Shadowing in Alzheimer's Sign of Fear, Anxiety

Fear and anxiety are two disturbing symptoms exhibited by many people with Alzheimer’s disease. These symptoms are completely understandable, considering the fact that people with dementia are often confused about their surroundings. Confusion that won’t go away leads to fear and fearful people tend to be anxious. This need to calm anxiety and feel safe can lead people with Alzheimer’s to a behavior called shadowing.

As the term implies, shadowing is a behavior where people with dementia follow their primary caregiver as closely as a frightened child follows a parent.

Shadowing is terribly sad on two fronts. It is an outward expression of the fear that the person with Alzheimer’s is suffering from and it’s smothering for the caregiver who finds it difficult to have a moment alone. The behavior can occur anytime, but for those who are prone to sundowning, which is another type of anxiety related behavior, shadowing can precede it.

The need for reassurance playing out as shadowing would seem to call for many of the same responses from caregivers as those recommended for coping with sundowning. My article 10 Tips to Ease Alzheimer’s Sundowning focuses mainly on stress reducing steps that caregivers can try. If your loved one’s sundowning is preluded by shadowing, you’ll know to start the coping mechanisms earlier in the day.

Even if shadowing is not a prelude to sundowning in your loved one’s instance, the tips on reducing stress may still be appropriate. Soothing music, quiet activity and distraction can be helpful, as can extending daylight by installing broad spectrum lights and turning them on before dusk.

Gary LeBlanc writes in his article on shadowing that offering his dad the distraction of a bowl of ice cream helped the situation. The diversion would calm his dad and break some of the cadence of the shadowing behavior.

The diversion of a snack has also been used successfully for night wandering by the Parker Jewish Institute in New Hyde Park, N.Y. The staff found that if they provided people with dementia who became anxious and agitated at night with a snack, the wandering elder would often calm down and return to bed.

A bowl of ice cream is as good a diversion as any that I can think of, but caregivers will find that each elder is different, as is each situation. General tips would be to stay alert to the stresses that may cause the behavior of shadowing to escalate and try to scale down or eliminate those occurrences when possible. Make use of distractions that calm and redirect your loved one. Then, take a deep breath and accept that shadowing, as with other Alzheimer’s behaviors, will likely change over time, probably to be replaced by another behavior.

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Carol Bradley Bursack
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Carol Bradley Bursack

Carol Bradley Bursack is a veteran family caregiver who spent more than two decades caring for a total of seven elders. This experience provided her with her foundation upon which she built her reputation as a columnist, author, blogger, and consultant. Carol is as passionate about supporting caregivers work through the diverse challenges in their often confusing role as she is about preserving the dignity of the person needing care. Find out much more about Carol at