, he couldn’t figure out how to use it, we also hid his shoes he didn’t go out without them on, It’s a horrible disease RIP daddy.
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The main thing is it needs to be something they won’t remove. We put one on shoes, and she never noticed. We also had one in her coat pocket because she never left the house without her coat.
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Another thought on this.
I heard one case where the spouse / caregiver placed different door knobs on the door and just the extra door knobs was enough to confuse the person trying to open the door.
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I've tried several options, including different watches and a shoe device. None of these worked well either because my husband took them off or the GPS system was inadequate. I finally found something that works really well called a jiobit (see jiobit.com). It's a small device that can be attached to clothing, belts loops, etc. It has an excellent tracking system that is pretty precise. You can even set up a family and friends support network so that others can help you track your love one.
My first line of defense is a door chime system (secrui) which was easy to install and has been very effective. Plus, I have a special lock on the main door. All systems are subject to human error. I have on one occasion failed to replace batteries in the door alarm system in a timely manner, forgotten to lock the door, and neglected to attach the jiobit. As a result, my husband wandered away, but thankfully didn't get far.
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okay, don't even understand this, sorry.  I have shoe inserts because I have a bad arch.  And what kind of watch is good for someone wandering?  maybe I am not up-to-date on everything with new gadgets.  hope someone can help you out.
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Marylepete Jan 2021
In answer to your question. There are GPS trackers in watches and shoe inserts. So a person can be easily found. But that might be to late. I wear a watch that does so much, including if I fall, as I did a few days ago, it will notify 911 if I do not respond and it knows where I am, in a parking lot, store, home etc. because of the GPS.
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You did not mention if the person lives alone. Living alone with this disease is extremely dangerous and especially for when they wander. If there is a 24/7 caregiver there are many ways, as mentioned by others, to help notify of their exit. If the person lives alone seek a secured memory care home or 24/7 in home care.
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Imho, the tracker will only work if the patient is wearing the shoes or the watch and if they are both charged, if needed.
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My mom just moved in with me and my son and I'm also looking for something to put on her 'just in case'. She doesn't like watches or anything around her neck. She usually sleeps through the night, but sometimes she's up at 4am and wants to go for a walk and forgets to tell anyone! We live in a gated community, so I'm not worried about her getting out on the streets beyond the gates, but she will walk around and 'visit friends' that she thinks she knows and she doesn't always remember to take her purse or phone! I need something she can have on her while she's sleeping and will let me find her in case she does go for a walk before I wake up.
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