1. Etiological factors that have been identified in relation to wandering include mental impairment, confusion, darkened or unfamiliar environment, boredom, stress, tension, anxiety, lack of control, lack of exercise, diseases of the central nervous system and cardiac decompensation. 2. The findings of this pilot study indicate that in structured settings such as SCUs, behaviors appear to be related to activities in the environment, e.g., quiet behaviors at night and more active behaviors during the day. 3. Psychotropic medications may not have the desired effect on behaviors in patients with Alzheimer's disease, however, nursing interventions geared toward modifying the environment may be useful in shaping behaviors of patients with dementia.

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Systematic observations of people suffering from dementia of the Alzheimer's type (DAT) reveal they regress in behavior and become childlike. These observations have been used to structure clinical research and therapeutic interventions for dementia patients. However, no concise framework explains successful caregiving. Models for care exist but they lack an adequate framework for the long-term care of a person with DAT. This state of the science review describes what is known about cognitive functioning in people with DAT. It examines studies based on cognitive functioning. It also then relates this information to an emerging theory tentatively identified as a "cognitive developmental approach" which may be useful for understanding people with dementia and for predicting caregiver requirements.

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