Walking enables us to connect with people and places, carry out tasks and keep fit. Walking benefits people with dementia. However, there is risk of getting lost or injured when awareness of location and finding the way home again is affected.
Balancing safety for people with dementia, along with the need for independence and choice, is complex as people’s abilities change over time. How these tensions are resolved will depend upon the environment in which walking takes place and, families/whānau and carers support in finding ways to walk safety.
Why might people with dementia walk around?
There could be a number of reasons why a person with dementia walks around. If there is a change from normal walking habits try keeping a journal for a couple of weeks – record when walking takes place and any reasons why. Identify triggers or reasons for walking to help work out how safe walking can be supported.
When there is a sudden change in behaviour check with the doctor if needed to rule out health issues such as pain, discomfort or clinical anxiety/agitated depression. If the person is more confused than usual it might be as a result of an underlying illness.
Possible reasons to walk around include:
- continuing a habit of regular walking
- feeling lost or unsettled in a new place
- feeling bored and needing to keep occupied
- using up energy
- searching for people or places that are part of the past
- responding to anxiety
- getting confused about the time – day and night
Supporting safe walking
Encourage movement and exercise. Do not limit the urge to walk. Instead find a way to walk safely. Approaches will depend on environmental risk (e.g. the risks of a busy city location compared to a small community where the person is well known), the person’s abilities to cope and communicate, and the ability to modify triggers to walking.
Strategies for reducing risk include:
- Have a family/whānau discussion about how to support safe walking as part of advanced support planning after the diagnosis of dementia is made. If possible, work together to support safe walking habits before there is a risk of getting lost.
- Safer walking strategies include regular routes that the family/whānau know well and how long they take. Encourage walking during the day rather than in the evening, wear suitable shoes, and walk with a companion or group.
- Carry some form of identification showing the name and phone number of someone who can be contacted if necessary. The identification could be sewn into a jacket or handbag so it is not easily removed. An identity bracelet can be worn.
- Consider a locator device such as a mobile phone with a GPS function, or specialised devices using GPS or radio frequencies. This Dementia Australia help sheet provides useful information about the benefits and limitations of locator technology. Your local organisation can also provide information about available technology.
- Encourage usual activities such as gardening, housework, hobbies and recreational interests so as to maintain an active lifestyle.
- When there is a risk of getting lost avoid triggers that may encourage walking alone. Keep coats, bags, umbrellas and the dog lead out of sight. Outside doors can have a bell/buzzer which sounds when the door is opened. An approach that suits the person with dementia is important- talk to your local organisation about options.
- Avoid confronting the person with dementia if they really want to leave and cannot go alone as this will upset both of you. Help with suitable clothing and walk together until the focus can be shifted on to going home. Do take your mobile phone in case you need a lift home.
- Let people you trust in your neighbourhood know when getting lost becomes a concern and give them your contact number so they can keep a look out.
If a person with dementia goes missing
- Try not to panic.
- Make a thorough search of the house, surrounding area, and known routes. Notify your neighbours and ask if anyone has seen the missing person.
- Contact your local ambulance and hospitals in case they have picked up the person and are caring for them.
- If there is an immediate life risk to the person (i.e., extremes of weather/poor health) or if you are unable to find them in the immediate neighbourhood within 15-20 minutes, call 111 and ask for Police.
- Important questions the Police may have, include providing a good description of the person, information about past walking, or where the person may have gone, e.g. old neighbourhoods, former workplaces or favourite places.
- Police will arrange for local taxis and public transport to keep a lookout for the person.
- Providing a recent photo of the person will be useful for Police and other searchers.
- Leave someone at home to answer the phone while you search.
- Often people who are still traffic safe follow the same route when out walking. If you know this route and they are longer than expected it may help lessen the search time as you will know the time they normally take and the routes they follow.
When the missing person is found:
- Don’t fuss. Reassure. Remain calm.
- Join them – walk with them and gradually move in the direction of home.
- If you are in a car, offer the person a lift.
- Don’t forget to notify all possible ‘searchers’ when the person has been found, including the police.
Safer Walking NZ Te Ara Pai
Check out the Safer Walking NZ Te Ara Pai website for tips and strategies to support safer walking. These include suggestions for changes to the home environment, as well as technology that can be introduced to to help you and the person you care for feel safe and be able to be located if required.
The website also contains a list of organisations and other resources that can provide advice and support.