Pacing In The Cognitively Impaired

Definition
Pacing is a repetitive physical movement and should not be confused with wandering.

Cause
Psychological – the result of psychological problems or conditions
Drug Related – the result of a side effect to psychoactive medications
Anxiety – the result of nervousness or anxiety
Physiological – the result of a physical condition or medical problem

Caregiver Hot Tips

1. Provide a safe environment for pacing. Check the environment daily for any possible hazards that can result in a fall or injury. Remove all throw rugs, keep a clear pathway for safe wandering and try to direct the individual along the path. Try to keep furniture and personal objects in the same place to reduce confusion and anxiety. Clean all spills immediately.



2. Outside walkways should be evaluated for tripping hazards. Keep access to stairs limited to prevent falls.



3. Provide finger foods and high energy snacks to avoid weight loss. Snack bars, sandwiches, fruit, small bags of healthy snacks are easy to carry and to eat on the go. Keep some easy to open snacks on the table or counter within easy reach



4. Provide sufficient fluids to prevent dehydration. . Use juice boxes or Styrofoam cups with lids and a straw to prevent spills. These can be purchased very inexpensively at a warehouse store likes Sam’s Club, BJ’s or Costco. (www.samsclub.com; www.bjs.com; www.costco.com)



5. Monitor pacing behavior – check to see if it occurs at a specific time of the day. Try to engage the individual in quiet activities during these periods.



6. Pacing to exhaustion can also occur – attempt to have the individual sit even for short periods of time (5 to 10 minutes if possible). Use a favorite food or drink as an enticement to get the individual to rest. Certain herbal decaffeinated tea may also have a calming effect – chamomile and sleepy time teas may help. Check with your local health food store.



7. Avoid caffeine commonly found in coffee, chocolates, soft drinks and other food products. Check food labels carefully



8. Know each medication the individual takes including the intended effect, side effects, and adverse reactions, especially any psychoactive medications. If pacing occurs a half hour to an hour after administering medications speak to the physician or pharmacist about the possibility of the medication causing the pacing.



9. Anxiety can result in pacing. Attempt to determine the cause of the anxiety including any patterns of occurrence – time, before or after certain activities, when others are present, at bedtime or later in the day when the lighting changes. Try to keep the lighting inside consistent.



10. Try a backrub or some warm milk prior to bedtime to decrease anxiety that may lead to pacing.



11. Keep a nightlight or room light on to prevent falls or injury at night.