Vicki123 Asked August 2016
How likely is in that Mom with dementia and Alzheimer's will walk again?
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After breaking her arm in June and then suffering double pneumonia, Mom is under hospice care. Now in adult foster care, she is totally dependent on her care taker. Is this part of the disease?
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My cousin has severe dementia and after a fall that fractured her spine, she went to a wheelchair. She had other fractures too, but, for over a year she was barely able to transfer out of the chair with the aid of another. Then, about 7 months ago, she started getting out of the chair without aid and falling down. She fractured both shoulders doing that and we had to put an alarm on her bed and wheelchair.
Last week, I saw her transfer quite well from her wheelchair to a sofa. I was shocked. She has little other ability though and needs all things to be done for her. From what I understand, her abilities fluctuate daily.
I think it's very difficult to predict how their physical abilities will progress or decline. I've just learned to expect the unexpected.
To be on hospice, a doctor has signed a statement to the effect that most people in the person's situation, with similar symptoms, stage of disease, will not live more than 6 months. Hospice care is intended to keep them pain-free and comfortable and engaged to the extent they can be. Typically hospice care does not involve any therapy or treatments intended to cure.
Those 6-month prognoses are obviously not always applicable to the given individual.
Ask about PT for your mother. It may or may not be possible under hospice. If she does improve and get discharged from the program PT may be appropriate then.
No amount of PT is going to allow my mother to walk again, but that is because of the nature of the break in her hip, not because of her dementia. She has had some PT since leaving hospice care, for her arms and upper body, to ensure she can continue to feed herself, etc. She is wheel-chair bound, but she participates in activities, socializes, enjoys meals, etc. At 96 she is content with her situation.
Vicki, yes, it is very, very sad to see our loved ones so weak and dependent. It is possible that your mother will get stronger, but that isn't the typical path at this point.
My Mom developed severe dementia after a serious head trauma due to a fall. She was 97 at the time. She went into rehab and they tried to get her to stand and walk. Sadly she was unable to do either. For some reason Mom would still try to stand up and walk, only to fall. I believe if she was much younger maybe, just maybe, the brain would have healed itself enough for her to become mobile.
You are right, it is sad to see this happening especially to someone, who like my Mom who use to walk 2 miles per days up into her early 90's, along with my Dad.
As to if she will walk again..it depends on how determined she is and how determined you are to help her. And this is the biggie...is it safe for her to walk again. If she is a fall risk maybe she is better off not walking, broken wrist is one thing broken hip another.
Usually if an arm is immobile for 2 or more weeks, the muscles clamp tight, thus making it almost impossible to use that arm.... and it can throw one's balance off as you can't use that arm to help with the balance. It can take several months of physical therapy three times a week to stretch and stretch those arm muscles but it also can be very painful.
I would also look into a "sit-to-stand lift". These also help a person stand up from a sitting position but have a sling that gives total access to the waist/bottom area allowing toileting to be done in a natural way. It also helps keep up the persons leg and arm strength.
Finally if your loved one is bed bound I recommend looking into a Hoyer lift (electric if at all possible as that is much easier on the elderly person and on the caregiver and gives the caregiver much more flexibility on where they can stand and how they can help the elderly person when lifting or laying them down). If you go to the doctor and Medicare they will give you a cheap sling with mesh and metal bars, hooks and chains which is horrible. Please ask for or look into a "hygiene" sling and make sure you get a cloth one with cloth straps. This is U-shaped and allows easy access to the rear-end. With my mom this allowed us to lift her off the bed and put her over the commode, then easily remove the dirty brief and lower her onto the commode, then when she was done we would lift her up, clean her and move her back over the bed where we had already laid out the brief, lower her onto the brief, easily remove the sling and finish with her brief. Thus we did not have to roll her over on her side multiple times like one would have to do with the "conventional" sling thus making the toileting process easier for her and us and making it as much as possible a "normal" toileting process thus helping to preserve her dignity. I hope these comments help. God bless you for caring for your loved one.
Take care and God bless