Supporting a person with dementia who walks about

If the person you are caring for wants to walk, try to find a way for them to do so safely.

Take the time to try to understand why they are walking about and what they need – this can often help to manage the situation.

It is important to remember that walking may be a phase that the person is going through.

Helping a person with dementia walk about safely

• Try keeping notes for a couple of weeks about the person’s behaviour and what is happening when they walk about. Write down any reasons they might give. This might help you to identify any triggers or patterns.
• Create a safe space to walk at home. If the person’s home has a garden, you could look for ways to make it safe for them to walk around. For example, you could make sure there are no obstacles on the ground and that the grass is not overgrown. You could create a flat, even path with a handrail. To make the experience more enjoyable, it could lead to points of interest, such as birdfeeders and garden ornaments.
• Find a local service, group or organisation that helps people with dementia take part in activities, including walking. Some organisations also specialise in structured leisure and wellbeing activities for people with dementia.
• See if there are local volunteer schemes in your area that help people with dementia to return home. For example, Neighbourhood Return notifies local volunteers who can help to look for someone. Contact your local council for more information about the scheme and to see whether it operates in your area.
• Support the person’s desire to walk where possible. If the person you are caring for is determined to leave their home, try not to argue with them. This could be upsetting. Instead try to find out where they want to go. Help them take appropriate items, such as a mobile phone. You can also help them put on appropriate clothing if necessary, such as a coat. Accompany them if you can, and then try to divert their attention so that you both return home safely. If you are not able to go with them, ask for support from family and friends who may be able to help.
• Make sure the person carries some identification or the name and phone number of someone who can be contacted if they get lost. You could sew this information onto a jacket or handbag so that it is not easily removed. Or the person may find it useful to carry one of Alzheimer’s Society’s Helpcards to show other people. You could also get them an identification bracelet, like those provided by MedicAlert.
• Save emergency contacts. If the person uses a mobile phone, make sure some ‘in case of emergency’ (ICE) numbers are saved and easily accessible. This might be the phone number of their primary carer. 
• Consider using tracking technology. If the person’s mobile phone is switched on, it may be possible to trace them if they go missing. They would need to consent to this tracking before it is switched on.
• Get support from the community. If you trust local shopkeepers and neighbours, consider sensitively telling them that the person has dementia. You could also give them your contact details. Ask them to call you if they see the person walking about. You should get the person’s consent to tell other people that they have dementia, if they are able to give it. If the person can’t give their consent, only tell others about their diagnosis if you think it is in the person’s best interests.
• Inform the people involved in their care. If the person is in day care, respite residential care or long-term care, tell the staff about their need to walk about. You can also ask about the policy on safe walking and care for residents who walk about. Some care homes have an ‘open door’ policy, which may not be best for someone who walks about.

Helping a person stay independent

It is important for a person with dementia to stay independent for as long as possible. However, you may be worried about the person being at risk of harm or injury. If the person is walking about, try to balance their independence with keeping them safe.

In daily life, there will always be some degree of risk. You, the person and any other people involved in their care need to decide what level of risk is acceptable. This helps maintain their quality of life and protect their independence and dignity.

Remember that if the person has capacity (the ability to make decisions) then they can decide to do things even if they put themselves at risk.

If the person does not have capacity, they should still be involved in discussions about their care as much as possible. All decisions must be made in their best interests.

The steps you take to look after the person will depend on how well they are able to cope and the reasons why they spend time walking.

Try to think about whether their environment is safe and whether anything can be done to make it safer. 

There is no such thing as a risk-free environment, but some places are safer than others. For example, a quiet area where the person is well known within the community is likely to have fewer risks. Looking at the person’s environment can help you to see whether you can reduce any risks.

Getting an assessment for care and support

You or the person you are caring for may be able to get help through a care needs assessment. This is also called a community care assessment in Northern Ireland. It is the process that local authorities use to assess the care needs of a person with dementia. 

• Assessment for care and support in England 
• Assessment for care and support in Wales
• Assessment for care and support in Northern Ireland 

What to do if the person walking wants to leave the house

During a walk, a person with dementia may leave the home. This can be worrying for carers. It can be hard to know how to manage this situation without affecting the person’s independence.

If you want to encourage the person not to leave the house, try to gently focus their attention onto something else.

Suggest an activity – many carers find even everyday tasks like folding clothes or laying the table can help divert the person’s attention. It can help if you suggest activities that involve moving around.

You can also try installing a door sensor. These can play a pre-recorded message asking the person not to leave the house. It may also help if you switch off any outside lights at night to minimise what they can see through the windows.

Smart home and telecare technology can help to keep the person safe. Devices such as movement monitors and pressure pads send an alert to a carer when they are stepped on.

For instance, these could be placed at the front door so it is clear when the person has walked out of their home. 

Locking doors when a person has dementia

Some carers may consider locking the doors when a person with dementia is home so that they cannot leave.

However, a person with dementia should never be locked in when on their own. This can be very dangerous, for example if there is a fire, or if they have an accident or fall. Locking the person in may also cause them to panic and injure themselves trying to get out.

If there is someone else in the house with the person, you may want to lock the doors to stop the person going outside. You might do this, for example, if they live near a busy road.

If the person has capacity (the ability to make decisions) then you can lock the doors if they give consent. You should discuss whether to lock the doors with any other people who are involved in the person’s care.

Any decisions that you make should not place the person with dementia at any risk. Doors should only be locked for the shortest time necessary. Be aware of any fire risks and ensure that the locks are easy for you or another carer to operate.

If the person doesn’t have capacity to agree to the doors being locked, it may be possible for this decision to be made on their behalf.

Locking a door is depriving someone of their liberty, in this case their freedom of movement – so it’s crucial that social services are consulted before this is done. They may wish to assess the situation to ensure that it is in the person’s best interests to do this. 
 

Advice for if a person with dementia goes missing

• As difficult as it may be, try to stay calm and focus on finding the person safely.
• If you can’t find the person, tell the local police. Keep a recent photograph of the person to help the police identify them. Consider taking part in the Herbert Protocol. This is a national scheme that encourages carers to complete a form of useful information. The form can be emailed or handed to the police if a vulnerable person goes missing.
• If possible, make sure someone stays at the person’s home while others go looking for them in case they return. 
• Think of places the person likes or has visited a lot in the past as they may have gone there. For example, they might have gone to places they previously lived or worked, or somewhere they like to visit. 
• Consider using the internet or social media to ask people in the local area to contact you if they see the person. You might find it useful to post to local area groups and missing persons groups. However, think very carefully about which groups you post to and how much information you decide to share online. For example, the person you are caring for may not want other people to know that they have dementia.

When the person returns

• Bear in mind that they may be feeling anxious if they were lost. Try not to react angrily or immediately question them too much about why they went out. Reassure them and try to get them back into a familiar routine. 
• Once they are settled back home, it could be useful to gently ask them where they were going and why they went out. This could help you understand the reasons they went out, and help you stop them becoming lost again.
• After the situation is resolved, try to give yourself time and space to relax. You may find it helpful to talk to a family member, a friend or a professional.