Dementia, Night-Time Wandering and Staying Safe at Home

Dementia in Ireland: the picture for families

Around 64,000 people are living with dementia in Ireland today, with roughly 11,000 new diagnoses each year, the equivalent of at least 30 people a day, and around 1 in 10 of them are under 65.¹ Ireland has never run a national dementia prevalence survey, so this is a careful, widely used modelled estimate rather than a head count, but it gives a reliable sense of the scale.²

The most important fact for this guide is where people with dementia live: 63% live at home in the community, not in residential care, and over 180,000 people in Ireland are or have been family carers for someone with dementia.¹ Night-time safety is therefore a kitchen-table issue for tens of thousands of Irish families, not an institutional one.

The takeaway: the number is rising fast. The Alzheimer Society of Ireland projects it will more than double to over 150,000 by 2045, and peer-reviewed modelling puts it near 99,000 by 2036.¹² More families will be supporting someone at home, more often.

Walking about at night: what it is and why it happens

The Alzheimer's Society uses the phrase "walking about" rather than "wandering", because wandering implies aimlessness, when in fact there is usually a reason or a belief behind it.³ Understanding the reason is the first step to helping. Common reasons for night-time walking include:

• Confusion about time, for example waking in the night and believing it is morning, then getting dressed
• Looking for a person, a place or an object
• Pain, discomfort, hunger or needing the toilet
• Restlessness, anxiety or excess energy
• Continuing a lifelong habit, such as a person who always rose early for work
• Feeling lost in surroundings that seem unfamiliar in the dark

What is sundowning?

"Sundowning" describes confusion, agitation, restlessness and sometimes walking about that emerges or worsens in the late afternoon, evening or night. It is linked to disruption of the body clock, which is common in dementia.⁶ How common it is varies a great deal between studies, with estimates ranging widely, so it is best thought of as a recognised pattern that affects a meaningful minority of people with dementia rather than something with a single agreed figure.⁶

The real risks at night (and how to think about them)

It helps to be clear-eyed without being frightened. Research suggests that around six in ten people with dementia will walk about at least once, and some do so repeatedly.⁵ At night, the specific concerns are:

• Falls in the dark. Poor visibility, sleepiness and an unsteady gait combine, and the route to the bathroom is a known hotspot.
• Leaving the house and getting lost or disoriented.
• Cold or exposure if the person goes outside, especially as someone with dementia may not recognise that they are cold.

A 2025 study that monitored 94 households over a full year found that when night-time going-out did happen, people were outside for an average of 2 hours and 40 minutes, which underlines the concern about cold and getting lost.⁷ The aim of everything that follows is simple: reduce the chance of these events, and make sure that if one happens, someone knows quickly.

How to help someone sleep and stay safe at night

Light the way

Gentle, motion-activated night lights along the route from the bed to the bathroom can reduce both confusion and falls. Steady, low-level lighting is better than a single harsh light that startles. The evidence here is encouraging: lighting interventions have been found to reduce night-time falls in older adults by roughly 30% to 34% in trial and care-home settings.⁸ Those figures come from controlled settings rather than ordinary homes, so treat them as a strong reason to improve lighting rather than a guarantee.

Anchor the body clock

A consistent routine helps the body know when it is night. The sundowning literature recommends a regular bedtime, daily physical activity (ideally some of it outdoors), good daylight exposure in the morning, and limiting daytime naps, caffeine and alcohol.⁶ A clock that clearly shows day versus night can ease the time confusion that prompts a person to get up and dress at 3am.³

A safer bedroom and home

Reduce trip hazards, keep a clear path to the bathroom, and think about where doors and locks are. Many of the same measures in our guide to preventing falls at home apply here, with night-time lighting and a clutter-free route being the highest-value changes.

Monitoring without surveillance

This is where many families feel torn. They want to know if their parent gets up, falls, or heads for the front door at night, but they do not want to put a camera on someone in their most private moments. The reassuring news is that you do not have to.

The 2025 study mentioned above deliberately used only ambient sensors, door contacts, motion detectors and under-mattress sleep sensors, with no cameras at all, across 94 real homes, and reliably flagged genuine night-time going-out events: 91.2% of the alerts it raised were confirmed as real.⁷ In other words, a carer can be alerted to a fall or to someone leaving the house at night without ever watching or recording the person.

The ethics literature strongly favours this approach. A 2025 review of sensor-based monitoring in dementia care concluded that non-camera ambient sensors are preferable to video monitoring precisely because they do not create identifiable images, and set out best practice: collect the minimum data, keep it anonymous, be transparent, and centre the person's dignity.⁹

This is exactly the principle behind SmartGuardian. It converts movement into an anonymous stick-figure model, processes it on the device, and keeps no video, so the only thing that ever leaves the home is an alert. For a family caring for someone with early-stage dementia, where a worn pendant is often forgotten or removed, that kind of non-wearable, privacy-first detection can be a gentle way to keep watch over safety without surveillance. It is one tool among several, and never a replacement for human care and company. You can read more about how the privacy works in our guide to privacy-first AI monitoring.

Dignity, consent and doing this the right way

Any monitoring decision sits in a genuine tension between safety and autonomy, and it deserves care. The guidance is practical and humane:⁹

• Involve the person as much as they are able, while they can take part in the decision.
• Choose the least intrusive option that meets the real need: a door or fall sensor before anything more.
• Be open about what the device does and does not do, and avoid recording private moments.
• Where a person can no longer consent, decisions are usually made by those closest to them, representing what the person would have wanted, and should be revisited as needs change.

Talking about this as a family is not always easy. Our guide on having the conversation about safety and support may help, and is written with exactly this kind of moment in mind. If you are caring at a distance, our guide for families of a parent living alone is a good companion read.

Where to get help in Ireland

• The Alzheimer Society of Ireland runs a National Helpline (1800 341 341), day-care and home-care services, and local support groups across the country.¹
• HSE "Understand Together" is the national dementia awareness and information programme, with guidance on supports and assistive technology.¹⁰
• HSE Memory Technology Resource Rooms let you see and try assistive technology, including clocks, sensors and reminders, with an occupational therapist's advice.¹¹

Frequently asked questions

Why do people with dementia walk about at night?

Usually for a reason: confusion about the time, looking for someone or something, discomfort, restlessness, or a disrupted body clock (sundowning). It is common, and the term "walking about" is preferred because it is rarely aimless.³

Should I use a camera to watch a parent at night?

Most ethical guidance favours non-camera sensors over video. Motion and door sensors, and anonymised fall detection, can alert you to a fall or to someone leaving the house without recording or watching the person, which protects their dignity.⁹

Wearable alarm or non-wearable detection for dementia?

A wearable alarm must be worn and the button pressed, which a person with dementia may forget or remove. Non-wearable detection works automatically, with nothing to wear or remember, which is why it often suits dementia care better.

Is it safe to lock the doors at night?

This needs care. Doors should never be secured in a way that could trap someone in an emergency such as a fire. Speak to an occupational therapist about safe options, and consider a door sensor that alerts you rather than a lock that confines.

References

1. The Alzheimer Society of Ireland. Dementia in the Media (national figures), 2020. alzheimer.ie
2. Pierse T, Keogh F, O'Neill S. Generating national projections of dementia cases for Ireland using a calibrated macro-simulation model. BMJ Open, 2020. pmc.ncbi.nlm.nih.gov/articles/PMC7418672
3. Alzheimer's Society (UK). Why a person with dementia might be walking about, 2023. alzheimers.org.uk
4. Alzheimer's Society (UK). Walking about (factsheet 501), 2023. alzheimers.org.uk
5. Alzheimer's Association. Wandering, 2026. alz.org
6. Reimus J, Siemiński M. Sundowning Syndrome in Dementia: Mechanisms, Diagnosis, and Treatment. Journal of Clinical Medicine, 2025. pmc.ncbi.nlm.nih.gov/articles/PMC11856004
7. Serban A-I, et al. Monitoring night-time safety in households with dementia using ambient sensing technologies. Alzheimer's & Dementia, 2025 (UK Dementia Research Institute, Imperial College London). pmc.ncbi.nlm.nih.gov/articles/PMC12725205
8. Light and Health Research Center, Mount Sinai. Lighting interventions to reduce falls in older adults, 2022. ledsmagazine.com
9. Lahr D, et al. Ethics of Sensor-Based Surveillance of People with Dementia in Clinical Practice. Sensors, 2025. pmc.ncbi.nlm.nih.gov/articles/PMC11990963
10. HSE. Understand Together: dementia information and supports. hse.ie
11. ALONE. Assistive Technology for Older Adults: A Literature Review, 2023. alone.ie

This guide is provided by SmartCare Living for general information and was accurate to the best of our research on 18 June 2026. It is not medical advice. Every person with dementia is different, so please speak to your GP, the Alzheimer Society of Ireland or an occupational therapist about your own situation. SmartGuardian is a home monitoring aid and is not a registered medical device.