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Managing Shadowing Behavior

Shadowing behavior (also called trailing or following) is very common and often exhausting behavior in people with dementia, especially in mid-to-later stages. 

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The behavior manifests as constant following of their caregiver around the house. They may stay right behind their caregiver, mimic actions, repeatedly check on their whereabouts. Often, individuals with dementia become anxious, agitated or upset when their caregiver is out of sight - even for a few moments. 

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This isn't intentional clinginess; it's usually rooted in fear, uncertainty, insecurity and confusion about their surroundings, time or purpose. The caregiver becomes their "anchor" or sense of safety in a world that is otherwise disorienting.

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This behavior may feel irritating, overwhelming and annoying to the caregiver. Read on for several strategies to help give you both some breathing room. 

Step 1: Understand and Reassure First

Recognize that shadowing is a communication of a need: "I feel lost/scared/alone without you." Respond with calm, consistent reassurace using short and simple phrases repeated like a mantra: "You're safe here with me. I love you. Everything is okay." Say it gently every day, even when things are calm. Avoid arguing or explaining logically - it often increases frustration for both of you. 

Step 2: Identify Triggers and Patterns

Keep a journal for a few days: when does the shadowing behavior worsen (i.e., late afternoon during sundowning, after overstimulation, or when you're busy with chores)? Common triggers include fatigue, hunger, pain, boredom or unmet needs. Addressing the basics (i.e., a snack, rest, pain relief) can lessen this behavior. 

Step 3: Create a Calming, Predictable Environment

Reduce confusion with good lighting (to minimize spooky shadows), familiar routines, and soothing elements like soft music or familiar photos. A structured daily schedule helps the person feel more secure, reducing the urge to "check" constantly.

Step 4: Use Gentle Distraction and Redirection

When shadowing behavior intensifies, redirect attention to a meaningful or enjoyable activity - like folding towels, looking at old photos, listening to favorite music, or a simple puzzle. Offer something they can do alongside you, like sorting laundry together so they feel involved without constantly following.

Step 5: Provide Tools for Brief Separations

For short absences (i.e., bathrooom, quick chore), use visual/tactile aids since time sense is often lost:

  • Set a wind-up kitchen timer and say "I'll be back when the bell rings - stay here and fold these napkins."

  • Leave a recorded voice message/video of your reassuring words (i.e., "I'm just in the next room, I'll be right back."

  • Place familiar objects in a safe spot to comfort them (i.e., a blanket or photo)

Step 6: Build in Respite and Support

Shadowing thrives with the primary caregiver. Introduce other trusted people, like family, friends, or professional aides, to build familiarity and reduce dependency. Schedule regular breaks for yourself - respite care or adult day programs can make a huge difference. Seek out support groups, even if they are virtual only.

Step 7: Prioritize Your Own Well-Being

This behavior is frankly draining - don't take it personally. Practice self-care: light a candle, deep breaths, take a walk, or talk to someone. If shadowing leads to aggression, agitation or safety concerns, consult a doctor or health care professional. They may check for underlying issues (i.e., infection) which can exacerbate dementia symptoms. In other cases, they may recommend medication therapy.

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