Understanding and Responding to Wandering in Aged Care

What is Wandering?

Wandering, walking or pacing describes behaviour where a person roams around repeatedly (Dementia Support Australia 2024).

Wandering is typically associated with Alzheimer’s disease or other types of dementia. Around 60% of people with dementia will wander on at least one occasion, and some may do so repeatedly (Alzheimer's Association n.d.).

Wandering behaviour could also be associated with:

• Autism
• Down syndrome
• Conditions that may lead to dementia
  • Stroke
  • Head injury
  • Parkinson’s disease.

(Ellis 2024)

In a safe environment, wandering isn’t necessarily an issue (Dementia Support Australia 2024).

However, someone might wander at any time of day or night, and this can be dangerous if the person leaves their place of residence and finds themselves in an unsafe situation. As dementia often causes difficulties with memory, orientation and recognising places and faces, a person who wanders may become lost and unable to find their way home. This can be greatly worrying for staff, carers and loved ones (Alzheimer’s Society 2021; Alzheimer's Association n.d.).

Older people should always be afforded free movement and dignity of risk - that is, the right to make decisions and take risks. However, at the same time, providers must also appropriately manage risks and ensure individuals understand the potential consequences of their choices (ACQSC 2025).

Providers have a duty of care towards older people, i.e. the responsibility to ensure they do not sustain harm or injury that could have been reasonably foreseen. When managing wandering, which may put older people at risk of harm, it’s essential to achieve an appropriate balance between the person’s dignity of risk and your duty of care. Always look for solutions that are the least restrictive of the client’s choice and independence.

Why do People Wander?

Wandering is common among people with dementia, and there are many reasons why it may occur. However, due to difficulties with memory and communication, the person may be unable to remember or explain why they are wandering (Dementia Australia 2024).

Potential reasons why someone may wander include:

• Disorientation due to a new environment (e.g. entering an aged care facility)
• Wanting to escape from a noisy, busy or uncomfortable environment
• Short-term memory loss (e.g. going to the shops and forgetting where they are going and why along the way)
• Excess energy
• Boredom or lack of physical activity
• Searching for someone or something related to their past (e.g. a deceased loved one or previous home)
• Difficulty distinguishing between day and night due to insomnia, disorientation or sensory impairment
• Continuing a previous habit (e.g. wandering at the same time they used to walk the dog)
• Agitation, restlessness or anxiety
• Discomfort or pain (e.g. due to tight clothing, illness or needing to use the toilet)
• Feeling as if they have a job or task to perform
• Difficulty distinguishing between dreams and reality.

(Dementia Australia 2024; Alzheimer’s Society 2021; Dementia Support Australia 2024)

What are Signs that Someone is Wandering?

Someone who wanders might:

• Return from a regular outing later than usual
• Forget how to get to familiar locations
• Talk about former obligations, such as work
• Want or attempt to ‘go home’ despite already being home
• Pace, make repetitive movements or become restless
• Have difficulty finding familiar places such as the bathroom, bedroom or dining room
• Ask where past or deceased friends and family are
• Act as if they are performing a hobby or chore without actually getting anything done
• Feel lost in a new or changed environment
• Be anxious in crowded areas.

(Alzheimer's Association n.d.)

When is Wandering an Issue?

Wandering may be an issue if:

• Repetitive walking results in discomfort or distress
• The person does not want to sit down
• The person appears to be distressed or anxious.

(Dementia Support Australia 2024)

Responding to Wandering

Read: Behaviour Management and BPSD

Strategies that may be helpful include:

• Validating the person’s needs and providing reassurance (e.g. ‘You’re safe here’)
• Placing familiar and meaningful objects and photos in the person’s room
• Playing the person’s favourite music
• Maintaining a routine that allows the person to participate in meaningful activities
• Providing adequate opportunities for exercise and activity
• Identifying whether there is any underlying pain, illness or discomfort that may be contributing to the behaviour
• Conducting a medication review (this must only be performed by a medical doctor or pharmacist)
• Determining any underlying reasons for the behaviour
• Determining whether there is a specific pattern to the wandering (e.g. certain time of day, certain triggers) and addressing any patterns that are identified (e.g. planning activities during times of the day when the person is more likely to wander)
• Implementing night lights, sensor lights and signs to help keep the person orientated
• Monitoring noise levels
• Ensuring the environmental temperature is comfortable
• Ensuring the person’s room is away from stairs and elevators and close to the nursing station (so that they will have to pass it when leaving)
• Ensuring staff are notified that the person may wander
• Establishing indoor and outdoor areas where the person can safely walk and pace
• Ensuring the person has identification on them at all times
• Recording a daily description of what the person is wearing and ensuring that an up-to-date photo of the person is available
• Regularly checking on the person.

(VIC DoH 2024; Dementia Australia 2024; Alzheimer’s Society 2021; Alzheimer's Association n.d.)

Remember that strategies should always be tailored to the person’s individual needs (Dementia Support Australia 2024).

What to do if a Client Goes Missing

Read: Unexplained Absences and Missing Residents