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It’s 2 a.m. You wake to a sound, or maybe to the absence of a sound you expected. You check the bedroom and the bed is empty. The front door is unlocked.
If your loved one has Alzheimer’s or another form of dementia, this is one of the most common and most frightening situations caregivers face.
Texas families face it at an outsized rate: according to the Alzheimer’s Association, Texas has one of the three largest populations of older adults with dementia in the country, with approximately 460,000 older adults living with the disease. That’s 11.9% of Texans aged 65 and older, above the national average of 10.9%.
Being prepared before that moment matters more than anything else you can do.
Wandering usually has a cause, even when it isn’t obvious from the outside. It’s driven by what feels, to the person with dementia, like a completely logical need.
Alzheimer’s and other forms of dementia damage the brain’s ability to recognize familiar places, people, and situations. A person may wake up disoriented and believe they need to get to a job they retired from decades ago, or that they’re searching for a parent who passed away years before. They may feel restless, hungry, in pain, or in need of a bathroom, and simply have no way to communicate that.
People who led active lives before dementia developed are particularly prone to wandering. The drive to be outside and to keep moving doesn’t disappear with the diagnosis. What changes is the judgment that used to keep it within safe boundaries.
Sundowning adds another layer of risk. This is the pattern of increased confusion and restlessness that tends to intensify in the late afternoon and evening. For many people with dementia, this is the highest-risk window of the day.
It’s a common one. According to the Alzheimer’s Association, six in 10 people with dementia will wander at some point, and many do so repeatedly. Risk increases as memory loss and disorientation worsen, but it can begin at any stage. Common early warning signs include returning from familiar walks later than usual, getting lost in places they’ve always known, or repeatedly attempting to leave a home.
No single precaution eliminates wandering risk entirely. The strongest protection comes from layering several strategies so that if one fails, others hold.
Home modifications to put in place now:
Texas has a Silver Alert system for missing older adults with a cognitive impairment, but it doesn’t activate automatically. Law enforcement requires the family or legal guardian to provide documentation from a medical or mental health professional confirming the diagnosis, and the Texas Department of Public Safety defines acceptable documentation as a signed, dated statement on a physician’s letterhead. The DPS Silver Alert program also requires that the person be 65 or older and that their home be in Texas.
Ask for that letter at your next neurology or primary care appointment and keep a copy with your loved one’s other records. Families who wait until someone is missing end up scrambling to reach a physician’s office during the hours that matter most.
Many families also find it worth setting up wandering response services in advance. Services like MedicAlert offer ID jewelry paired with a 24-hour emergency response line that coordinates with law enforcement and notifies your emergency contacts if someone finds your loved one. Enrollment only takes a few minutes and is usually budget-friendly, but it does nothing for you if you sign up after someone goes missing.
Search guidance consistently puts bodies of water near the top of the list when someone with dementia goes missing. For families in this area, that means the Guadalupe and Comal Rivers, Canyon Lake, and neighborhood retention ponds. If your home is near any of them, identify the access points now and include them in the first places you would check.
Usually something specific. They may believe they’re late for work, that they need to pick up a child who is now an adult, or that they don’t recognize the home they’re in as their own. Physical needs like hunger, pain, or the need to use the bathroom are frequent drivers that a person with dementia can’t always name.
Daily routine plays a big role, too. A structured day that includes regular mealtimes, physical activity, time outdoors in a safe setting, and mentally engaging activities reduces restlessness, which is one of the most common wandering triggers. When someone has a meaningful reason to be where they are, the unnamed urge to leave becomes easier to manage.
Step One. If your loved one is missing, search the immediate area for no more than 15 minutes: closets, the backyard, water access nearby, and familiar favorite spots. The Alzheimer’s Association reports that 94% of people who wander are found within 1.5 miles of where they disappeared, and that wandering generally follows the direction of the person’s dominant hand.
Step Two. If they’re not found within 15 minutes, call 911 immediately and tell the dispatcher the missing person has dementia. This is important: disclosing the diagnosis changes how law enforcement prioritizes and responds, and in Texas, it may qualify your loved one for a Silver Alert. Have the physician’s documentation ready when you call, since law enforcement will ask for it.
Step 3. If your loved one is enrolled in a wandering response service, call it now as well, and have the account information handy.
Step 4. Keep a recent, clear photo of your loved one on your phone at all times. Search areas connected to their past first: a former workplace, a previous neighborhood, routes they used to walk regularly.
At some point, the level of supervision a person with dementia needs is more than one person can provide around the clock. Recognizing that point before a crisis, rather than after, makes all the difference.
ComForCare New Braunfels caregivers receive specialized training through DementiaWise, ComForCare’s proprietary dementia care program endorsed by the Alzheimer’s Association. All caregivers learn to recognize behavioral patterns, identify wandering triggers, and redirect a person who is becoming restless or disoriented before the situation escalates.
For families in New Braunfels, Kyle, Cibolo, San Marcos, and the surrounding area, overnight and 24-hour in-home care means someone is awake and present during the hours when sundowning peaks, watching exits, redirecting restlessness, and helping with trips to the bathroom that might otherwise end at the front door. Care doesn’t have to start at 24 hours. Many families begin with evening coverage a few nights a week and adjust from there.
Families managing dementia may also qualify for the GUIDE program (Guiding an Improved Dementia Experience), a Medicare initiative that provides qualifying clients with up to $2,500 in annual respite care at no cost. Most families aren’t aware it exists or how to qualify, but we can help. ComForCare New Braunfels is a credentialed GUIDE provider serving families throughout Comal, Guadalupe, Hays, and Bexar counties.
Yes. Wandering can occur at any stage of the disease, not just in advanced dementia. Early-stage wandering often looks like getting lost on a familiar drive or losing track of time on a walk. Families shouldn’t wait for the disease to progress before putting safety measures in place.
No. GPS tracking tells you where your loved one is after they’ve already left. It doesn’t stop them from leaving in the first place. Combine GPS devices with environmental modifications, daily routine, and caregiver supervision. Each layer compensates for the gaps in the others.
The GUIDE program is a Medicare-funded initiative that allows qualifying clients with dementia or Alzheimer’s to receive up to $2,500 in annual respite care at no cost. It’s designed to support family caregivers managing dementia at home who need relief. Eligibility depends on Medicare enrollment, participation in a GUIDE dementia care program, and living at home with an unpaid caregiver.
Wandering is one of the most common safety risks in dementia care, and one of the most preventable with the right plan in place. A layered home safety approach, trained caregiver support, and knowing exactly what to do in a crisis are what stand between a frightening moment and a tragic one.
ComForCare New Braunfels serves families throughout New Braunfels, Kyle, Cibolo, San Marcos, Seguin, and the surrounding communities. Call us at (830) 632-5887 or visit our website to schedule a free in-home consultation and learn more about DementiaWise and GUIDE program eligibility.
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