Wandering Resident advice

  1. In our 40 bed facility, we don't have a separate Alzheimers wing. We have a lady with alzheimers who has been 'wandering' at nite.

    There are only two of us at noc and sometimes it's hard to keep track of her if we're busy with other residents, and she'll go into other residents rooms before we can catch her.

    When she first gets up, we offer her a snack and a drink - she's fully ambulatory and doesn't seem to be having any discomfort - we turn on the TV and give her magazines. I'm going to take in assorted 'laundry' for her to fold (a suggestion I was given to keep her busy).

    If she just walked in the halls, I wouldn't mind, but she'll follow us into rooms, or go into other residents rooms and 'mess' with things.

    I've reported this to the DON, but am not getting much help - they're going to try to get her a PRN order for Tylenol.

    What do you guys do with residents like this?
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  2. 16 Comments

  3. by   CoffeeRTC
    As far as keeping her out of some of the residents rooms....can she read? We use those velcro nets across doors with a stop sign on them, or put her pic up on her door so she knows what room she is in. With one res like that, we would take her with us when we went down the halls. We would bring a chair with us and move it room to room and make her bring her note pad (she worked as a secretary) and take "notes". For her it worked. She would get up to walk around a little bit, but would for the most part stay close enough to keep and eye on.
    Of course rule out the basics....food, toileting,pain etc.
  4. by   banditrn
    Michelle - I've never seen the nets you talk about, sounds like a great idea - also the 'taking notes' thing. I wonder if she'd think coloring would be fun?

    She denies being in pain, and doesn't display any SX of it. She is still able to go to the BR by herself. I forgot to say in my first post that days reports that she doesn't sleep much during the day either.
  5. by   CoffeeRTC
    Hey....anything that works...coloring or painting worked for one of our resident artists...
    Try getting into thier reality...what does she think she is doing when she is wondering, etc.
  6. by   snowprincesspa
    Hi ,

    I'm a nursing student but I'm a CNA at a large facility. I'm very familiar with the wanders. We have sensor bells attached to all the resident door frames , letting us know if we have a wander. The sensor bells have 2 chimes, the normal door bell when staff is entering/leaving, then panic bell is set off with a resident's bracelet, it's a constant ring letting the staff know you have a wander in a room. It's kinda like the door chimes you'll hear at a store in a shopping mall. As far as keeping her busy, your doing pretty much the same thing I'm doing. Maybe your facility will get the door senors?! Good Luck.
  7. by   Quickbeam
    OP, for many years I was the night RN at a facility similar to yours. Very limited night staff (often, just me). I do recommend that you continue to document the behavior and your efforts. Include any patient complaints about finding this woman in their room, etc. I found that many times my manager didn't see the issue so didn't think it was important enough for funding of a solution. Especially since your unit is not set up for wanderers, it can be dangerous for the patient. Good luck to you.
  8. by   marjoriemac
    I see your problem, I would think perhaps she is following a routine that she may have practised in her earlier life. What did she work as? You could provide tasks relevant to her previous work. We had a lady who was a midwife and then house wife. She was settled when she could help with cleaning, laundry and washing dishes. We used to put clean dishes in the sink just so she would wash them. Unfortunately our ideas reached difficulty when her husband was admitted and she continued to attempt to care for him, not allowing care staff access to her. We eventually had to move her to the upstairs unit for his benefit but she enjoyed this as it allowed her 'excursions' to see her husband who she believed was in hospital. It may also help to keep this lady busy during the day and she may tire at night. Approach sedation with caution though as where there's a will there's a way and it would be dangerous for her to continue to wander in a sleepy state.
  9. by   banditrn
    Quote from snowprincesspa
    Hi ,

    I'm a nursing student but I'm a CNA at a large facility. I'm very familiar with the wanders. We have sensor bells attached to all the resident door frames , letting us know if we have a wander. The sensor bells have 2 chimes, the normal door bell when staff is entering/leaving, then panic bell is set off with a resident's bracelet, it's a constant ring letting the staff know you have a wander in a room. It's kinda like the door chimes you'll hear at a store in a shopping mall. As far as keeping her busy, your doing pretty much the same thing I'm doing. Maybe your facility will get the door senors?! Good Luck.
    I heard of a facility that did something like this, but the one I work at now isn't likely to spend any extra money on something like this, unfortunately.

    I had been assured by days that she doesn't sleep during the day, but I went in the other day for a meeting and found her sacked out on a sofa!! I pointed this out to the DON.
  10. by   supernurse65
    Quote from Quickbeam
    OP, for many years I was the night RN at a facility similar to yours. Very limited night staff (often, just me). I do recommend that you continue to document the behavior and your efforts. Include any patient complaints about finding this woman in their room, etc. I found that many times my manager didn't see the issue so didn't think it was important enough for funding of a solution. Especially since your unit is not set up for wanderers, it can be dangerous for the patient. Good luck to you.
    The State board of nursing that comes to visit your 40 bed facility won't like it that you have a "wanderer" that is going in to other resident's rooms. that is an issue you can present to the "powers that be"
  11. by   supernurse65
    Quote from marjoriemac
    I see your problem, I would think perhaps she is following a routine that she may have practised in her earlier life. What did she work as? You could provide tasks relevant to her previous work. We had a lady who was a midwife and then house wife. She was settled when she could help with cleaning, laundry and washing dishes. We used to put clean dishes in the sink just so she would wash them. Unfortunately our ideas reached difficulty when her husband was admitted and she continued to attempt to care for him, not allowing care staff access to her. We eventually had to move her to the upstairs unit for his benefit but she enjoyed this as it allowed her 'excursions' to see her husband who she believed was in hospital. It may also help to keep this lady busy during the day and she may tire at night. Approach sedation with caution though as where there's a will there's a way and it would be dangerous for her to continue to wander in a sleepy state.
    you have to careful with these types of "duties" for her to keep busy. you must care plan them very well and make sure the follow up is there that this is working and if it isn't then try something else.
  12. by   banditrn
    Quote from supernurse65
    The State board of nursing that comes to visit your 40 bed facility won't like it that you have a "wanderer" that is going in to other resident's rooms. that is an issue you can present to the "powers that be"
    Really?! I have to say that I don't know a lot of the state regs and requirements. I seem to be the only one who charts things like this, altho I know that it happens with the other noc nurse.

    I chart when this particular res. gets up, any interventions we've applied, such as giving her a snack, etc. I chart that she denies discomfort (she does), and that the usual sx of pain are absent.

    I also chart what we've done to try to keep her in the lounge, and what we were doing when we found her in another room, such as answering another resident's lite.

    Should I also chart that the behavior is reported to the DON? I leave her frequent notes about it.
  13. by   ktwlpn
    Isn't it sad that this lady does not have the benefit of a secure unit populated with residents just like her and staffed with people attuned to their needs? I bet the other higher functioning folks are having a fit when she goes into their rooms and "gets into" their stuff.In my experience the higher functioning have little tolerance for the lower-they can be mean as snakes.(Maybe because they KNOW that they could end up like that in a second) No dignity for her either-when the others snap and snipe at her.I'm sure this behavior is not only happening on your shift.
  14. by   banditrn
    Quote from ktwlpn
    Isn't it sad that this lady does not have the benefit of a secure unit populated with residents just like her and staffed with people attuned to their needs? I bet the other higher functioning folks are having a fit when she goes into their rooms and "gets into" their stuff.In my experience the higher functioning have little tolerance for the lower-they can be mean as snakes.(Maybe because they KNOW that they could end up like that in a second) No dignity for her either-when the others snap and snipe at her.I'm sure this behavior is not only happening on your shift.
    Yes, you are right - in my opinion, she should be in an Alzheimers unit but that's not going to happen until something significant happens and the other residents or their families start to complain a lot. It seems to be all about the money with these folks.

    We do the best that we can, but on our shift there are only two of us for between 37 and 40 patients - and we have two other residents that wander at noc, but at least the other two don't go into the other resident's rooms. Some nites it's a real zoo when all three are up, going in different directions.

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