When people with dementia walk
Sometimes concerns arise because a person with dementia seems to have a need to walk. The first important point here is that there’s nothing wrong with walking! In fact, it is unreasonable to expect that people should be happy to spend their time just sitting.
Simply having a diagnosis of dementia doesn’t mean that people can’t cross the road safely.
Why is this happening?
Some reasons why a person with dementia might walk include:
- The person might be lost and trying to find their way.
- The person might be looking for someone or something which may or may not be there.
- The person might be reliving an old routine.
- The person might be trying to cope with troubling emotions or physical pain.
- The person might be lonely or bored.
- The person might feel in need of exercise or might simply enjoy walking.
Although the word ‘wandering’ is often used to describe walking by people with dementia, the term suggests that there is no aim to the person’s walking, which is not actually the case. There is nearly always a reason why a person with dementia wants to walk. It might simply be that the person has energy they wish to use. Or it could be that the person is walking to try to resolve some kind of problem they have – perhaps they are completely bored, or maybe they are looking for something.
If we are attentive, the person will usually indicate, either verbally or non-verbally, whether there’s something they need. Once we understand why the person is walking, we will know if they need us to respond in some way – for example, to provide something interesting for the person to do, or to help them find whatever it is they’ve lost.
Walking can become more of an issue if we are worried that the person is at risk. Perhaps we know that this person has had falls in the past, or the person wishes to go out and we are worried that they will come to harm. Here, it is important that we conduct a thorough analysis of the risk. We need to consider how likely it is that the person will come to harm – and this depends on the individual’s specific abilities and difficulties.
Simply having a diagnosis of dementia doesn’t mean that people can’t cross the road safely – some people can and others can’t. And just because a person has had one fall, it doesn’t necessarily mean that they are likely to fall again, particularly if we know that there was a specific reason for their previous fall (a loose-fitting rug, for example) that has now been resolved.
We need also to consider the benefits that the person gets from walking. Keeping mobile will generally help to contribute to a person’s fitness and general health, and walking might also be a key way in which an individual brings interest to their life, interacts with others and maintains their own sense of identity.
It is never possible to eliminate risk from a person’s life altogether, and so it’s best if we can come up with a solution that keeps the person as happy and healthy as possible. If a particular woman is able to cross roads safely and find her own way home, there may be no reason why she shouldn’t go out on her own, but it will be important for us to know when she’s gone, where she’s going and when she’s likely to be back. In this way, if a problem does arise we’ll be able to respond quickly. It will also be important to monitor her abilities since, as dementia progresses, the level of risk might increase.
If someone has lost the necessary abilities to go out alone, we need to think about alternative ways of meeting their needs – perhaps they could be accompanied out every day, or maybe there’s an enclosed garden where the person could safely spend as much time as they want.
If we are concerned that a person might fall, there are many things we can do to lessen the possibility of this happening: for example, ensuring that the person has been assessed for appropriate walking aids, that their footwear fits properly and that the environment is well-lit and free from obstacles and hazards.
Knowing a person as an individual, recognising their abilities as well as their difficulties, and keeping focused on their needs, will help us know when and how to intervene when people with dementia walk.
Access and download additional resources
Further reading Open
Alzheimer’s Society (2012) ‘Walking about’, Factsheet 501, London: Alzheimer’s Society.
Kemshall, H. and Pritchard, J. (eds) (1996) Good practice in risk assessment and risk management 1, London: Jessica Kingsley Publishers.
Marshall, M. and Allan, K. (eds) (2006) Dementia: Walking not wandering – fresh approaches to understanding and practice, London: Hawker.
Useful links Open
Alternatives to antipsychotic medication: psychological approaches in managing psychological and behavioural distress in people with dementia
This 2013 British Psychological Society briefing paper sets out guidance for practitioners on how to respond to distress in people with dementia by following a ‘staged approach’: a series of steps involving identifying, understanding and implementing individualised interventions.
The Alzheimer’s Society produces over 80 factsheets on all sorts of topics related to dementia, including many that relate to difficult situations in supporting a person living with dementia: Dementia and aggressive behaviour (509), Sight, perceptions and hallucinations in dementia (520), Managing toilet problems and incontinence (502), Walking about (501), and Sex and intimate relationships (514).
Dementia: Supporting people with dementia and their carers in health and social care
This 2006 guideline jointly published by the National Institute for Health and Clinical Excellence (NICE) and the Social Care Institute for Excellence (SCIE) offers comprehensive best-practice advice on the care of people with dementia and on support for carers.
Positive and proactive care: reducing the need for restrictive interventions
The Department of Health’s 2014 guidance on restraint is aimed at all health and social care staff working with adults in England.
Related pages from this section Open