Why a person with dementia might be walking about

Like most people, a person with dementia may want to spend time walking. Walking is good exercise and can help relieve stress and boredom. However, a person with dementia may walk repeatedly around at home or leave the house during the day or night. 

When a person with dementia walks about, it is often referred to as ‘dementia wandering’. However, this can be an unhelpful term because it suggests the person is walking with no purpose. In fact, there will often be a reason or belief behind it.

Walking may become a problem, especially if the person has difficulties with memory or can’t find their way home. A change in walking habits can also be a sign that a person has a need that is not being met.

It can be difficult to understand why the person you are caring for is walking about. By exploring the reasons, you can support them with their needs and help them to remain independent and safe. 

Why might someone with dementia want to spend time walking? 

1. Memory loss
2. Confusion about the time
3. Relieving pain and discomfort
4. Restlessness, agitation and anxiety
5. Relieving boredom
6. Lack of physical activity
7. Continuing a habit or interest
8. Searching for a person or something from the past
9. Feeling lost

The reasons why a person with dementia might want to walk about may not be obvious. If you ask the person, they may not remember the reason or they may not be able to tell you.

As the person’s carer, friend or relative, you are likely to know them best. Trust your instincts and try to use your knowledge of the person to understand why they are walking. This may help you find ways to support them.

Memory loss

A person with dementia might begin a journey with a particular goal in mind. However, due to short-term memory loss, they may then forget where they were going, or the route they need to take, and become lost. 

Some people with dementia may also forget where they have put an item and think that someone has taken it. The person might then start walking to try to find it.

You can try to make this easier for them by keeping personal items where they can easily see them. You can also use notes or pictures on cupboards and drawers to show what is inside.

Confusion about the time

People with dementia often become confused about the time. They may wake up in the middle of the night and get dressed, ready to start the day.

This confusion is easy to understand. In winter or summer, it is common to go to bed and wake up while it’s either still dark or still light outside.

It can help if you place a large clock by the person’s bedside that shows whether it is the morning or afternoon. Some clocks also show the day of the week and the date. 

Clocks are available at shops selling independent living aids and equipment. They are also available from Alzheimer’s Society’s online shop.

The person you are caring for may walk a lot during the night if they have difficulty sleeping.  This is common in older people and is particularly common in people with dementia. You can do simple things to try to help them sleep.

For example, encourage them to develop a routine when going to bed at night. It may help if they avoid daytime naps, caffeinated drinks, and alcohol.  

Relieving pain and discomfort

People often walk when they are in pain because they are trying to ease their discomfort. Alternatively, a person may walk to try and ‘escape’ from their pain. The cause of a person’s pain will not always be obvious – for example if they have a headache or pain in their tooth.

Sometimes a person will feel distress or emotional pain due to a memory or a thought they have had. Speak to the person about what they are thinking or feeling to try and find out why they have a need to move around.

It might be that the person you are caring for is walking because they are uncomfortable. Check to see if any of the following may be causing them a problem:

• They might need the toilet or be constipated
• They may be wearing ill-fitting shoes, clothing or dentures
• Their environment may be uncomfortable. For example, it may be too hot or too cold, or there may be poor lighting or unfamiliar smells. 
• It may be too noisy for them. People with dementia can find it difficult to cope with a lot of noise. Simple things like closing a door when you are vacuuming or lowering the television can help.
• They may be overwhelmed. If a person has had a busy day where a lot has happened, they may find it too much to process. Ask them what might help them feel more settled.
• A person with dementia may walk about more when they are feeling unwell. If you notice a sudden change in them – for example if they become less able to focus or to be still – ask whether they feel unwell. 

If you think the person is walking about due to pain, discomfort or illness, talk to the GP. A GP can examine them for any physical causes or illnesses.

Restlessness, agitation and anxiety

People with dementia who walk about may sometimes simply be feeling restless, like anybody else. They may appear agitated, fidget, tap their fingers or make other repetitive movements.

These behaviours are known as ‘restlessness’. They may be a symptom of the physical changes in the brain caused by dementia.

It can be useful if you start by checking for any physical causes. Make sure they are wearing comfortable shoes and clothing. You can also try adjusting the heating to change the temperature.

There is also a medical condition called ‘restless leg syndrome’. It gives people an overwhelming, irresistible urge to move their legs to stop unpleasant sensations.

This condition causes people to get up and walk about during the night. If you think the person you are supporting might have restless leg syndrome, talk to their GP.

Some people may walk about because they feel anxious. A number of things can cause anxiety.

If the person feels anxious and needs to walk, go with them if possible. Try to encourage them to tell you why they are feeling this way. Reassure them, for example by holding their hand if appropriate.

Encourage them to breathe slowly and deeply, or to sing a song which you can gradually slow down. If they are walking too fast, try to keep pace with them and gradually go slower to encourage them to slow down too.

If the person is feeling overwhelmed with anxiety, then they likely will not be able to explain what has triggered this until they feel calmer. This may not happen until they have walked for a while.

You may need to try different things to work out why the person is restless, agitated or anxious. 

A person may feel the need to walk about as a side-effect of certain medicines, such as some antipsychotic medicines. You could ask their GP whether their prescription could cause restlessness.

Relieving boredom

A person may walk or pace because they don’t have enough things to do or have not been busy enough during the day.

They may feel bored because they don’t do as much as they used to – for example, seeing friends or going out. Having things to do gives everyone a sense of purpose and self-worth. 

Try to find ways to help the person stay mentally engaged and physically active. For example, encourage them to play games or to take part in hobbies that match their interests.

Reminiscence and creative therapies can also help. Being involved in housework or daily tasks can help the person to stay active and engaged. Carrying out these tasks can also help the person’s self-esteem and confidence.  

Bear in mind that activities may need to be adapted, and the person may not want to do them for long periods of time. 

Lack of physical activity

If the person you are caring for is constantly walking around, it may be because they have energy to spare. They may feel the need to do more regular exercise.

If they are able, they could try exercise classes or activities such as walking or dancing groups. You can also help them to include more daily exercise without making big changes.

If they are able, the person could accompany someone to leave the house at least once a day to get some fresh air. It helps to see regular routines, such as the rubbish being collected, post being delivered or children going to school.

It also helps to see the weather outside and the clothes that people are wearing. This can orientate them in terms of the time of day or year.

Continuing a habit or interest

As much as possible, people with dementia will often want to continue with habits or interests they had before their diagnosis. Walking may be an activity they have always enjoyed, or may be connected with another habit. 

You may find that the person you are caring for goes for a walk at times of the day when they used to be out and about. For example, this may be when they would have gone to work or walked the dog.

Try to support their need to walk for as long as you can. If the person is mistaken about their need to walk, correcting them may cause distress and confusion. Try to change the subject or suggestion another activity instead.

Think about why they may be feeling the need to go to a particular place. It is much more important to focus on the person’s feelings rather than whether what they are saying is true.

If you find that the person often wants to walk at the same time each day and you are unable to accompany them, it may help to go out with them slightly earlier in the day instead.

Keeping to the same routes can give a sense of familiarity. It can also reduce the risk of the person feeling disoriented. If you can’t go with them at all, you could ask family or friends if they can help.  

In some areas there are dementia-friendly walking groups. These groups help people with dementia to continue walking in a safe environment with other people.

Searching for a person or something from the past

If the person is on their own, sometimes even for short periods, they may walk about to try to look for a specific person. This may make them feel extremely anxious. It can help to leave notes when you’re going out to remind them about where you are and when you will return.

Try to put the notes where they will stay in place and where the person will see them. This could be near the kettle or on the inside of the front door. You may find it helpful to write key information on a whiteboard. Make sure the person’s phone is nearby so that they can call instead of leaving home to try and find you.

As dementia progresses, the person you are caring for may try to find someone or something from their past. For example, they may not remember that someone has moved or died.

Encourage them to talk about this so you can try to understand who or what they are searching for. Show them that you are listening and taking their feelings seriously. Try to avoid correcting what they say.

It is much more important to focus on the person’s feelings rather than whether what they are saying is true. 

Feeling lost

A person with dementia might walk about because they feel lost. This can happen in unfamiliar surroundings, such as when moving house, attending a new day centre or moving into a care home. 

If the person’s living environment has changed, make sure they keep familiar items. This might be photographs, ornaments or furniture.

Try to reassure them that they belong in the new place. If you can, match the layout of their new home with their previous one, using some of the same furniture if possible. 

The person may need extra help from family, friends or care home staff to find their way around. As the surroundings become more familiar, they may become less disorientated.

As dementia progresses, the person you are caring for may begin to feel lost in their own home.

For example, they may forget where the bathroom is and walk around to try to find it. Leaving the bathroom door open and the light on could help. Signs on the doors can also be useful.