Mapping the maze of terms and definitions in dementia-related wandering

Purpose: An operational definition of dementia-related wandering is proposed to aid in clinical recognition, to promote research precision and validity, and to provide a pathway toward standardization of language in wandering science. Design and Methods: (1) One-hundred-and-eighty-three journal articles from multiple databases (Medline, OVID, CSA Journals, OCLC First Search, Google Scholar, PubMed, EBSCO) were reviewed to extract alternative terms and definitions for wandering or wandering-related behaviours; (2) terms and definitions were ordered alphabetically into a glossary; (3) a consensus approach was used to group glossary terms with related meanings into possible domains of wandering; (4) four domains (locomotion, drive, space and time) were found sufficient to encompass all wandering definitions; (5) wandering terms were placed into a conceptual map bounded by the four domain concepts and (6) a new provisional definition of wandering was formulated. Results: An empirically-based, operational definition improves clinical and research approaches to wandering and explicates historical inattention to certain beneficial aspects of the behaviour. Implications: Adoption of the proposed operational definition of wandering behaviour provides a platform upon which dementia care may be improved and standardized language may evolve in wandering science.

[1]  B. Therrien,et al.  The Effect of Familiarity on Distraction and Single Cue Use after Hippocampal Damage , 2000, Biological research for nursing.

[2]  B. Therrien,et al.  Impact of Cognitive Impairment on Wandering Behavior , 2001, Western journal of nursing research.

[3]  Cathy Antonakos,et al.  Are wandering and physically nonaggressive agitation equivalent? , 2008, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[4]  E L Bogue,et al.  The Algase wandering scale: Initial psychometrics of a new caregiver reporting tool , 2001, American journal of Alzheimer's disease and other dementias.

[5]  R. Lévy,et al.  Psychiatric Phenomena in Alzheimer's Disease. IV: Disorders of Behaviour , 1990, British Journal of Psychiatry.

[6]  L. McNeal,et al.  Travel behavior of nursing home residents perceived as wanderers and nonwanderers. , 1991, The Gerontologist.

[7]  C. Cox,et al.  Wandering: AN INTEGRATIVE REVIEW , 2002 .

[8]  A. Burns,et al.  Psychiatric Phenomena in Alzheimer's Disease. III: Disorders of Mood , 1990, British Journal of Psychiatry.

[9]  G. Allen,et al.  Age-related differences in adults' macrospatial cognitive processes. , 1992, Experimental aging research.

[10]  R. Ohta,et al.  Special units for Alzheimer's disease patients: a critical look. , 1988, The Gerontologist.

[11]  D. Arthur,et al.  Wandering behaviour in people with dementia. , 2003, Journal of advanced nursing.

[12]  R. N. Mohan,et al.  Wandering in dementia sufferers , 1991 .

[13]  D. Algase,et al.  Wandering. A dementia-compromised behavior. , 1999, Journal of gerontological nursing.

[14]  T. Zandi,et al.  Graphomotor Perseveration and Wandering in Alzheimer's Disease , 1995, Journal of geriatric psychiatry and neurology.

[15]  J. Greene,et al.  Measuring behavioural disturbance of elderly demented patients in the community and its effects on relatives: a factor analytic study. , 1982, Age and ageing.

[16]  Donna L. Algase,et al.  Biomechanical activity devices to index wandering behaviour in dementia , 2003, American journal of Alzheimer's disease and other dementias.

[17]  B. Therrien,et al.  Cue Familiarity Reduces Spatial Disorientation Following Hippocampal Damage , 1993, Nursing research.

[18]  V. Henderson,et al.  Spatial disorientation in Alzheimer's disease. , 1989, Archives of Neurology.

[19]  D. Hermans,et al.  Subjective barriers to prevent wandering of cognitively impaired people. , 2001, The Cochrane database of systematic reviews.

[20]  T. Kuhn The structure of scientific revolutions, 3rd ed. , 1996 .

[21]  Elizabeth Beattie,et al.  Evidence for implementing nonpharmacological interventions for wandering. , 2004, Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses.

[22]  E. Beattie,et al.  Estimates of stability of daily wandering behavior among cognitively impaired long-term care residents. , 1997, Nursing research.

[23]  Donna L. Algase,et al.  Wandering in Long-Term Care , 2003 .

[24]  R. Passingham The hippocampus as a cognitive map J. O'Keefe & L. Nadel, Oxford University Press, Oxford (1978). 570 pp., £25.00 , 1979, Neuroscience.

[25]  C. Duffield,et al.  Validation of the Algase Wandering Scale (Version 2) in a cross cultural sample. , 2004, Aging & mental health.

[26]  Marie F Santiago Responsive Care, Behavioral Interventions with Elderly Persons , 1987 .

[27]  T. Kuhn,et al.  The Structure of Scientific Revolutions. , 1964 .

[28]  J. Butler,et al.  Window of wandering. , 1991, Geriatric nursing.

[29]  Donna L. Algase,et al.  The Interrelatedness of Wandering and Wayfinding in a Community Sample of Persons with Dementia , 2004, Dementia and Geriatric Cognitive Disorders.

[30]  C. Holahan Cognition and Environment: Functioning in an Uncertain World. , 1984 .

[31]  Betty J. Ackley,et al.  Nursing Diagnosis Handbook: A Guide to Planning Care , 1995 .