Challenging Behaviors in Dementia

Why My Mom Walks Back and Forth
Wandering and Pacing

My mother has dementia and she also has macular degeneration which has left her with very very low vision (if any) so I am sure one can understand that having to take care of someone like this presents many different challenging behaviors. In the case of my mom she spends much of her day pacing back and forth. Continually she walks back and forth, around and around, as far as she can go and then back again. For me just watching her brings me to the point of exhaustion. Why she does not want to (or maybe she isn't be able to) sit down and relax is something I will never understand, though I try.

Wandering

 We have had a few episodes where she has made it out the door and off she goes on what I call her walkabout. New to Virginia Beach, we were staying at a friends house at the beach while I was in the process of looking for a place for us to live. In any event on this day I was emptying the groceries out of the car and of course I walked her into the house and got her comfortable. Or so I thought, for when I went for the 2nd trip to the car she made her escape and went out the patio door. When everything was out of the car I went to ask her if she wanted a snack, problem was I could not find her. To make this story short, immediately I called the police and they immediately had the beach helicopters, dune buggies and patrol men searching for her. She was found hiding under a dune a good 20 blocks from the house within an half hour. The fear and relief that took over me is pretty indescribable. But thank god she was found and quickly! So I knew I now had a challenge with a new priority on my list of what and where we would live. Sadly it was not going to be anywhere near the beach! Eventually I found a nice community that is more or less a maze to get in and out of. So if she does get by me and out the door she can't get very far and she certainly won't get to the entrance of the development before I find her or a neighbor sees her. I thank my lucky stars that her wandering has happened only a few times. Anyway, the walk abouts are under control these days but the pacing exhausts me. And it is one of dementia's challenging behavior I desperately would love to understand.

One thing I do know is my mother has also been a 'runner" and I don't mean like in exercise. It's more like she always needed to be someplace, usually it had to do with shopping or running off to a casino. But in the last few years between the dementia and her vision loss shopping and casinos are not on her agenda.

 Pacing 

While no one seems to know what causes pacing in dementia, experts have said that in every case, elderly pacing is a repetitive behavior and may be related to the following triggers or conditions:

• Pain or discomfort (something she has trouble conveying to me) 
• A need for exercise (physically she is fit but if I do take her for a walk she moans and groans and wants to go home) 
• Searching for something familiar (may be consciously doing so or not) 
• Boredom (this I think applies to my mom but then again she never had many interests) 
• Anxiety 
• Hunger or thirst (feeding her usually works but sometimes paces in between bites)
• Need for the bathroom 
• Disorientation 
• Sometimes I think she just may want company, and is pacing to get attention and company.

Best Advice for Responding to Pacing 

This is a hard one for me as her sole caregiver when I hear or see her as she goes back and forth and then back and forth again it automatically raises my anxiety level. And when I say that I can't even believe but the anxiety I feel is off the charts. And whatever it is I am doing it always disrupts my thinking which means whatever it is I am doing either doesn't get done or I make a mistake. Talk about challenging behaviors!  What I have learned is the following:

• Don't try to force her to sit down. (because I know she will do the opposite)
• Try playing calming music for distraction.
• Try to figure out if she is not in pain. (not an easy task but one to look out for)
• Direct her to the bathroom in case he needs to use it.
• Offer meaningful activities that engage him. ( I have tried audio books but her attention span is short lived and not many things seem to interest her)
• If I can I try to sit with her as she probably just wants someone to be with.

 Caregiver Inspiration

As I was researching this behavior I came across this gem. It is a poem by by Norman McNamara and it really made me think and understand why my mom sometimes Wanders and asks repetitive questions.

When I Wander