How can I stop my mother with Alzheimer's disease from walking constantly?

Shela asked...

Both of my parents have been diagnosed with Alzheimer's disease, but they show very different symptoms. The one concerning me at the moment is my mom constantly paces the floor, very small steps, knees bent and slumped to the point that she has terrible back pain. We have tried to show her how to walk so that it does not puts stress on her back, but of course she does not understand that. She will wall and walk and if she gets to a wall she will just walk in place. Is this common for Alzheimer's disease patients, and do you have any suggestions?

Expert Answer

Jytte Lokvig, PhD, coaches families and professional caregivers and designs life-enrichment programs and activities for patients with Alzheimer's disease and related dementia. Her workshops and seminars help caregivers and families create a healthy environment based on dignity and humor. She is the author of Alzheimer's A to Z: A Quick-Reference Guide.

People in the advanced stages of Alzheimer's disease are prone to pacing. If they start to shuffle it may well be part of the natural progression of the disease, but their pace, balance and posture can also be aggravated or even caused by medications and other reversible external factors. It's a good idea to meet with her doctor to review all her medications and other possible physical issues, such as dehydration, thyroid disorders, urinary tract or low-grade infections.

Alzheimer's affects people's sense of time, space and signals from their own bodies, so it makes it harder for them to gauge their physical needs or problems. Many pacers don't sense when they're exhausted and may be unable to stop without intervention. You can break her cadence by joining her to walk side-by-side. Sing a favorite song to her, tell her a story or engage her in a conversation. When you join in her activity, you'll be more successful in getting her involved in a distraction, including sitting down for a rest. Music, dance, and foods often work really well as diversions.

Her biggest risk at this point is a fall. People with Alzheimer's typically lose their peripheral vision, so when you check her walking path, look at it from her eye-level. It should be free of obstacles like area rugs, small or short items on the floor, low tables and ottomans. Dramatic contrasts in floor surfaces can throw her off her pace and make her stumble. The contrasts could be a tile floor butting up against carpeting "“ or a light floor going to a very dark area, which can look like a hole in the floor to a person with Alzheimer's. - This misperception can be used to your advantage: a black or very dark bath rug makes an excellent deterrent when placed in front of an exit.

Because of her pacing, your mom needs lots of extra fluids and also extra snacks, especially if she's been losing weight. Alzheimer's disease often increases a person's metabolism and when she's also a pacer, she requires additional calories just to maintain normal weight. If she has a hard time sitting still to eat a meal, you have a couple of options: you can walk along with her as you offer her bite size finger food and you can place healthy snacks within easy reach along her path: water, ice tea or diluted juices, high protein smoothies, nutritional bars and bananas for starters.