Shuffling of the feet in a person with Alzheimer's or dementia typically occurs in the moderate to severe to later stages of the disease.

Shuffling is a common cause of falls in affected people because sliding feet can more easily trip on rugs, door thresholds or even slightly uneven surfaces. Your grandmother may be experiencing a fear of falling because of some depth perception or orientation issues, so her shuffling gives her a little more confidence in walking.

However, shuffling of the feet usually occurs with the loss of muscular coordination as the part of the brain governing these motor skills is being affected by the disease. Simply, the brain and body are not communicating, and thus the affected person has difficulty picking up his or her feet to walk and may be unsteady or begin to stoop.

It is important for your grandmother to wear shoes that fit well and that have soles that are neither too slick nor too rigid. Some tennis shoes can be the culprit of falls because the person can't sufficiently lift his or her feet, causing a fall because of the heavy treads in the shoe.

Teepa Snow, a noted occupational therapist and national dementia expert, describes a practice for people with Alzheimer's disease or dementia who shuffle their feet and are at greater risk for falls:

As your grandmother is walking, walk beside her, placing your arm around her and joining her hip to hip. Next, sing a song with a good tempo, one that she knows and that she can sing along, too. For instance, "Row, Row, Row Your boat" is an excellent choice and one that she should know well. As you both are singing, rock sideways back and forth.

This will give your grandmother the opportunity to pick up her feet and move forward, hardly realizing that she is not shuffling her feet anymore. The rocking motion will make her pick up her feet, reducing the risk of a fall. She'll also enjoy the singing and her self-esteem will increase from the success of getting from one point to another with greater ease.

If your grandmother is consistently shuffling when she walks, it would be a good idea to get her fitted with a walker or a cane. These devices can give her added confidence and support. She may resist the use of a walker at first, but once she gets used to walking with it and feels it gives her greater balance and control in walking, she will welcome its use.

That being said, because of the disease process, you may have to remind her repeatedly to use it as she likely will forget. Keep it in a place where she can see it so she has easy access to it. You also will want to remove anything in her home that might cause her to fall, such as throw rugs and any clutter in the house or, more specifically, the pathways she follows throughout her home.

Always check with her physician about her shuffling as you want to make sure it is part of the disease process and not a result of medication changes or something else that is treatable. Additionally, try to keep your grandmother moving and exercising as the shuffling might cause her to give up walking completely.

Questions about Alzheimer's disease or a related disorder can be sent to Dana Territo, the Memory Whisperer, director of services at Alzheimer's Services of the Capital Area at or visit the organization at 3772 North Blvd., Baton Rouge.