Supporting safe walking and managing missing incidents in dementia: a qualitative narrative synthesis of current evidence.

BACKGROUND: People with dementia are at risk of going missing while walking outdoors, which can significantly affect their safety and well-being. However, evidence on their lived experiences during such incidents, as well as on strategies that may improve care remain limited. AIM: To conduct a narrative synthesis of qualitative studies exploring the lived experiences and preferences of people with dementia, family carers and professionals in relation to strategies for supporting safe walking and preventing missing episodes in both community and residential care settings. METHODS: Four electronic databases (Medline, Embase, PsycINFO and CINAHL) were systematically searched up to April 2025. Studies were appraised using the Critical Appraisal Skills Programme qualitative research checklist. A narrative synthesis framework was adapted to explore themes emerging within and among studies. RESULTS: Of the 19 207 articles identified, 25 met the inclusion criteria. Four themes emerged: (a) emotional impact of missing episodes, (b) safe walking as a fundamental need for people with dementia, (c) existing strategies for safe walking and responding to missing episodes and (d) experiences of using technological solutions to prevent and manage missing incidents. CONCLUSIONS: Preventive and reactive strategies, including technological devices, can promote safe walking for people with dementia. There is an urgent need to embed safe walking plans within dementia care packages to mitigate harms associated with missing incidents. Initiatives that raise awareness of risk among people with dementia, carers and professionals should form a core component of clinical practice.