Walking About and Managing Risk

Background:

Following a Safeguarding Adult Review (SAR), concerns were raised regarding the risk of adults ‘walking about’.

VM passed away in February 2020 when she was hit by a lorry whilst walking about during the day. Professionals were aware of her walking about behaviours in the weeks prior to her death, but opportunities to effectively intervene and properly safeguard were missed.

It was felt that one of the reasons for this was that, whilst professionals could recognise there was risk, they were unsure how to effectively respond.

Recommendations:

Recommendations arising from this case include better understanding and management of ‘walking about’ behaviours. The Alzheimer’s Society Guidance provides essential information in this regard, and its key points are summarised in this document.

'Walking About’

People who walk about may do so at any time of day or night, around the house or outside. Often, problems with memory and orientation mean finding their way home again can be difficult.

We use the term ‘walking about’ not ‘wandering’, as the latter implies a lack of purpose. People who walk about will often have a reason for it, and walking about can be a sign of an unmet need. To reduce risk to an individual, it is a good idea to try and understand what these unmet needs might be, and look for solutions.

Why might someone walk about?

Tackling reasons for walking about may help to reduce the behaviour, and keep an individual safe.

  • Memory loss and confusion: People with dementia or Alzheimer’s may struggle to keep track of time, causing them to walk about late at night thinking it is early morning. Keeping a clock next to the bed clearly showing ‘am’ or ‘pm’, and displaying days of the week, can be helpful.
  • Relieving pain or discomfort: People will often walk around if they are in pain, to try and help them feel better. If you think an individual may be walking around due to illness or pain, encourage them to speak to their GP.
  • Boredom and a lack of activity: A person may be bored and walk around for something to occupy themselves. Suggest ways to stay mentally engaged through games, puzzles, or daily tasks. If the individual is in need of more physical activity, look for local walking groups, or suggest home based exercise such as housework or gardening.
  • Continuing a habit and staying independent: If a person wishes to continue walking as part of old habits or routines, try to accompany them on their walks.
  • Feeling lost or looking for someone: People with dementia may become very anxious when left alone, and may be compelled to go looking for someone. It helps to note down reminders to let them know where you are, and when you’ll be back.

Limiting risk

If individuals do walk about, carers can support them to limit risk in a number of ways. 

  • Make sure emergency contact numbers are on the individual, and not easily lost. For example, a main carer’s phone number could be sewn into a jacket or handbag.
  • Consider using a GPS device to help locate the individual – but remember to gain the individual’s consent if you decide to look into this option.
  • Get help from the local community. Do local shopkeepers and neighbours, know the individual well? It may help to inform them of their diagnosis and share a carer’s contact details.
  • Try installing a door sensor that plays a pre-recorded message asking the person not to leave the house.
  • If they have a garden, ensure it is safe to walk around.

If a person wants to leave their house:

Do not argue or try and talk them out of it as this can be distressing. Instead, ensure they are appropriately dressed and accompany them.

Do not lock the individual inside on their own. They may have an accident or fall, and if there were a fire they would be trapped.

Do not use medication to try and help the individual stay asleep at night. This can cause them to be drowsy, more confused, and potentially result in injury.

Consolidate your learning

This briefing can used for individual learning and in group discussions to increase understanding of ‘walking about’ and how to limit risk.

The full SAR VM report, including additional recommendations is available on our reports page.

Information in this briefing was summarised from the Alzheimer’s society guidance relating to ‘walking about’.