Shadowing

Not everyone who has a dementia diagnosis experiences shadowing. Some of the following tips may work for you and the person you are caring for and some may not. As always, it is important to remember that every person is unique and so these suggestions may not work for everyone and what works this week may not work next week.

However, we hope learning about shadowing will help you understand what could be happening and ways you may be able to assist the person with dementia.

What is Shadowing?

Shadowing is defined as when a person, who has a dementia diagnosis, constantly follows their care partners around.

Shadowing can be related to the person’s feelings of insecurity, anxiety, and fear. The person with dementia may be thinking ‘Where am I?’, ‘What am I supposed to be doing?’, ‘Do I know you?’, ‘Where did my Wife go?’ The care partner represents a lifeline/protector, and a person they can trust. The person may need to constantly see/hear the person they most trust.

People with a dementia diagnosis often experience changes in their short-term memory. If the person who they trust leaves the room or house, they may not recall where you said you were going and when you said you would return. The person is likely to feel scared, confused, and disorientated. ‘Five minutes can seem like five hours’ for some people with dementia.

What happens when a person with dementia is shadowing

The person may call out and search for the care partner. They may mimic what the care partner says and does.

They may constantly follow their care partner throughout the day.

Shadowing behaviours can be worse after a move to a new home or when there is a change to the person’s daily routine.

Shadowing behaviours tend to occur in the middle and later stages of dementia.

How does shadowing affect care partners

Some care partners report to feeling claustrophobic, and like their personal space and privacy have been affected.

For some care partners, even taking a shower can be challenging for them.

Shadowing can add to the care partners stress and affect their general health and well-being as well as put a strain on their relationship with the person with dementia.

How to respond

  • One way to reduce the frustration of being constantly followed around is for the care partner to remind themselves, that the person is afraid and anxious, they are not purposely trying to irritate you.
  • Stay calm. Say reassuring words (frequently if needed). E.g.: ‘You are safe’, ‘I love you’. Use short, simple sentences.
  • Always try and see the situation from the person with dementia’s perspective. Treat them with respect/kindness and be patient.

What to do about shadowing

  • Always discuss your concerns re changes in a person with dementia behaviour with the GP.
  • Try and keep to a structured daily routine. If the person can read: write daily routine on a whiteboard. Use a written note – so the person knows where you have gone to and when you will be home. Ensure the person has access to an easy-to-read clock.
  • Try and determine what activities, changes in the person’s routine/environment tend to increase the Shadowing type of behaviour, and work to minimise these.
  • Create a ‘toolbox of ideas/activities’ which may be of interest to the person, while you leave the room for a short time.
  • Consider setting up the activity you plan to do, in the same room as the person with dementia – so they can see you. E.g., do the ironing in the lounge room.
  • Make an audio tape of your voice, or any familiar persons’ reassuring voice or a video tape. The tapes could include a collection of short and meaningful stories from the person’s past.
  • Offer the person a task to do, e.g., sort silverware, fold tea towels, sort box of nuts and bolts. There are age-appropriate jig-saw puzzles available on-line, specifically designed for use by people who have a dementia diagnosis. Calming, favourite music (headphones?), set up a digital play list of favourite songs. Adult colouring in. Large print Word Searches (Junior level?). Setting the table. It may help the person to focus on an interesting short activity, rather than on what you are doing. Trial familiar, repetitive, calming type of activities.
  • Create a Memory Book – use familiar photos and items, which the person can look at, hold, and enjoy. Label each picture clearly with names and places.
  • Keep some age-appropriate picture books or magazines on hand.
  • Encourage person to watch reruns of favourite TV programs/sporting events/concerts etc.
  • Offer a favourite, safe snack (ensure there is no risk of choking) and a drink, as a diversion.
  • Set up a large egg timer or alarm clock, as a reminder of when the care partner will be back in the room. The person you are caring for can hold/watch/check the sand while you have a shower etc. There are non-breakable type egg timers available on-line.
  • Consider asking a family member/friend/neighbour to visit regularly and spend time with the person who has a dementia diagnosis, so that you are able to take short breaks and get some time to yourself. They may like to take the person for a short walk or go for a short drive.
  • Consider discussing with GP or Dementia Waikato staff the referral process to the Waikato DHB DSL Needs Assessment Service. The person with a dementia diagnosis may be eligible for funding for services such as Day Programs and Respite Care.
  • Try and find time for yourself, even short breaks may help you feel better. We all need a little quiet time to ourselves.

Finally, Be Kind to Yourself

You are human. None of us are perfect-especially during these times at home.

Look after yourself and try to get enough rest.

Take care of yourself, as well as your family member who has dementia.

Feel free to contact us at Dementia Waikato if you need to talk about any issues you are having with the person you are caring for. Dementia Waikato staff are all working from home and can speak with you on the phone 07 929 4042 or via email info@dementiawaikato.org.nz

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