When it happens
At any point, especially moderate- to severe-stage dementia
Why it happens
Initially, a shuffle may be caused by a fear of falling due to changes in depth perception or orientation; the person takes more tentative steps. A shuffling walk can also be an early sign of a loss of muscular coordination as the part of the brain governing motor skills (the parietal lobe) is affected. The brain and body don't communicate well. The person has trouble picking up his or her feet to walk and may be unsteady or begin to stoop.
What you can do
Make sure shoes fit well and have soles that are neither too slick nor too rigid. Some sport shoes actually contribute to falls because wearers can't sufficiently lift their feet, causing them to trip on the heavy treads.
Provide a cane or walker for added support and confidence. Walkers are associated with a lower risk of falls but often are met with greater resistance at first.
Repeatedly remind the person to use a cane or walker, as he or she will likely forget. Store it in view as a visual reminder.
Reduce the risk of falls by removing throw rugs and clutter from pathways.
Especially remove throw rugs that present a color contrast, which can be perceived as a step.
If you're remodeling, know that monotone wall-to-wall carpets that extend into hallways and other rooms are ideal for someone with walking and perception problems.
Mention walking trouble at the next medical checkup, especially if there's been a medication change; you'll want to be sure that this (or something else treatable) isn't the actual cause of the shuffling.
Make sure there's been a vision check within the past year to further help reduce falling risk.
Do try to keep the person moving; don't let a shuffle cause him or her to give up walking completely.
Exercise has been shown to reduce the risk of falls even in people with dementia.
Allow more time to get places.