Top Tips for Dealing with “Distress-related Behaviours“ in Dementia Care

Distress‑related behaviours are often a form of communication. These tips can help you understand what the person may be trying to tell you and support them safely, compassionately and respectfully.

Walking, NOT ‘Wandering’

Behaviours such as walking about are often labelled as “wandering”, which suggests the person has no purpose. This wording ignores the feelings and needs behind the behaviour. People may walk for many reasons — for comfort, reassurance, routine, safety, or because they are trying to find someone or something.

All Behaviour Has Meaning

Understand the Cause

• Start by exploring what the person may be trying to communicate.
• Work as a team to consider possible causes, including past routines or life roles (for example, a former nurse doing rounds, or a teacher checking on others).
• Group walks and outings can also provide purpose, comfort and connection.

Check for Reversible Factors

• Look for pain, infection, constipation, incontinence, thirst, depression or delirium.
• Consider possible medication side effects, including Akathisia.
• Treat or address anything that can be improved.

Avoid Restrictive Responses

• Avoid trying to stop or hold the person back, as this often increases distress.
• Respond calmly, kindly and safely.

Use the Environment

• Gentle environmental cues and signage can reduce distress or exit‑seeking.
• A strip of tape on the floor, a mirror near an exit, or painting exit doors the same colour as surrounding walls may help.
• Disguise doors/exit ways by ensuring they are the same colour as the walls.
• If using personal alarm devices, be mindful of issues around restraint and deprivation of liberty.
• Make the environment as safe as possible so the person can walk freely.

Support the Walking

• Support the walking rather than trying to control it.
• Provide safe and accessible garden areas where appropriate, as outdoor walking can be calming and purposeful. Offer drinks and snacks to support hydration and energy.
• Offer drinks and snacks to support hydration and energy.

Meaningful Activity

• Offer meaningful activities throughout the day — music, exercise, dancing, games or simple moments of connection.
• Social contact and light stimulation can reduce distress‑related walking.

Encourage Rest and Sleep

• Position chairs in places that naturally encourage pausing and resting.
• At night, gently show the person that it is dark outside to help them understand that it is time to rest.

Support Orientation

• Use clear pictures or symbols on bathroom, toilet and bedroom doors.
• Walk alongside the person and talk to them. Gentle conversation or looking at photos can offer reassurance and connection.

A Helpful Reminder

Record What Works

• Record and share anything that works well. This helps everyone give consistent support and reduces confusion for the person.

Reflection Prompts

• Which ideas stand out for you? Why?
• What might change for you — and for the person — if you tried these approaches?
• What support would help you put these ideas into practice?
• What have you learned from your own experiences that others could benefit from?

Over to YOU: Release Your Potential

These are my thoughts and perspectives (I’m not necessarily right or wrong, simply starting a conversation).

So, what about your thoughts? What is YOUR perspective?

I’d love to hear your thoughts, reflections, gut reactions, perceptions, experiences and wisdom.

• Do any of these things ring true for you and can you picture yourself putting these tips into action?
• What would it look, sound and feel like if you put some of these tips into action – for you and others?
• What barriers might you come against when putting these tips/ideas into action? How might you overcome them?
• Who could give you support and how?
• Have you tried these tips and ideas out and, if so, what have you learned?

Remember that sharing our experiences can help others, so your thoughts and comments are always welcome.