Is it Time to Consider a Wander Alert System?

Is it Time to Consider a Wander Alert System?

It’s a caregiver’s worst nightmare. An older woman with dementia goes missing in the middle of the night. She’s prone to confusion, and lives near a major highway.

Whether the woman in this scenario wanders from a residential care facility, her own home, or the home of a family member, she almost certainly leaves a trail of anxiety and concern in her wake.

Family caregivers often panic in these situations. They know the statistics. If a daughter acts as the primary caregiver for her Alzheimer’s-afflicted father, she’s almost certainly read that 6 in ten people with the condition will wander.

And yet, family members often have the sense that it won’t happen to their loved one (if only they are devoted enough, if only they do all of the proper research, if only they do everything right).

If you work in residential care, you know better. You’re aware that anyone with dementia who has memory problems is a potential wandering risk – including those in the early stages.

Of course, it’s not just dementia associated with this problem. Autism spectrum disorder, Down syndrome, and a host of other conditions can also cause wandering behaviour.

Given these facts, why isn’t every residential care home in North America equipped with a wander alert system? Why is it that many of the owners and operators of these facilities are hesitant when it comes to adopting these technologies?

If you’re wondering whether your facility should be using wander alert, there are several important things to consider. Read on to learn more (please note: this post focuses on dementia, but many of the points it makes are also relevant for other conditions).

How Well Does Your Wandering Prevention Work?

According to the Alzheimer’s Association, up to half of all individuals who wander due to dementia will die or be seriously injured if they aren’t found within 24 hours.

To state the obvious, that’s a scary statistic.

If you own or operate a residential care facility, you take your responsibility to keep residents safe seriously. You probably subscribe to the old saying, “an ounce of prevention is worth a pound of care”. While we can’t yet prevent or cure all of the conditions that cause wandering, it’s obvious that taking a proactive approach to dangerous situations is critical.

Your facility is probably using a variety of tactics designed to not only prevent your residents from wandering, but improve their mental health and overall quality of life. For Alzheimer’s, here are just a few examples.

  • Identify triggers: assessing and documenting a resident’s wandering patterns can help caregivers identify and avoid triggers (such as noise, overstimulation, etc.)
  • Maintain routine: unexpected events can act as triggers. Routine can be a source of stability, especially when that routine includes activities or chores patients carried out in the past.
  • Keep family mementos: providing a resident with easy access to photo albums and other mementos may reduce urges to go out and physically find family members.
  • Encourage activity & engagement: preventing boredom and providing a sense of purpose can greatly reduce wandering urges. Some facilities try to offer patients activities related to their past occupations to keep them engaged.

Those who work in residential care see a clear pattern when it comes to techniques that reduce dangerous behaviour. The tactics above (along with many others that can be useful) involve recognition of the basic humanity of those with dementia and other stigmatized conditions.

But is this enough to prevent all instances of wandering? The stats say no. Despite the persistent efforts of facility caregivers to keep residents with dementia calm and happy, figures put wandering from facilities (long-term care, specifically) at between 11-24%.

Vigilant in-person monitoring can help staff catch residents in the act of wandering, but this tactic doesn’t always work (especially when facilities are short staffed).

Embracing Innovation, Remaining Person-Focused

Many residential care facilities use wander alert systems as a last resort. But why wait until the problem is unmanageable?

One of the biggest reasons is that facility operators are, for the most part, firm believers in solutions that get to the root of the problem. These professionals often want to improve resident quality of life as they prevent dangerous situations. For this reason, they may prefer tactics that focus on prevention and the motivations of the individuals involved.

There also seems to be a sense among some facility operators that alerting systems are disruptive. There is a conception of alarms as unsettling for residents and their families, and obtrusive for caregivers trying to go about their work.

Some operators also oppose tracking patients on ethical grounds.

Perhaps you share one or all of these concerns.

Finally, many decision-makers have invested a lot into emergency preparedness. The idea of supplementing a well-thought-out system with unfamiliar technology can be stressful.

These worries and objections are understandable, but there’s a way around all of them. Understanding wander alert technology means being aware of the following points.

1) Technology can be part of a holistic approach.

Managing wandering patients doesn’t require caregivers to adopt an either/or approach. Wandering prevention and personal enrichment activities for residents are vitally important. Using an alert system as a safeguard doesn’t detract from these efforts.

2) Technology can be discreet, convenient, and unobtrusive.

There’s no reason alerting systems have to be loud. Some recent technologies are essentially invisible to residents and visitors. Caregivers can use their mobile devises and desktops to receive private notifications.

3) Not all systems rely on patient tracking.

There has been some concern that technologies such as patient GPS are invasive. But there are other options available. Some solutions merely alert caregivers when patients are in potential danger – before they get too far.

4) There are a variety of technologies available. Decision-makers can now consider the needs of their facilities and find a solution that fits. What can you afford to spend? Do you need to use data related to wander incidents in your facility (e.g. to create reports, track staff response times, etc).

Wander Alert Technology in Action

At Aetonix, we believe patient safety matters. We also believe in the life-saving potential of technology, which is why we’re strong proponents of systems that help caregivers detect and respond to wandering episodes, falls, instances of missed medication, and various forms of distress.

When it comes to keeping people safe, finding what works is worthwhile. Our hope is that all residential care facilities find a technology that ensures the security of residents and meets organization-specific goals – regardless of who produces this technology.

We’ll leave you with the story that inspired this post. It doesn’t involve a person with dementia, but it does clearly illustrate the power of technology to prevent the often-tragic consequences of wandering.

Recently, we heard from Dianne Austin, Aetonix user and executive director of the Brampton location of Peel Cheshire Homes (a provider of supportive housing for people with physical disabilities).

Austin emailed her staff, a handful of the organization’s key decision-makers, and some of us at Aetonix to share a victory related to resident safety.

It seems that a resident had followed a group of visitors outside the previous night. The safety bracelet of the person in question sent out an immediate alert of the wandering incident, and staff responded quickly.

The executive director was especially proud of the way one staff member reacted when the resident was located. “It was as if they had been outside for a few moments enjoying the nice evening air,” says Austin, “and nothing was out of the ordinary”.

For us, these types of emails highlight the good that can result when reliable technology is paired with the responsiveness and sensitivity of topnotch caregivers.

Making a Decision

There are always reasons not to look into new solutions. In a field dependent on caring personal relationships, technology may seem trivial. But the impact of innovative solutions can be positive and significant.

Wander alert systems save lives. We believe every facility should at least consider this type of technology.

Feature image courtesy of Sodanie Chea

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COPD Education – Onboarding


To complete a thorough needs assessment / initial evaluation for a COPD patient of an outpatient clinic

Patient, Educator (Nurse, RT, the Physician could also be the educator)

One 60-90 min session with the Educator

  • This protocol should be established for all COPD patients from a given clinic, independently of whether they are new patients or they are known to the clinic. This protocol is the basis to engage the patient into other protocols such as education, exacerbation follow-up, etc.
  • We need to identify patient goals/concerns to guide the interventions
  • A thorough evaluation is carried on, with the objective of understanding where the patient is on their disease journey and follow-up treatable traits: dyspnea, exacerbation or dyspnea and exacerbation.
  • It includes the use of objective questionnaires such as the mMRC, CAT, HADS, Frailty Scale, etc.
  • Identify if the patient needs to be referred to other resources (e.g. Physiotherapist, social worker, occupational therapist)
  • Once Onboarding is completed, the patient continues to the COPD Education workflow
COPD Education – Continuous Maintenance


To cover in depth all the necessary elements of self-management education as per the LWWCOPD, with priorities based on patient goals and identified treatable traits

Patient, Educator (Nurse, RT or Physician)

A number of “Core” educational modules have been identified which cover the basic COPD education from the LWWCOPD program. Additionally, optional modules can be used to respond to patient needs. The timeline (frequency, number of modules to be covered at a given education session) is fully customizable, although we recommend to have education sessions every 2-weeks during the “active” phase of education. Once this is completed, the patient continues to the Maintenance Mode (see below).

  • Launched at the onboarding protocol
  • Provide basic overview of COPD self-management based on LWWCOPD (medication adherence, inhaler techniques, PLB technique & energy conservation) up to the development of an Action plan for early exacerbation recognition and management.
  • Prioritize self-learning by the patient (e.g. watching videos, reading educational materials, completing homework) in addition to live sessions with the Educator. Educational materials are sent to the patient directly via the platform, and become the patient’s own library. The Educator can customize which “homework” the patient receives.
  • Educators have access to “User guides” to standardise their educational intervention. These user guides include: objectives, interventions, suggested questions, evaluation of self-efficacy, and learning contracts for each module.
  • Once the core education is completed, the patient can continue to the Respiratory Status Follow-up Workflow (run in parallel)

The Maintenance Mode
  • As soon as the maintenance mode is engaged, the frequency of visits Educator/Patient is reduced to once every 6 months.
  • During the Maintenance Mode sessions, the educator has access to all the education modules and can choose any piece of content that needs to covered with the patient. 
  • A streamlined evaluation (similar to the initial eval.) is done during each “maintenance” visit to identify any substantial changes on the patient’s needs that will require some adjustment. The patient could come back to an “active” education mode (more frequent education sessions, e.g. every 2 weeks).
COPD Respiratory Status Follow-up


Monitoring of stable patients from a clinic in order to identify early any aggravation of symptoms (exacerbation) and implement an action plan

Patient, Educator (Nurse, RT or Physician)

Scheduled regular automated follow-up to the patient symptoms. Intensity/Frequency can be adjusted by the Educator depending on patient needs (e.g. daily, every week, etc.). Ongoing through the year.

  • Launch: Patients who have completed the Core Educational including setting-up an action plan.
  • Regular automated questions allow to identify any change in patient’s symptoms and severity.
  • If an exacerbation is detected the patient gets a reminder to engage their self-management strategies while waiting for the Educator to call back.
  • An alarm is generated for the Educator, so they immediately call back the patient. At this call they will evaluate any further intervention required and schedule additional follow-up.
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