Understanding Dementia and Shadowing: A Guide for Caregivers

For caregivers of loved ones living with dementia, certain behaviors can be particularly challenging to understand and manage. One of the most common yet emotionally taxing of these is shadowing.

What is Shadowing?

Shadowing refers to a behaviour where a person with dementia constantly follows their primary caregiver, moving from room to room. This isn’t a choice, but a behaviour driven by deep-seated anxiety, fear, and confusion. It is a plea for reassurance – a need to know they are safe and not alone. Often, the person may become visibly agitated or distressed if the caregiver steps out of sight, even for a moment. At its heart, shadowing is a symptom of profound insecurity and the neurological changes caused by dementia.

Why Does Shadowing Happen?

Understanding the “why” can help soften frustration and build compassion. The behaviour stems from several core needs:

Insecurity and Fear: Dementia can create a world that feels unpredictable and threatening. Your loved one may feel unsafe and fear being alone or abandoned.
Loss of Orientation: Memory loss and impaired spatial awareness mean they can easily forget where they are, where you are, or how to find you. You are their anchor in a confusing world.
Need for Reassurance: Following you is their way of confirming that you (their primary source of comfort and safety) are still present and that everything is okay.
Cognitive Impairment: Changes in the brain can diminish the ability to process information independently, making imitation and close proximity feel safer and more predictable.

Recognising the Signs of Shadowing

Physically following you everywhere in the home.
Becoming distressed, anxious, or angry when you leave the room.
Repeatedly calling out or asking where you are and what you are doing.
Mimicking or mirroring your actions.

Strategies to Cope and Manage Shadowing

While shadowing can be draining, practical strategies can help manage the behaviour and preserve your well-being.

Provide Gentle Reassurance: Verbally acknowledge their feelings with a calm, kind tone. A gentle touch on the hand or a hug can communicate safety when words fail.
Create a Sense of Security: Use comforting background stimuli like familiar music, family photo slideshows, or audio recordings of your voice to provide a continuous presence.
Offer Distraction and Engagement: Provide simple, purposeful activities that they can do near you – folding laundry, sorting buttons, or organising magazines. This can sometimes redirect their focus.
Establish Predictable Routines: A consistent daily schedule reduces general anxiety by making the world feel more predictable.
Use Visual Cues: A large, clear timer can help them understand that your absence (for example, to take a shower) is temporary and that you will return.
Widen Their Circle of Trust: Gradually introduce other trusted family members or friends into their daily care. This helps them feel secure with more than one person, giving you essential breathing space.
Channel the Energy: Shadowing can be a release for pent-up nervous energy. Safe, guided physical activity like a short walk in the garden or using a stationary pedaler can be beneficial.
Prioritise Respite and Support: This is crucial. Enlist help from family, friends, or respite care services. You cannot pour from an empty cup. Taking time for yourself is not a luxury – it’s a necessity to prevent burnout and sustain your caregiving journey.
Release the Guilt: Remember, their behaviour is a symptom of their condition, not a reflection of your care. Taking breaks does not make you unloving; it makes you sustainable.

You Are Not Alone

Shadowing is a profound expression of need, and navigating it requires patience, creativity, and immense compassion for your loved one and for yourself. At ADASA, we understand the complexities of the caregiving journey.

If you are feeling overwhelmed, reach out. Our support groups and resources are designed to offer you emotional backing, practical advice, and a community that truly understands.

Let’s walk this path together, with strength and shared understanding.

Welma Geldenhuys
Senior Social Worker
ADASA Gauteng