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Shadowing refers to the situation when the person with dementia constantly follows his care provider around. He may mimic him and go wherever he goes. He may peer down at the caregiver while he sleeps. He becomes worried when his caregiver spends time away from him. He may even tip-toe lightly and peer around corners to make sure that his care provider is always in sight.

This behavior occurs during the later stages of the disease. It happens due to the person’s feeling of uncertainty and anxiety. He feels like his caregiver is his one safe refuge. Like a small child to his mother, the person with dementia becomes totally dependent on his caregiver. The moment the latter is out of sight, he becomes upset and angry.

While shadowing is not as challenging as the other behaviors that the patient exhibits, it can be a problem on the part of the caregiver. The caregiver may find it annoying, leaving him with a feeling of claustrophobia and without privacy. He can no longer do his personal matters, like going to the bathroom without interruption.

Coping up with shadowing

Although it may be difficult to be always followed around, you must always remember that the person you are tending to is afraid and anxious. Recognize that his shadowing behavior is a reaction to confusion and anxiety.

To ease your frustration, you may apply some strategies in dealing with your loved one.

Give him a sense of security. With reassuring words, tell him something like, “You are safe.” “Everything is going to be alright.” “Don’t worry, I am here to protect you.” Say these words every day in a calm and loving voice. Make sure your words are simple, short, and the same.

Organize predictable daily routine. Keep your loved one busy with familiar and uncomplicated activities in a calm environment.

“Cereal therapy” or “gum therapy”. Divert his attention from constantly following you by giving your loved one some food to snack on or a gum to chew. Just make sure the snack you give is not likely to cause choking.

Play music. You may give the person headphones from which he can listen to his favorite music. It has been proven that music tremendously benefits people with dementia.

You may also make a recording of your own voice speaking reassuring words to him. Familiarity can be calming and relaxing to your loved one.

Set a timer. When you need to go to the bathroom or spend some alone time, you may set a timer. Set it for as long as you want to be in the bathroom or at rest. Let the person hold the timer and make him wait for it to ring. Return within your loved one’s sight when the timer goes off.

Find a way to escape periodically. No matter how dedicated, loving, and patient a caregiver you are, you also need some time off. You need to take a break to keep your emotional well-being, and to be relieved from stress. Ask other family members to tend to your loved one while you are away. You may also ask a neighbor, whom you trust and who is familiar to the dementia patient, to take a walk with him for a couple of hours.

If necessary, make an audio tape of your voice for him to listen to while you take a break. The tape should contain some short and meaningful stories from your loved one’s past. Again, the tone of your voice must be reassuring and calm.

Keep in mind, however, that what strategy works today may not work tomorrow. And what didn’t work yesterday may work perfectly well the next day. Just be patient and creative in finding ways to distract the person from following you all the time.

Enjoyed the article? 

You can find more great content here:

How To Handle Verbal Abuse By A Dementia Patient

About the author 

Dr Michael Chua PT, DPT

Dr Michael Chua is a physical therapist practising in Home Health, Skilled Nursing Facilities and Acute Care Hospital. His clinical interest involves pain management, geriatrics and dementia management. He enjoys treating patients and bringing out the best in them using positive treatment approaches, his dynamic work setting in a rural area provides an opportunity to treat a wide range from geriatrics to orthopaedics.

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