Activity-based engagement for wandering behaviors

While safety protocols and monitoring systems are essential, one of the most effective ways to reduce wandering from senior living facilities is through meaningful engagement. Activity-based interventions not only provide structure and stimulation but also help fulfill emotional and physical needs that may otherwise lead to restlessness or exit-seeking behavior.¹

Why activities matter

Wandering often reflects a resident’s need for comfort, familiarity, or purpose². While confusion may play a role, emotional and cognitive needs are frequently at the root. Engaging in meaningful activities can reduce restlessness by offering structure and a sense of normality.

Smaller group settings or one-on-one interactions are often more effective for individuals who become overwhelmed in larger environments. Activities that connect to personal history or long-term memory can help promote calm and focus.

Examples of meaningful, personalized activities

The most effective activities reflect a resident’s life history, interests, and identity. Here are some real-world examples:³

• Former teacher: Provide papers to “grade,” organize books in the facility’s library, or lead a small reading group.
• Retired pilot: Encourage storytelling about places they’ve flown, use maps or travel magazines to spark conversation, or create a “travel log.”
• Homemaker: Folding laundry, setting tables, or arranging flowers can offer comfort through familiar routines.
• Gardener: Invite them to water plants in the courtyard, pick tomatoes from raised beds, or help with seasonal planting.
• Music lover: Use personalized playlists to spark memories. Residents may become calmer, more focused, and less likely to wander. Many will sing along, smile, or even dance as the music brings comfort and familiarity.
• Outdoors enthusiast: Lead morning walks, birdwatching sessions, or outdoor group activities like making bird feeders or painting flowerpots.

Designing an effective activity program

To reduce wandering through engagement, activity programs should be:³

• Individualized: Based on each resident’s personal history, preferences, and cognitive level.
• Purposeful: Activities should feel useful or familiar, not just recreational.
• Routine-based: Offering structure and predictability throughout the day.
• Flexible: Adapt to the resident’s mood, energy level, and changing needs.
• Safe and supervised: Especially for outdoor or movement-based activities.

Staff should be trained to use activities not only as scheduled events but also as real-time redirection tools when early signs of wandering appear, such as pacing, exit-seeking or restlessness.¹

Family involvement and trial-and-error

Involving family members in the care planning process is essential. Families can provide valuable insight into the resident’s past roles, preferences, and comfort items. Simple touches, like photo albums, familiar décor, or recreating a favorite routine, can help a resident feel more at home and less inclined to wander.

According to CMS guidance under F679, activity programs must be designed to support each resident’s well-being and should incorporate information from family interviews, life history, and personal preferences.¹

It’s also important to recognize that activity planning is often a process of trial and error. What engages one resident may not resonate with another, and preferences can change over time. Facilities should remain flexible and responsive, adjusting activities based on observation, feedback, and outcomes.