Wandering: A Concept Analysis

Background: Wandering should not be simply considered as a uni-dimensional concept resulting in a simple categorization of wanderers or non-wanderers, but wandering is a complex, multifaceted behavior with variations in its expression often with observable patterns. Multiple disciplines and professions, as well as lay people dealing with wandering or its consequences, attribute varied meanings to the word. Understanding concept of wandering in nursing clinical setting is needed in order to improve dementia patient safety. Aim: to expand understanding of the concept of wandering; specifically, clarify the wandering meaning among dementia patients in the clinical care setting. Methods: The Walker and Avant concept analysis approach was applied. Results: The critical attributes of the concept of wandering include: pointless movement/aimless walking/walking with inappropriate purpose, walking with appropriate purposes but inappropriate frequency/repetitive movement; lapping, random, and/or pacing patterns, night-time walking, being brought back home and attempts to leave home/locomotion that cannot be easily dissuaded or redirected, hyperactivity, scanning, seeking, checking or searching behaviors. Biological, psychosocial, and person-environment interaction are the antecedence for wandering in older persons with dementia. Wandering behavior seems innocent enough, but it is exhausting for the family and clinicians as well as for healthcare policymakers, because accidents, getting lost/missing, malnutrition fatigue, sleep disturbance, social isolation, high risk of fall, earlier institutionalization are associated with wandering. Conclusion: Wandering did not emphasize specifically on getting lost/missing condition, however, getting lost/missing seem the consequence of wandering. In addition, locomotion is central of wandering, provided of space is recommended for dementia clinical nursing care. Clinical health-care provider would need fully attention on wandering characteristics for dementia care patients safety.