Empirical Derivation and Validation of a Wandering Typology

• Published in: Journal of the American Geriatrics Society (JAGS) 2009-11, Vol.57 (11), p.2037-2045
• Main Authors: Algase, Donna L., Antonakos, Cathy, Beattie, Elizabeth R. A., Beel-Bates, Cynthia A., Yao, Lan
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Alzheimer Disease - diagnosis; Alzheimer Disease - psychology; Assisted living facilities; Behavior; Biological and medical sciences; Body Temperature; Circadian Rhythm; Classification; cluster analysis; Cross-Sectional Studies; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dementia; Female; General aspects; Geriatric Assessment; Homes for the Aged; Humans; Male; Medical sciences; Mental Status Schedule; Miscellaneous; Neurology; Nursing Homes; Observation; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; Statistics as Topic; typology; wandering; Wandering Behavior - classification; Wandering Behavior - psychology
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/j.1532-5415.2009.02491.x

OBJECTIVES: To develop and validate a wandering typology. DESIGN: Cross‐sectional, correlational descriptive design. SETTING:: Twenty‐two nursing homes and six assisted living facilities. PARTICIPANTS: One hundred forty‐two residents with dementia who spoke English, met Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, criteria for dementia, scored less than 24 on the Mini‐Mental State Examination (MMSE), were ambulatory (with or without assistive device), and maintained a stable regime of psychotropic medications were studied. MEASUREMENTS: Data on wandering were collected using direct observations, plotted serially according to rate and duration to yield 21 parameters, and reduced through factor analysis to four components: high rate, high duration, low to moderate rate and duration, and time of day. Other measures included the MMSE, Minimum Data Set 2.0 mobility items, Cumulative Illness Rating Scale—Geriatric, and tympanic body temperature readings. RESULTS: Three groups of wanderers were identified through cluster analysis: classic, moderate, and subclinical. MMSE, mobility, and cardiac and upper and lower gastrointestinal problems differed between groups of wanderers and in comparison with nonwanderers. CONCLUSION: Results have implications for improving identification of wanderers and treatment of possible contributing factors.