A century of progress: today's strategies for responding to wandering behavior

1. In an effort to protect wanderers, nurses have overused physical restraints. Such practices have been reinforced by the potential for lawsuits charging negligence when wandering results in negative outcomes. 2. Wandering is movement changing over time and, thus, is a nonlinear ultradian rhythm, with locomoting and nonlocomoting phases. As a rhythm, an individual's wandering pattern is stable over a 1-week period. 3. Because most travel is direct, most ambulation, even for known wanderers, may not be wandering at all. Among inefficient travel patterns, lapping was the most frequently observed. 4. Behavior modification, grids, camouflage, and other environmental interventions are preferable to chemical or physical restraint in attempting to reduce unwanted or unsupervised exits by wanderers. These methods are not fail-proof, however, and do not replace careful supervision of wanderers by personnel.