Walking is an activity that is very dear to my own heart and a passion that I share with many other people. I walk to enjoy the open air, to revisit old sites and make new discoveries, to keep fit and to clear the mental cobwebs. Yet if a person with dementia has the desire to walk it is sometimes seen in a negative light. They may be described as ‘wandering’ or their inability to sit still or ‘escape’ might be viewed as disruptive and something to discourage. Many articles start from the perspective of walking being troublesome behaviour. My aim is to explore this activity in a positive light and think about ways of enabling people with dementia to maintain participation in this activity for as long as possible despite physical and cognitive limitations.
In my many years of working with people with dementia I’ve been delighted to meet many who continue to enjoy the benefits that walking brings. The way that they engage in the activity varies according to their physical and mental health and what they want to achieve by going for a walk. Some enjoy it as a solitary activity, others walk with their dog or with other people. The type of walking that they engage in varies too. Some prefer a gentle stroll around the block whilst others are seasoned hikers who think nothing of strenuous mountain treks.
Supporting a Person with Dementia to Continue Walking: Some Thoughts
- Don’t assume that a person with dementia is unable to walk alone, especially in the early stages of their illness.. Issues such as road safety, abilities to gauge their activity tolerance and being able to find their way around all need to be risk assessed on an ongoing basis. However people are often safe out on their own even when their dementia has advanced to moderate stages. As usual this is very individiualised. One size does not fit all.
- If a person has a strong preference for walking alone it may be sensible for to used to walking with a companion before it becomes absolutely necessary for them to do so for their safety. Think about the people who might fulfill this role.
- Can a person call for help on a mobile phone or are they willing to carry a GPS tracking device? Do they carry identification in case of an emergency? Common sense safety precautions that apply to all walkers need to be considered for people with dementia. Have they told someone where they are going so that their estimated return time is known?
- Are there local walking groups that are dementia friendly and a good match for a person’s abilities and preferences? And what about a walking holiday? Follow the link to Dementia Adventure, a UK organisation that arrange these
- is the person aware of risks associated with walking in certain weather conditions or at night?
- Walks can be planned with a particular focus. They can be used to encourage socialisation, watch nature or visit historic landmarks or as a vehicle for maintaining or increasing fitness. What does the person want to get out of walking?
- Make sure footwear and clothing is suitable for the type of walking the person is going to engage in. Full wet weather gear and walking boots may be needed for more strenuous hikes but sensible footwear and comfortable clothing will often suffice
- Is the person able to gauge what clothing is appropriate or do they need guidance.
- Walking can be an important part of a sensory diet that can improves symptoms of agitation and distress that lead to behaviours that others find challenging
- At all stages of dementia walking can have a positive role in alleviating anxiety and agitation and can augment or be one of the substitutes for drug therapies. It is important to point this out to professionals when advocating for the type of care that a person needs.
- As dementia progresses and the need for supervision increases think about the value that a person places on walking and activity and how these needs are going to be met, particularly if they live in a care setting. Where their access to outside space is restricted is there room for them to walk around freely in the home that they live in? Walking loops, circuits in buildings can be helpful. Look for availability of these when choosing care.
- Seek advice from a physiotherapist when a person has mobility issues. They made need extra support to help them regain their optimal physical function that will allow them to resume walking to a level that is the best of their abilities. For example, walking aids may be harder for them to get used to and they may need more support to see through an exercise programme.
The above list is not exhaustive but I hope it is helpful in explaining how people with dementia can maintain their walking activity. It is such a versatile, accessible and life affirming occupation.