1 / 26

Dementia-related Wandering: Management Interventions

Dementia-related Wandering: Management Interventions. D. Helen Moore, PhD Barbara McKenzie, MA USF Geriatric Education Center Summer Institute June 13, 2007. Part I. Introduction . definition significance quality of wandering high-risk/low-risk wandering

kendall
Download Presentation

Dementia-related Wandering: Management Interventions

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Dementia-related Wandering: Management Interventions D. Helen Moore, PhD Barbara McKenzie, MA USF Geriatric Education Center Summer Institute June 13, 2007

  2. Part I. Introduction • definition • significance • quality of wandering • high-risk/low-risk wandering • what, where, when and course of wandering

  3. What is Wandering? “a syndrome of dementia-related locomotion having a frequent, repetitive, temporally-disordered and/or spatially-disoriented nature that is manifested in lapping, random, and/or pacing patterns, some of which are associated with eloping, eloping attempts, or getting lost unless accompanied.” Source: Algase, DL, Moore, DH, Vandeweerd, C & Gavin-Dreschnack, D (2007). Mapping the Maze of Terms and Definitions in Dementia-related Wandering, Aging & Mental Health, in press.

  4. Why Care About Wandering? “Most common unsafe behavior in persons with dementia”

  5. High-risk/low-risk wandering • activity of the wanderer • care setting • caregiver knowledge and awareness

  6. Qualities of Wandering • haphazard • may lack apparent destination • fretful, pacing • cannot be easily redirected • may result in unintended leaving

  7. The “When” of Wandering • begins in the morning hours • increases throughout the day • peaks at 5 pm to 7 pm.

  8. The “Where” of Wandering • nursing home settings • community-based settings • home-based settings

  9. The Course of Wandering • 60% of all dementia cases • mild, moderate and severe dementia • Persistent - lasts for years • subsides in late-stage, profound dementia

  10. Wanderer Medical Personality Environmental Social Physical Part II. Causes of Wandering

  11. Medical Causes • visual/perceptual deficits • attentional problems • medication side effects

  12. Personality Causes • extroversion • hx. of exercise to manage stress • pre-morbid occupation

  13. Social Environment Causes • staff mix and stability • overall ambiance • extent of social engagement

  14. Physical EnvironmentCauses • light • noise • temperature • complexity of architecture • crowding

  15. Part III.Problematic wandering:management goals and recommended interventions

  16. Excessive walking GOAL - Support patient’s physical needs: • adjust medications • hydrate • provide nutrients • provide safe environment

  17. Elopement, day or night GOAL - Alert caregivers: • door alarm systems • pressure-activated systems • combined systems

  18. Trespassing GOAL - Keep patient out of off-limits areas: • visual exit barriers • tape barriers • mirrors

  19. Losing way GOAL - Guide patient: • signs, landmarks, cueing • enhanced lighting • establish toileting schedule

  20. Exiting-seeking GOAL - Reduce exit seeking behaviors: • architectural barriers • locks • visual exit barriers

  21. Shadowing • “Shadowing” in dementia-related wandering is defined in the literature as the patient’s close following or trailing a caregiver’s locomotion.

  22. Patient may go missing GOAL - Track patient’s location: • RFID • GPS • personal guidance systems

  23. Patient missing in the facility Goal: Staff response to quickly locate patient and prevent injury or exit • policies • procedures

  24. Patient missing in community GOAL: Community quickly locates and returns the patient • Alzheimer’s Assoc. Safe Return® Program • Community-based search and rescue

  25. VA Patient Safety CenterSafe Wandering Resources http://www.visn8.va.gov/ patientsafetycenter/

  26. Contact D. Helen Moore, PhD Health Science Specialist VISN 8 Patient Safety Center of Inquiry (118M) 11605 N. Nebraska Avenue, Tampa, FL 33612-5738 813-558-3931 ph; 813-558-3990 fax Dorothy.Moore4@va.gov

More Related