Dementia Gateway: Difficult situations

Walking

Key messages

People with dementia might walk for a variety of reasons.
Once we understand the reason, we know whether there's anything we need to do.
If we are concerned that the person is at risk, we need to give full consideration to the person's abilities and difficulties to come up with a plan that meets their needs.

Simply having a diagnosis of dementia doesn't mean that people can't cross the road safely.

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.

Explore the links below now to read more about this topic:

1. Introduction Open

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.
2. Understanding why Open

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.
3. Checking risks Open

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.
4. Benefits Open

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.
5. Solutions Open

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. (See the 'Gardens' feature in the 'Environment' section.)

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. (For more on this, see the 'Lighting' feature in the 'Environment'' section.)

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.

Over to you!

Click here to do a quick activity that will deepen your understanding of this topic. The activity can be done alone or with colleagues and you can also download a copy. Trainer's notes have also been provided.