Is it typical to be afraid to be alone?

Jw812 asked...

I understand the concept of an Alzheimer's patient wandering. My mother has not exhibited this behavior as yet. However, she recently has started following me around, often taking every step I take even when I tell her where I'm going. For example, I'll tell her I'm going to the bathroom and she will get up from her chair and follow me. I believe she is afraid I'm leaving her. She has never been alone in her life. She has been diagnosed at Stage 6. Is this typical behavior?

Expert Answer

Lisa P. Gwyther, a social worker specializing in Alzheimer's services, is the author of The Alzheimer's Action Plan. An associate professor in the Duke University Medical Center Department of Psychiatry and Behavioral Sciences, she's also a past president of the Gerontological Society of America.

Alzheimer's is almost synonymous with "afraid to be alone".  Families describe your mother's following you to the bathroom as "shadowing".  In essence, you are the person who makes sense of her world, and if she can't see or touch you, she is scared.  She becomes your shadow.  

She feels safe by your side because she thinks you protect her from mistakes, remind her of what she is doing and save her embarrassment or frustration which she inevitably experiences when she tries to keep up with too many things at once.  Her shadowing you has nothing to do with whether she ever lived alone or not. 

This is her brain disease "talking", and yes, she is afraid of being left by you.  You are her interpreter in an increasingly confusing and complex world.  Her fear is not an indictment of you.  It doesn't mean you have ever given her reason to believe you would abandon her. 

Although this is very typical behavior, it doesn't necessarily mean she won't ever "wander" off, especially in search of you, someone from the past, or some responsibility from the past like a job. 

She needs reassurance in the moment, and you will need respite breaks or time outs to meet your separate needs.  This complete lack of privacy or down time will try your patience and limit the effectiveness of your care. 

She may be reassured by familiar sounds of your activity without actually following you to the bathroom or standing by your side as you talk on the phone.  Try an audiotape of sounds of you cooking, doing laundry or usual activities while she is seated in her favorite chair.  Some people are comforted if they just hear the person they rely on, knowing or feeling their presence close by.  This might provide some temporary privacy for you. 

By the time people with memory disorders are shadowing, they can't safely stay alone and the demands on primary family members are too much for any one person.  Make sure you have time for the other people in your life, especially for you.  Your mother will benefit if you can be fully present and reassuring because your separate needs are being met.