Health

What To Do When Someone With Alzheimer’s Disease Wanders

Published

2 years ago

November 21, 2023

Prevention and preparation can help you keep your loved one safe

November 21, 2023 – The definition of wandering varies from context to context. Technically, wandering is an umbrella term for several different behaviors. This includes elopement (attempts to escape), repetitive pacing and becoming lost. According to neurologist, Jagan Pillai, MD, PhD, Assistant Professor, Neurology, Cleveland Clinic Lerner College of Medicine, most of the caregivers he works with think about wandering in terms of the latter — when someone becomes lost outside of the home, without their knowledge.

However you define it, wandering is a serious concern. It tends to occur in moderate to advanced stages of Alzheimer’s disease. According to the Alzheimer’s Association, 60% of people living with the disease will wander at least once. Most individuals who wander, wander repeatedly.

As you can imagine, wandering is incredibly dangerous. In fact, of individuals who aren’t found within the first 24 hours of their departure, 50% end up either severely injured or dead. That’s why it’s so important to take action to prevent wandering, and implement a plan for recovering a loved one if they go missing.

It’s worth noting that Alzheimer’s isn’t the only condition that can cause wandering. It also occurs in other neurodegenerative diseases like Parkinson’s disease, specific forms of dementia like Lewy body dementia and developmental disorders like autism spectrum disorder (ASD). While the advice below focuses on Alzheimer’s, it might be worth a read for others, too.

According to Dr. Pillai, as Alzheimer’s disease progresses, certain abilities degrade, like sequential planning and keeping track of a daily routine.

“People with Alzheimer’s may not perceive the outside world in the same way anymore,” he explains. “The way they perceive colors and distances might change, too, so they’re not able to make judgments about how far apart things are, or how one object relates to another.”

This combination makes it difficult for the person with dementia to figure out where they are — and what to do next.

Many people who wander are motivated by a goal of some sort. Some of the common motivations include a need to escape from what one perceives as an unfamiliar or unsafe setting, a desire for social interaction or simple restlessness.

It’s often impossible to determine why an individual is wandering because, as Dr. Pillai notes, a combination of these things can happen all at once. He offers an example of going to get the newspaper.

“They’ve done that a zillion times in their life,” he explains, “but as the disease progresses, there will be a point where they pick up the newspaper, and suddenly the world doesn’t seem the way it used to seem. They get confused and they take a wrong turn.”

Something as simple as changing weather might be enough to disorient a person with dementia. As Alzheimer’s disease affects both memory and sequential planning, it’s hard to know what triggers the behavior.

If you have a loved one with an Alzheimer’s diagnosis, you’ve likely heard of a common phenomenon called sundowning. The term refers to a number of symptoms — like irritation, confusion, agitation and depression — worsening over the course of the day. While most people experience sundowning after the sun goes down, as the name suggests, it can actually happen at other times of day, too.

About 20% of all people with Alzheimer’s disease experience sundowning.

While it’s true that sundowning can prompt nighttime wandering, Dr. Pillai doesn’t see it as often among his patients as the literature would lead us to expect.

“Wandering typically means the person is breaching the threshold between their home and the elements,” he explains, “and people don’t usually go outside as much at night, although they might be wandering inside the house.”

That said, when people do have a wandering episode after dark, it’s extremely dangerous.

Wandering is a sign of disease progression, so it tends not to happen out of the blue. Your loved one may be at risk of wandering if they start:

Forgetting how to get to familiar places, both inside and outside the house.
Talking about obligations from their past, like going to work or picking children up from school.
Asking about the whereabouts of family members who’ve passed away.
Expressing a desire to “go home” while at home.
Getting disoriented or anxious in crowded or public spaces.

If you notice these behaviors, it’s time to implement your wandering safety plan.

If you have children, you’ve probably sat down with them at some point to create a fire safety plan. It’s important to do the same thing for wandering. Having a wandering safety plan allows you and any other people involved in your loved one’s care to prepare for an emergency long before it happens. Here are some things to consider for your safety plan:

Get a medical identification bracelet. According to Dr. Pillai, this is perhaps the most important component of the wandering safety plan. The bracelet should include the individual’s name, their medical condition (for example, “Alzheimer’s” or “memory loss”), a contact number for their primary caregiver and, if possible, their address.
Enroll in a safe return program. Multiple companies sell medical alert devices with GPS tracking. In addition to facilitating the safe return of a loved one, they can also be used to summon the authorities in the event of a medical emergency. The Alzheimer’s Association, in collaboration with the MedicAlert® Foundation, has a 24/7 Wandering Support program.
Take regular photos. In the event that your loved one goes missing, it’s crucial that you have a recent close-up photo to share with the authorities.
Inform your neighbors. Contact the people living in the immediate vicinity of the person with Alzheimer’s and ask them to alert you if they see the individual walking around unsupervised. If possible, provide them with a photo. According to Dr. Pillai, “People are sometimes hesitant about sharing this information with their friends or family, or members of the community, but making sure people are aware is a huge safety net.”
Write down likely wandering destinations. Make a list of the places your loved one has gone in the past or places you suspect they might try to go during a wandering episode. For example, if the person thinks they still have a job, they may try to go to their office.
Install an alarm system. In addition to conventional home security systems, there is a wide range of products on the market specifically designed for wandering prevention, including bed, chair and gate alarms. There are also pressure mats with built-in alarms that can alert you when your loved one is walking into an unsafe area of the house.
Hide your keys. Make sure your home and car keys aren’t readily accessible to a person living with dementia.

While you can’t stop people with Alzheimer’s from wandering, you can create an environment that discourages it. Here are some tips for managing wandering:

Cover the basics. All humans need regular access to food, water and a toilet. Those needs going unmet may prompt a person living with dementia to wander.
Build routines. Even if your loved one hasn’t had issues with wandering, structure can be helpful. Involve your loved one in daily activities like preparing meals. If you aren’t providing day-to-day care, arrange to call at the same time every day to check in.
Schedule with symptoms in mind. Look for patterns in the individual’s wandering. If they’re prone to wandering at a particular time of day, plan activities during that time.
Encourage “safe walking” and other exercises. Restlessness and lack of exercise are common causes of wandering. Give your loved one scheduled, supervised opportunities to get outside and be active.
Camouflage exits. Where possible, match your door handle to the door color. If you can’t change the hardware, try covering the doorknob in fabric. You can also hang art on the door, giving it the appearance of a wall. Keep in mind, if you’re loved one is wandering, they can’t be alone — concealing the door is only safe if the individual is being monitored.
Consider aromatherapy. While the scientific evidence is far from conclusive, the UK’s Alzheimer’s Society notes that aromatherapy might reduce aggression and improve cognition in people living with dementia.

While it’s important to keep your loved one from wandering, remember to NEVER leave them in a locked house by themselves. If you discover that a person with Alzheimer’s is missing, it’s important to act fast.

Within the first 15 minutes after learning your loved one is lost, do as many of the following steps as you can:

Search the entire residence, including areas where the individual might not usually go (like a garage, basement, attic or crawlspace).
Make sure there aren’t any cars missing from the residence.
Search in the yard, if there is one, and in the surrounding neighborhood. Be attentive to the landscape. According to the Alzheimer’s Association, many individuals who go missing are found within brush or brier.
If the individual has gotten lost in the past, search the areas where you previously found them.
According to the Alzheimer’s Association, most people who wander are found within 1.5 miles of their starting location. As you widen your search area, favor the direction of the person’s dominant hand. For example, turn right at a fork in the road if your loved one is right-handed. When people with dementia wander, they tend to follow the direction of their dominant hand.
Alert neighbors, friends and family members that the individual is lost. If possible, show them a recent picture of the missing person so they can keep an eye out.

If after 15 minutes of searching, you’ve been unable to locate your loved one, you should call 911 and report the individual missing. The authorities can then determine whether or not to issue a Silver Alert.

A Silver Alert — similar to the Marco Alerts you receive following a child abduction — is specific to missing persons who have a cognitive disorder, mental disability or brain disorder. The alert notifies everyone within the locale, region or state to be on the lookout for the missing individual.

No matter how much you plan or how hard you work, taking care of a loved one with Alzheimer’s or dementia will never be easy. It’s an emotionally, mentally and physically taxing experience. Without proper support, you run the risk of burning out. That’s why part of being an effective caregiver is knowing when to seek help.

Dr. Pillai recommends caregiver support groups to his patients’ families, explaining that, “There’s a lot of value in talking to other people going through the same experience.” Support groups provide a space to process grief, release stress and learn healthy coping strategies.

Dr. Pillai also notes that talking to other caregivers in your area is a great way to learn “what strategies to prevent wandering work in the real world.” If you’re not comfortable attending a support group, consider joining an online forum.

Millions of people are living with Alzheimer’s disease around the world — and millions more are caring for them. Wandering is scary, yes, but it isn’t unique. Your loved one isn’t alone in this fight, and neither are you.

Health

29 Million Strong, the World Salutes Nurses as International Nurses Day is Observed

Published

1 day ago

May 12, 2026

Deandrea Hamilton

On Tuesday May 12, the world pauses to honor one of humanity’s most trusted, exhausted, resilient and indispensable professions — nursing.

International Nurses Day is observed annually on the birthday of Florence Nightingale, widely regarded as the founder of modern nursing, and comes at a time when global healthcare systems continue to rely heavily on nurses carrying extraordinary emotional, physical and professional burdens.

According to the World Health Organization, there are an estimated 29 million nurses worldwide, making nursing the largest professional group within the global healthcare workforce. Yet despite their numbers, many countries continue to face severe nursing shortages, burnout crises and migration challenges as healthcare demands rise faster than staffing levels.

Still, nurses remain the heartbeat of healthcare.

They are present at life’s first breath and often its final moments. They work through hurricanes, pandemics, emergencies and violence. They calm fear, interpret pain, comfort families and frequently become the bridge between doctors, patients and hope itself.

In small island nations like those across the Caribbean, nurses often carry even greater responsibility — serving communities where resources may be stretched, specialists limited and healthcare systems under constant pressure.

This year’s observance again shines a spotlight not only on the compassion nurses bring to their profession, but also on the growing global call for better pay, safer working environments, improved mental health support and stronger investment in healthcare staffing.

For many people, the most memorable face in healthcare is not always the surgeon or specialist — it is the nurse who stayed a little longer, explained a little more gently or cared a little more deeply during a difficult moment.

Tomorrow’s observance is therefore more than ceremonial.

It is a reminder that behind every functioning hospital, clinic, emergency room, health center, operating theatre and recovery ward stands a nurse — often overworked, sometimes underappreciated, but consistently essential.

To nurses across The Bahamas, Turks and Caicos, the Caribbean and the wider world: thank you for showing up, even on the hardest days.

Developed by Deandrea Hamilton • with ChatGPT (AI) • edited by Magnetic Media.

Government

$94.1Mfor Health; Knowles Pushes to Keep Care at Home

Published

3 weeks ago

April 25, 2026

Deandrea Hamilton

Turks and Caicos, April 25, 2026 – A major shift in how healthcare is delivered in the Turks and Caicos Islands is at the center of the Government’s latest budget, with a focus on reducing reliance on overseas treatment and strengthening services at home.

Presenting his contribution to the national debate, Kyle Knowles outlined a strategy aimed at building a more sustainable healthcare system—one that allows more residents to access quality care within the country.

The health sector has been allocated $94.1 million, making it one of the largest areas of public spending in the $550.8 million Budget passed on April 23.

Central to the Minister’s approach is a restructuring of the Treatment Abroad Programme (TAP), which has grown significantly in recent years as more patients are sent overseas for specialized care.

The Government now aims to reverse that trend.

“We are reforming healthcare to ensure long-term sustainability,” Knowles indicated, pointing to efforts to strengthen local services and reduce the need for travel.

The strategy includes improving healthcare infrastructure, expanding services available within the islands and increasing efficiency through the digitization of medical records.

Digitization is expected to support better coordination of care, reduce delays and allow for more accurate tracking of patient needs—part of a broader effort to modernize public services.

The Minister emphasized that the goal is not only cost control, but improved access.

“No family should have to leave home to get quality care,” he said, underscoring the Government’s intention to refocus healthcare delivery on local capacity.

The shift comes as rising healthcare costs continue to place pressure on public finances, with overseas treatment representing one of the most expensive components of the system.

By investing more heavily in domestic services, the Government is seeking to reduce that burden while improving outcomes for residents.

While the direction is clear, details on timelines and the pace of expansion for local services were not fully outlined in the presentation.

Still, the emphasis on sustainability, access and modernization signals a strategic pivot in how healthcare is expected to evolve in the Turks and Caicos Islands.

Angle by Deandrea Hamilton. Built with ChatGPT (AI). Magnetic Media — CAPTURING LIFE.

Health

Turks and Caicos Islands Hospital Celebrates 16 Years of Advancing Quality Care and Innovation

Published

1 month ago

April 9, 2026

Deandrea Hamilton

PROVIDENCIALES, Turks and Caicos Islands – April 9, 2026 – Turks and Caicos Islands Hospital (TCIH), operated by InterHealth Canada, proudly marks 16 years of service to the people of the Turks and Caicos Islands, celebrating a legacy of delivering safe, high-quality, and evidence-based care since opening its doors 10th April 2010.

Background: Public-Private Partnership Model
Turks and Caicos Islands Hospital is delivered through a public-private partnership (PPP) between the Government of the Turks and Caicos Islands and InterHealth Canada Limited (ICL). In January 2008, InterHealth Canada entered into an agreement with the Government to design, build, finance and operate the country’s acute secondary healthcare facilities. This partnership was established almost two decades ago aimed to modernize healthcare infrastructure, improve access to services and ensure the delivery of high-quality care aligned with international standards.

Under this model, hospital operations are delivered through two specialized entities operating within the InterHealth Canada framework:

A clinical services company, responsible for the delivery of all medical and clinical care
A facilities management company, responsible for infrastructure, maintenance and non-clinical support services

Both entities operate under InterHealth Canada Limited, have distinct management structures and provide services in accordance with the terms outlined in the Project Agreement with the Government.

The hospital services were officially commissioned on April 10, 2010, with:
20 inpatient beds at Cheshire Hall Medical Centre
10 inpatient beds at Cockburn Town Medical Centre

Importantly, both facilities collectively called the Turks & Caicos Islands Hospital (TCIH) were designed with built-in expansion capacity, including “shelled” spaces that can be retrofitted to increase inpatient bed capacity as demand grows. This forward-looking design on the part of the Turks & Caicos Islands Government aimed to support long-term scalability and enables the health system to respond to the evolving needs of the population.

Since its establishment, TCIH has transformed healthcare delivery across the islands through infrastructure development, international partnerships and a steadfast commitment to clinical excellence. The hospital system, comprising facilities in Providenciales and Grand Turk, introduced a new era of accessible, comprehensive care for residents and visitors alike.

A Legacy of Quality and International Recognition
Since its establishment, TCIH has maintained a strong focus on quality improvement and patient safety. Turks and Caicos Islands Hospital continues to distinguish itself as one of the few internationally accredited hospitals systems in the Caribbean, reflecting a sustained commitment to quality, safety and accountability. TCIH has maintained Accreditation Canada International accreditation at the Diamond level since 2012, the highest level achievable under the program, demonstrating consistent compliance with rigorous global standards in patient safety, governance and clinical care. Accreditation Canada’s Qmentum Global program is an internationally recognized framework used in more than 40 countries to drive continuous quality improvement, strengthen safety culture and ensure evidence-based care delivery across health systems. Within the Caribbean, hospitals achieving full international accreditation remain relatively limited, underscoring the significance of TCIH’s achievement.

As a growing centre for education and workforce development, TCIH has played a pivotal role in building local capacity within the healthcare sector. In 2019, the hospital achieved accreditation through the University of the West Indies accreditation body to support physician internship training, marking a major step toward developing a sustainable, homegrown medical workforce.
The hospital has also delivered a robust institutional training program since inception, supporting several health professionals across the Turks and Caicos Islands. Through collaborations with the Ministry of Education, TCIH has hosted one of their largest cohorts of interns and apprentices, while partnerships with the Turks and Caicos Islands Community College have enabled the introduction of the first clinical nursing rotations on-island.

Advancing Evidence-Based Care: Best Practice Spotlight Organization(r)
Turks and Caicos Islands Hospital has further strengthened its commitment to quality care through its designation as a Best Practice Spotlight Organization(r) (BPSO(r)) by the Registered Nurses’ Association of Ontario in 2025. The BPSO(r) programme is an internationally recognized initiative that supports healthcare organizations in implementing and sustaining evidence-based clinical practices. Through this designation, TCIH has demonstrated its ability to integrate best practice guidelines into everyday care, improving outcomes in key areas such as patient safety, person- and family-centred care, falls prevention and pressure injury prevention. For the community, it means greater confidence that care delivered at TCIH is safe, consistent and aligned with internationally recognized standards, ultimately contributing to better patient experiences and improved health outcomes across the Turks and Caicos Islands.

Advancing Surgical Safety: AORN Go Clear(tm) Award
Turks and Caicos Islands Hospital has also demonstrated leadership in surgical safety through its achievement of the AORN Go Clear(tm) Award in 2020, an international recognition granted by the Association of Perioperative Registered Nurses. The Go Clear(tm) Award recognizes healthcare facilities that have successfully implemented a comprehensive surgical smoke evacuation program, ensuring that operating theatres are effectively “smoke-free.” Surgical smoke-produced during procedures using lasers or electrosurgical devices-can contain harmful chemicals, toxic gases, and biological particles that pose risks to both patients and healthcare professionals. By meeting AORN’s stringent criteria, TCIH demonstrated that it has:

Adopted standardized protocols for smoke evacuation in surgical procedures
Equipped operating rooms with appropriate smoke evacuation technology
Trained clinical teams in safe surgical practices
Embedded a culture of safety within perioperative care

At the time of receiving this recognition in 2020, Turks and Caicos Islands Hospital was recognized as the first hospital in the Caribbean to achieve the AORN Go Clear(tm) Award, marking a significant milestone for patient safety and clinical excellence in the region. For patients, this achievement translates into safer surgical environments, reduced exposure to harmful airborne contaminants, and alignment with international best practices in operating room care. For healthcare professionals, it reflects a workplace that prioritizes occupational health and safety, reducing long-term exposure to surgical smoke and supporting a safer, more sustainable clinical environment.

Investing in the Next Generation of Healthcare Professionals
Turks and Caicos Islands Hospital is committed to building a sustainable healthcare workforce by inspiring and developing the next generation of health professionals. Through its READY Programme, TCIH provides high school students across the Turks and Caicos Islands with early exposure to careers in healthcare. The programme introduces students to a wide range of clinical and non-clinical roles, helping them better understand the pathways into the health sector and equipping them with foundational knowledge and career guidance. Complementing this initiative is the hospital’s Clinical Observership Programme, which offers students currently pursuing tertiary education in health sciences the opportunity to spend their summer months immersed in the hospital environment. Participants gain valuable hands-on exposure by shadowing experienced healthcare professionals, while also benefiting from structured mentorship and professional development support. Together, these programmes reflect TCIH’s commitment to nurturing local talent, strengthening workforce capacity and supporting long-term sustainability within the health system-ensuring that future generations are equipped to meet the evolving healthcare needs of the Turks and Caicos Islands.

The hospital has also contributed to workforce development in the Turks and Caicos Islands. Through partnerships with the Ministry of Education National Internship and Apprentice program and the Turks and Caicos Islands Community College. Further strengthening professional development, TCIH has worked closely with the Health Professionals Authority to introduce nurse clinical examinations locally. In collaboration with international partners, including the Hamilton Education Foundation, Massachusetts General Hospital and Harvard Medical School, TCIH has supported the introduction of Advanced Trauma Life Support (ATLS) training within the islands-enhancing emergency care capacity and preparedness.

Building Life-Saving Skills in the Community
Turks and Caicos Islands Hospital has also played a leading role in strengthening emergency response capacity across the islands through education and training. TCIH is recognized as the first fully accredited training centre in the Turks and Caicos Islands under the American Heart Association, delivering a comprehensive suite of internationally recognized resuscitation programmes. Through this initiative, the hospital provides annual training to more than 300 participants, including healthcare professionals, first responders and members of the wider community. These programmes focus on essential life-saving skills such as cardiopulmonary resuscitation (CPR), first aid, and advanced resuscitation techniques. By expanding access to this training, TCIH is helping to build a more resilient community, equipping individuals with the knowledge and confidence to respond effectively in emergencies and improving outcomes in critical situations. This achievement reflects the hospital’s broader commitment not only to delivering high-quality clinical care, but also to empowering the community with the skills needed to save lives.

Rising Utilization Reflects Growing Demand for Hospital Services
TCIH’s milestone comes at a time of rapid national growth, placing increasing demand on healthcare services. According to the Turks and Caicos Islands Statistics Authority, the population has grown significantly-from 18,491 in 2000 to 50,828 in 2024-while total visitor arrivals reached approximately 1.81 million in 2024, driven largely by continued expansion in the tourism sector. This growth trajectory is expected to continue. The Government’s National Tourism Development Strategy projects an increase in registered accommodation rooms to over 6,000 by 2032, reflecting sustained expansion in the hospitality sector and further growth in visitor and migrant workforce numbers. This demand is further intensified by the rising prevalence of chronic non-communicable diseases, which is contributing to greater complexity in care delivery and placing sustained pressure on both critical care services, outpatient visits and overseas referrals. At the same time, the hospital is closely monitoring an increase in trauma-related cases, adding another layer of demand on emergency and acute care services.

Over the past fourteen years, Turks and Caicos Islands Hospital has experienced a significant increase in patient activity, reflecting both national population growth and rising demand for healthcare services. Between February 2012 and February 2026, total patient encounters across the hospital system increased from 5,841 to 9,050, representing a substantial rise in overall service utilization. This growth has been particularly pronounced in outpatient care, where on-island clinic visits more than doubled, increasing from 2,617 to 6,439 encounters over the same period.

At Cheshire Hall Medical Centre, the impact of this demand is most evident in inpatient services. Bed occupancy levels have risen from an already high 85.34% in February 2012 to 115.71% in February 2026, indicating sustained periods where demand has exceeded available bed capacity.

These trends are creating capacity challenges across several key areas:
Inpatient beds – High occupancy driven by medical complexity and longer lengths of stay
Emergency Department – Increased patient volumes, acuity and trauma presentations
Outpatient Clinics – Growing demand for both on-island and visiting specialist services
Laboratory Services – Expanded testing needs to support chronic disease management and acute care
Diagnostic Imaging – Increased reliance on ultrasound, CT, MRI and other imaging to support timely diagnosis and treatment

These trends underscore the critical need for greater investment in expanding services at TCIH to support reliable, high-quality healthcare services to both residents and the millions of visitors who travel to the islands each year and reduce the need the overseas care.

Recognising the Strength of Our People
At the heart of Turks and Caicos Islands Hospital’s success over the past 16 years is the dedication, professionalism and compassion of our naturally excellent team. TCIH recognizes that the strength of its services lies in its people-highly skilled and committed healthcare professionals and support teams who work every day to deliver safe, high-quality care to the community. Across both Cheshire Hall Medical Centre and Cockburn Town Medical Centre, our team continue to demonstrate resilience, teamwork and an unwavering focus on patient-centred care, even as demand for services continues to grow.

The Board of Directors of InterHealth Canada extends its sincere appreciation to all members of the TCIH team for their outstanding contributions over the years.

“We recognize and deeply value the commitment of our facilities management and clinical services team, whose daily efforts make a meaningful difference in the lives of patients and families across the Turks and Caicos Islands. Their dedication, expertise and compassion are the foundation of the hospital’s success. As we celebrate this milestone, we thank them for their continued service and for the vital role they play in supporting the health and wellbeing of the community.”

Dr. Denise Brathwaite-Tennant, CEO, highlighted the importance of forward planning and partnership: “As we celebrate 16 years of service, we are proud of how far we have come in transforming healthcare in the Turks and Caicos Islands. Our achievements reflect the dedication, expertise and compassion of our entire team, who continue to place patients and families at the centre of everything we do. As demand for healthcare continues to grow, driven by population increases, chronic disease and evolving patient needs, we are seeing sustained pressure across all areas of the hospital, including critical care, outpatient services and emergency care. We are also closely monitoring the rise in trauma cases, which further underscores the need for responsive and resilient systems. In collaboration with our partners, we continue to advocate for the additional resources and investments required to meet this rising demand and to ensure we maintain safe, high-quality care for our community. We remain committed to working collaboratively with our key partners the Ministry of Health and the National Health Insurance Board to strengthen capacity, enhance service delivery and plan strategically for the future, ensuring that the health system continues to meet the needs of the Turks and Caicos Islands.