How to Reduce and Respond to Pacing Behavior in Dementia Patients

Sometimes, a loved one or patient with dementia displays challenging behaviors, one of which is pacing. He might continually walk back and forth, around and around, as far as he can go and then back again to the point of exhaustion yet not want to (or be able to) sit down and relax.

A man in shorts walking on the sidewalk
Kristin Lee Tetra Images / Getty Images

Some people with dementia who are pacing are at risk to wander away or fall because of their fatigue. Pacing can be tiring for caregivers because they often feel they need to be with the person to keep him safe.

Causes of Pacing

While we don't know the cause in every case, pacing may be related to the following triggers or conditions:

  • Pain or discomfort
  • A need for exercise
  • Searching for something familiar (maybe consciously doing so or not)
  • Boredom
  • Anxiety
  • Hunger or thirst
  • Need for the bathroom
  • Disorientation

Tips for Responding

  • Assess for delirium if the pacing is more significant than normal for him.
  • Don't try to force him to sit down.
  • Try playing calming music of his preference for distraction.
  • Ensure he is not in pain.
  • Show him the bathroom in case he needs to use it.
  • Offer meaningful activities that engage him.
  • Walk with him if you're able.
  • Ask for help from friends and family to take shifts if you can't continue to walk with the individual.
  • Consider a GPS monitoring system or the Safe Return program of the Alzheimer's Association.
  • Evaluate whether the pacing really is problematic or if you can change your response to be able to "go with the flow."
  • If the person appears distressed consistently or is pacing to the point of potentially hurting himself, call his physician to ask about possible medications to help him relax.
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Article Sources
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  1. NHS. Coping with dementia behaviour changes - Dementia guide. Updated January 3, 2018.

  2. Nurse Partners. Responding to Pacing Behavior in Dementia.

  3. Alzheimer's Association. Six out of ten people with Alzheimer's will wander. Updated January 2018.

Additional Reading