The measure to recommend
Her mother has tried to walk out of the house at night. Wandering is managed with an identification bracelet, door alarms, supervision, and a safe home, and the client is never encouraged to go out alone. Fitting an identification bracelet and alarming the outside doors is the measure the nurse recommends. These steps allow the family to respond quickly when she tries to leave and help others return her safely if she does get out.
Why wandering is dangerous and how to manage it
In moderate dementia, impaired memory, disorientation, and poor judgment mean a person may leave home and be unable to find the way back. Night-time wandering is especially dangerous because of darkness, traffic, weather, and the chance that no one notices she is gone. Effective management combines prevention (a calm routine, adequate daytime activity, meeting needs such as toileting or hunger), detection (door alarms, motion sensors, bells on doors), and identification (a bracelet with her name and the caregiver's contact details). The goal is safety while preserving dignity and freedom of movement within a secure environment.
| Measure | Safe? | Reason |
|---|
| ID bracelet and door alarms | Yes | Allows a safe response to wandering |
| Short walks alone to the store | No | She cannot reliably find her way back |
| Vest restraint in the evening | No | Increases agitation, falls, and injury |
| Lock bedroom door from outside | No | A restraint; unsafe in fire or emergency |
Why the other measures are wrong
Allowing short walks alone is unsafe for a client with moderate dementia who already wanders. Locking a person in a room and using physical restraints are unsafe, restrict freedom, and increase agitation and injury. A vest restraint can cause falls, strangulation, skin injury, and severe distress. Locking the bedroom door from the outside is itself a form of restraint and could trap her during a fire or other emergency.
Supporting the caregiver
The nurse also suggests keeping a recent photograph available, informing neighbors, placing visual cues or covers on doors, ensuring adequate daytime activity and a calm evening, and connecting the daughter with dementia support services and respite care to reduce caregiver strain.
Exam takeaway
Key point For wandering, choose identification, alarms, supervision, and environmental safety. Restraints, locked rooms, and unsupervised outings are always wrong.