Some individuals with dementia are inclined to pace or walk constantly. There seems to be a certain restlessness to this behavior. Determining the underlying causes and creating a framework for the walking can turn a negative behavior into a positive one.
If you observe restless walking or pacing behavior, start keeping track of when it occurs. See if there are common triggers or events that occur before the walking begins.
Your mom or dad may be walking because of:
A feeling of boredom or a lack of sufficient engaging activity can lead to pacing or restless walking. Look at the structure of the individual’s day and try and include meaningful and engaging activities for them to do. Make sure they have sufficient mentally engaging activities. Consider hiring a cognitive coach for a few sessions a week. Also make sure there is sufficient physical exercise during the week to give them an outlet for pent-up energy.
Have a standby drawer or bag with items to sort or books to look at or color is another way of dealing with boredom. Simple puzzles or games can also spark interest in the individual.
- Stress or anxiety
An individual may feel that activities they are involved in or expectations placed on them are overwhelming, so they pace or walk to reduce anxiety. It can be difficult for an individual with dementia to express why they are feeling anxiety or stress. It is important to ask questions and give them time to process and express themselves.
Make sure that you express an open and accepting attitude when you are listening so that they feel comfortable in expressing their feelings. Remember that listening and understanding the individual with dementia is an acquired skill.
Pain or discomfort can cause the person to pace or walk around their living space. Arthritic pain can be relieved by walking and they may be walking for that reason. They may also find the temperature or amount of light causes them discomfort.
Often individuals with dementia have a difficult time expressing their levels of pain, so keep this in mind when trying to assess causes of pacing or restless walking.
- Time confusion
The time of day may trigger them to walk. It may be a time when they usually went to work, or a time when they where often outside. Knowing their previous schedule may help you anticipate this need. You may want to schedule a walk at this time of day.
Having a large clock that indicates AM and PM can also help reduce time confusion. This may help reassure them if they are worried about missing a meal or they are waiting for an event or appointment.
- Excess Energy
The individual may have a lot of untapped energy that needs to be released. Walking is an easy form of exercise. You can also get them riding the stationary or recumbent bike or climbing the stairs. It is important to supervise exercise so that the individual doesn’t overdo it. As well, individuals may lose their balance, so you want to ensure that they do not fall.
- They are lost
As the disease advances, locations that were familiar may become unfamiliar. The individual may be looking for a previous home or may not know where a room is located. You may want to make signs for rooms using simple words or pictures. For example, a sign on the bathroom or a picture of the toilet on the door may serve as a guide to its’ location.
If they are in a new environment it may be helpful to have accessible easily identifiable objects from their home. This may be a stuffed animal, a blanket or pillow. Pictures may be helpful but there will be a time when they don’t recognize the people in the pictures. At this time, pictures can cause more anxiety then provide comfort.
- Fresh Air
Being cooped up inside can cause restlessness and pacing. If possible, encourage them to walk outside each day. You may get them involved in light gardening or bird-watching. This is a great way to give them something positive to do as well as expose them to light and fresh air. Light exposure is important for Vitamin D.
- Side-Effect of Medication
Some medications may increase pacing or restless walking. Be aware of the side-effects and plan times for walking accordingly. You can also talk to your family doctor about our observations to see if other options may be available.
Protecting Them from Wandering
Even with your best efforts, an individual may still wander away. To forestall this, you may want to put a bell on the door so that you are alerted if they walk outside. Another option is to install locks higher up or lower down than usual on the door. Most individuals with dementia do not look outside of eye level.
As well, a black mat at the front door may also act as a deterrent. Often when perception fades, a black mat can look like a hole and the individual will not step on it. You will have to remember to remove it though if you want them to leave the house or room with you.
Investing in an ID bracelet and registering them with the Alzheimer’s Association Safe Return program is a good preventative measure. But if an individual does wander away, call the police immediately.