Why “Close to Home” Is Still a Risk: What Caregivers Need to Know About Dementia and Missing Incidents

Many caregivers assume that if their loved one with dementia stays close to home, they are safe. But research shows otherwise.

MedicAlert, in partnership with the University of Waterloo, studied the experiences of older adult MedicAlert subscribers who went missing. The findings, published in the Journal of Medical Internet Research (JMIR) in the study “The Prevalence of Missing Incidents and Their Antecedents Among Older Adult MedicAlert Subscribers: Retrospective Descriptive Study” (read the study here), revealed something surprising:

Most missing incidents occur close to home, not far away.

Why This Finding Matters

At first, this seems reassuring — after all, “close to home” sounds safe. But for someone living with dementia, familiar places can quickly become confusing. The neighborhood they’ve walked for years may suddenly feel strange. They may not recognize their own street, or they may set out with a clear purpose (to “go to work,” or “visit family”) but lose track of direction along the way.

This matters because many caregivers focus on preventing long-distance wandering — worrying about highways, buses, or travel. But the study shows that risk exists even in the most ordinary spaces: the sidewalk outside your front door, the corner store, or the park just a block away.

What This Means for Caregivers

The “close to home” risk changes how we think about safety. It means:

• Supervision matters, even in familiar places. A short walk around the block may not be as safe as it feels if your loved one is alone.
• Neighbors are part of your safety plan. Since many incidents happen nearby, having neighbors who recognize your loved one and know how to help is critical.
• Routine is important, but not foolproof. Daily habits like walking the same path can still lead to confusion if dementia symptoms worsen.

Practical Steps You Can Take

Here are some caregiver strategies inspired by this finding:

• Create a “neighborhood safety net.” Talk to neighbors, local shopkeepers, and community members. Share your loved one’s photo and explain that they may become disoriented.
• Practice safe walking together. If your loved one enjoys being active, accompany them whenever possible. Walking together preserves independence while reducing risk.
• Use identification every time. Ensure your loved one always wears a MedicAlert ID — even just for a walk in the yard. Since incidents happen close to home, responders need quick access to health information right where the episode occurs.
• Reassess routines as dementia progresses. What felt safe last month may no longer be safe today. Stay flexible and update safety plans as needed.

Turning Worry Into Preparedness

The finding that most missing incidents happen close to home is a reminder that dementia changes the meaning of “safe.” For caregivers, this can feel overwhelming — but it’s also empowering. By knowing where the risks truly lie, you can prepare in ways that make a real difference.

MedicAlert, through our research with the University of Waterloo, is committed to helping families turn knowledge into action. With IDs, Safe & Found programs, and partnerships with first responders, we ensure that when incidents occur, loved ones are identified and returned home quickly.

Preparation doesn’t mean living in fear — it means building peace of mind, step by step, right where you are.