A relationship-based approach to repetitive walking or pacing in people experiencing dementia

Repetitive walking or pacing is a common behavioural symptom of dementia, which can cause distress for the person experiencing it as well as those around them.

bpsd relationship based approach repetitive walking dementia centreThere are many reasons people may be walking, including having had an active lifestyle, looking for something or someone like the bathroom or a family member, or feelings of boredom or anxiety. While it may not be clear to the observer, the walking is often purposeful from the perspective of the person doing it.

This behaviour isn’t necessarily harmful if the environment is safe, although it can carry some risks like falls or fractures, sleep disturbance or social isolation. And it can be worrying for the carer too.

To support people experiencing behavioural and psychological symptoms of dementia (BPSD), we favour a relationship-based, personalised approach over pharmacological intervention.

“There is no reason to assume, after all, that the administration of any psychotropic drug is reasonably likely to stop somebody from walking, unless that outcome is achieved purely by sedation, which constitutes chemical restraint,” says Associate Professor Steve Macfarlane, Head of Clinical Services for The Dementia Centre and co-editor of a new textbook on BPSD.

This starts with understanding the person’s history, which will serve to uncover the meaning behind the behaviour for the person and any causes that might be addressed.

Once we have that deeper understanding, we can deploy different strategies to support the person. These might include connecting them to a walking group or engaging them in activities they enjoy to help reduce feelings of social isolation or anxiety. It could also be a review of wayfinding prompts or providing regular opportunities for exercise.

The new book providing a deeper understanding of the behavioural and psychological symptoms of dementia, their causes and guidance on how to support the person experiencing them is being launched at the International Dementia Conference: Brave New World in September.

The BPSD Textbook: Addressing behaviours and psychological symptoms of dementia is a comprehensive guide to understanding the causes of BPSD, issues of care, medical effects, the role of medication and the importance of individually tailored psychosocial interventions to support people experiencing BPSD. Edited by three leaders in the field, it covers the latest evidence and best practice in this area.

Associate Professor Steve Macfarlane and co-editor Associate Professor Colm Cunningham will be joined on stage at the International Dementia Conference by Lynn Sewell, whose husband lives with frontotemporal dementia, and Assistant Secretary responsible for the Dementia, Diversity and Design branch at the Commonwealth Department of Health, Robert Day, to discuss the support needed for people with dementia when behaviours become complex.

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