Some people with dementia become very restless at certain times of the day and some people even begin to pace or to walk around in what appears to be an aimless manner often in the early evening. It is not clear why this habit develops in some people and not in others. In the past this activity has been termed ‘wandering’ but it is now believed that the activity (usually walking around) is not actually aimless and that the person with dementia has a purpose in mind although they may be unable to explain this purpose or perhaps even to remember it.
Understanding restless behaviour
Often the carer will not be able to discover what is behind the agitated walking around but there are steps you can take to manage it.
People with dementia often become bored because they can no longer do the normal activities with which they filled their time. For example they may no longer be able to read with understanding, to carry out the hobbies previously enjoyed or even to understand a TV programme. Boredom is now thought to be a major reason for ‘difficult’ behaviour and can be the cause of much restlessness. It may help if you can find occupations to fill the time. Surprisingly perhaps, even seemingly pointless activities can help to calm restlessness. You can introduce ideas such as sorting books, DVDs or CDs on a shelf or into a box. Sorting by size or colour is a good activity; it is likely that sorting by author or title may be too challenging. Folding laundry, stacking plates and drying dishes after washing up are all possible activities. One carer found a large basket of assorted socks to be paired up was a useful ‘fallback’ activity. Adult colouring books are enjoyed by many as a quiet occupation. Some people with dementia can manage jigsaw puzzles with a little encouragement and help. Many carers find the person they care for is much calmer after a day spent at a day centre where they are engaged in various activities.
Physical exercise and activity
It is a good idea to ensure that the person with dementia has the opportunity for adequate exercise as agitation may result from a lack of physical activity. Walking, gardening, and some outdoor sports activities are all good forms of exercise and may be easy to incorporate into the day.
If the one you care for continues to walk around in an agitated fashion despite you taking these steps you might consider letting them carry on. Provided the person with dementia is walking in a safe place (for example around the garden or in and out of rooms in the house) then you can try to ignore the behaviour and not allow it to annoy you.
Sometimes people with dementia may set off on an expedition (for example a trip to the shops) and then forget where they are going. When people with dementia forget where they are going they usually do not do what we would consider the ‘logical’ thing such as pausing to re-orientate themselves, asking someone the way, or stopping until they remember their original aim. Instead they tend to continue walking and sometimes people can walk a considerable distance before they are found by a frantic carer, searching family or even the police.
Familiar surroundings
Carers should make sure that they know the usual haunts of the person they care for so that they know where to look first. You can also alert friends and neighbours so that they intercept the one you care for if they see them out alone when this is not usual or alternatively they can call you. You can obtain alarms which will alert you if an outside door is opened so that you can stop someone setting off on an unsupervised walk. Keep a recent photograph on hand so that if it necessary to call the police to help look they can identify your cared for.
About the author
Mary works for a national dementia charity and is an Associate Director of ELM (End of Life Management Ltd). She has had considerable experience of caring for elderly relatives and friends and worked in the NHS for 9 years. Earlier publications include books on Caring and on GP Practice Management, in addition to articles in nursing and social care journals and magazines. Mary is the author of ‘The Essential Carer’s Guide to Dementia’ published by Hammersmith Books £12.99 in print and £5.99.
About the Author / Mary Jordan
