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Medical Forum / Diseases and Disorders / Alzheimer's / June 2007Alzheimer's and equilibrium
Since my mother has been showing signs of Alzheimer's, she's been experiencing problems with walking and balance. Anyone else have experience with this? > Since my mother has been showing signs of Alzheimer's, she's been > experiencing problems with walking and balance. Anyone else have > experience with this? Yes - I think it's what made the Dowager fall and led directly to my moving her into an ALF. Also, within the past year, she had to be moved into a wheelchair, and, from there, into a reclining wheelchair because she kept feeling as though she were going to fall out of the other one. Or at least, that's how I interpreted the shrieks of fear, which the reclining chair seems to have stifled, at least for now. Baird Yup, totally to be expected, and goes with the territory. AD causes global brain damage, and with that comes loss of muscular coordination - both fine coordination and gross coordination, balance, slowing of reaction time, perception problems (i.e. impaired depth perception). You know that shuffling walk people in later AD get? Its from the disease, not from "old age". A lot of people will get into leaning to the point they fall over, whether on their feet, or in a chair. Ultimately, they lose their ability to walk entirely. My MIL stopped walking about two years before her death in the wake of a fall (she didn't fall over anything, she just stood up from a chair on a carpeted floor and went down like a stone, breaking a hip). In theory, she was healthy enough that once healed, we should have been able to get her back on her feet, but she couldn't cooperate with therapy and her sense of balance was shot - plus being upright made her afraid - so that was the end of that. If your mother is walking at all, I'd strongly recommend having a critical look at the furniture where she lives to reduce falls (i.e. get rid of cords, trip hazards, small rugs, install some grab bars) and putting her in hip guards. You can't be with her every second and she will be more and more prone to falls. M > Since my mother has been showing signs of Alzheimer's, she's been > experiencing problems with walking and balance. Anyone else have > experience with this? Yes. It was the main reason we placed my mother in law in a professional facility (nursing home). She kept falling down. She forgot that she had no balance and would try and get up and walk here or there anyway and fall down again. A couple of her falls were borderline serious. Onetime she fell in the middle of the night and banged her head and cut her leg, while thrashing around trying to get up. It was really and truly hard to deal with. The nursing home gave her something called a "merry walker" which was a contraption essentially like a walker she could also sit in. She couldn't get out of it, and she couldn't fall down, she had to hold onto it and walk around. They would take her on regular assisted walks without the merrie walker every day in an attempt to help her regain some of her ability to walk, but that didn't help at all. Although some patients adapted well to the merrie walkers, she didn't and she ended up in a wheel chair with a big foam cushion called a "lap buddy" across the lap so she wouldn't get up and fall again.  SignatureBest Regards, Evelyn > Since my mother has been showing signs of Alzheimer's, she's been > experiencing problems with walking and balance. Anyone else have > experience with this? Yes. My father, who had vascular dementia, had several very scary falls. They might have been related to repetitive TIA's (mini-strokes) or perhaps to his overall waning lack of balance and coordination. But a couple of them were a direct result of not locking his walker before he sat down, and not checking the lock before he tried to stand. Fortunately, he was quite willing to use a walker for moving around, although he never quite got the hang of the physical therapist's instruction on how to use it to stand. Watching him and trying to help him gain his feet could sometimes be an excrutiating experience. And also fortunately, he was sufficiently impressed by the injuries sustained by another resident of his facility as the result of a fall, that he himself purchased one of those paging devices and kept it close and within reach. However, as we watched his mental capacities begin to zig when they should have zagged, one of the biggest fears I had was that he would have an extremely injurious fall and be unable or unaware of how to call for help. And indeed, the episode which finally put him on the road to the final chapter in his life began with a fall in his apartment, and him paging for help. SignatureA R Pickett aka Woodstock "Sometimes the facts threaten the truth" Amos Oz, prize winning Israeli author Read my book reviews at: http://www.booksnbytes.com/reviews/_idx_ws_all_byauth.html Now blogging! http://www.journalscape.com/woodstock/ Remove lower case "e" to respond > > Since my mother has been showing signs of Alzheimer's, she's been > > experiencing problems with walking and balance. Anyone else have [quoted text clipped - 32 lines] > > Remove lower case "e" to respond Does anyone have any timelines re this balance problem? My husband may have mild/moderate AD and his balance, although somewhat impaired, seems have stabilized. Ironically, it was his balance problems that scared me more than the cognitive issues and pushed me into action. After reading these postings I know it is a matter of time and am wondering how and when to remodel the house (or move) to prevent a bad fall. His sibling is now in the nursing home because of a fall and it is breaking his heart. many thanks for your thoughts >> > Since my mother has been showing signs of Alzheimer's, she's been >> > experiencing problems with walking and balance. Anyone else have [quoted text clipped - 50 lines] > is breaking his heart. > many thanks for your thoughts When it looked like we were going to need to take care of my mother in law, we looked for a house that was all on one floor. We got lucky and found exactly the right one, and just where we wanted to live. There is carpeting in all the living areas, linoleum in the kitchen, and she still fell down a few times. As for a timeline, it is different in each case. My mother in law only started having balance issues late in the game. It was one of the last symptoms for her. The brain is a funny organ, and when it deteriorates it isn't always in exactly the same pattern for every person. If I were you, I'd make sure there were no throw rugs to trip over, and maybe even consider having the bathroom door or other critical doorways made wide enough for a wheel chair. In our case that never became necessary. By the time she needed to be in a wheel chair, she was already deeply into the illness and we were exhausted. We reluctantly placed her in a nursing home near here, and it was the best thing we ever did, both for her and for us at that point. SignatureBest Regards, Evelyn <snip> > Does anyone have any timelines re this balance problem? My husband > may have mild/moderate AD and his balance, although somewhat impaired, [quoted text clipped - 5 lines] > is breaking his heart. > many thanks for your thoughts Now would good. Remember that remodeling and moving both take *time*. In my experience, a change can come on very suddenly (or at least, build up in such small increments which escape daily notice that it _seems_ to happen suddenly). Blessed be, Baird California soup inquired - > Does anyone have any timelines re this balance problem? with my father, it was one of the earliest symptoms. Not falling, but the wavering sense of balance which was quite noticeable and which had us all on edge. As other responses have noted, the deterioration of the various faculties and abilities varies from patient to patient, which is one of the factors which make AD and other types of dementia so variable to deal with. SignatureA R Pickett aka Woodstock "Sometimes the facts threaten the truth" Amos Oz, prize winning Israeli author Read my book reviews at: http://www.booksnbytes.com/reviews/_idx_ws_all_byauth.html Now blogging! http://www.journalscape.com/woodstock/ Remove lower case "e" to respond > Does anyone have any timelines re this balance problem? My husband > may have mild/moderate AD and his balance, although somewhat impaired, [quoted text clipped - 3 lines] > wondering how and when to remodel the house (or move) to prevent a bad > fall. I really dont think thats practical or even possible. The main thing that would prevent falls would be multiple people to help him get out of bed, bath,move around, etc, something you are unlikely to find in a private house. SignatureTumbleweed email replies not necessary but to contact use; tumbleweednews at hotmail dot com > Since my mother has been showing signs of Alzheimer's, she's been > experiencing problems with walking and balance. it's common. some of it may be due to a perception problem --- dark spots are perceived as holes or depressions. read the 36 hour day for a discussion, or check your local library for other books on AD. > Since my mother has been showing signs of Alzheimer's, she's been > experiencing problems with walking and balance. Anyone else have > experience with this? yep, my dad has just started falling over recently. SignatureTumbleweed email replies not necessary but to contact use; tumbleweednews at hotmail dot com Gee, thanks for all the answers! I was relieved to learn that it's a common symptom and that it can occur in either the early or late stages of the disease. I don't have time to answer everyone individually, so let me clarify a few things and add what's happened since my post. Someone mentioned perception problems. I should add that my mother has macular degeneration and is legally blind. However, it hasn't seemed to effect her balance and mobility in the past. Even though I know people mean well when they recommend reading books, there is no way I could read a book right now. If I get a newspaper on Sunday, I can't even read the articles that interest me in a week. I can't read anything when my mother is awake, and by the time she goes to sleep, I'm too tired to read more than a paragraph or two. We went to see her doctor, and he said that her dizziness could be from taking Aricept which she's been on for two months. I've felt all along that her mental state has been getting worse since starting Aricept, so I was glad to take her off it. We also bought one of those four wheel walker things that has handlebars like a bicycle. She can walk right along with that, and it seems enough to keep her on balance. The other thing we're doing is starting physical therapy this week. Last year when she had trouble walking due to muscle atrophy and arthritis, she had physical therapy for about 2 months, and it helped so much she made it through the whole winter without a problem walking. > Gee, thanks for all the answers! I was relieved to learn that it's a > common symptom and that it can occur in either the early or late stages [quoted text clipped - 22 lines] > arthritis, she had physical therapy for about 2 months, and it helped so > much she made it through the whole winter without a problem walking. That's great! My mother in law never managed well with a walker of any kind, and I have heard of others who like her, couldn't learn to use any new thing, so it is a great that your mom is able to manage it! Preserving their ability to move around is important. And strangely enough, Aricept was a fantastic help for my mother in law, so much so, that when we stopped it briefly we called and begged the doctor to please let us put her back on it again. But many people have reported exactly the same thing as you have noticed, so I guess there are just so many variations of this illness that few solid rules apply. Every person seems to have their own set of symptoms and their own timetable. At any rate I am so glad you posted to let us know how it is going. SignatureBest Regards, Evelyn > That's great! My mother in law never managed well with a walker of any > kind, and I have heard of others who like her, couldn't learn to use any new > thing, so it is a great that your mom is able to manage it! Preserving > their ability to move around is important. It might help that my mother has been walking her dog and trying to do some gardening before the dizziness and loss of balance started a couple of weeks ago. Also, whenever we'd go in a store, I'd get her a shopping cart to push around and help her walk even though we didn't need it. > And strangely enough, Aricept was a fantastic help for my mother in law, so > much so, that when we stopped it briefly we called and begged the doctor to > please let us put her back on it again. But many people have reported > exactly the same thing as you have noticed I remember you saying that when I first posted about Aricept around two months ago. From the beginning, it was causing her to believe that things that happened 30-40 years ago were recent events while not doing a thing to improve her short-term memory. It got to the point that she was constantly accusing me of lying whenever I'd say something happened years ago. People told me that was just part of her condition, but she wasn't like that before taking Aricept. I'd rather she didn't remember anything than argue about when things happened and accuse me of lying every time I say something. > Even though I know people mean well when they recommend reading books, > there is no way I could read a book right now. If I get a newspaper on > Sunday, I can't even read the articles that interest me in a week. I > can't read anything when my mother is awake, and by the time she goes to > sleep, I'm too tired to read more than a paragraph or two. if you are *always* that fatigued, your health must already be suffering. for your own sake, get her into a day care program so that you have some recovery time, or get some home care help. you won't be much help to her if you end up seriously ill or disabled. seriously. it's not going to get any better. >> Even though I know people mean well when they recommend reading books, >> there is no way I could read a book right now. If I get a newspaper on [quoted text clipped - 9 lines] > > seriously. it's not going to get any better. Don, He's right you know.... it only gets worse as it goes along. Make your plans early. I waited too long even though everybody told me. SignatureBest Regards, Evelyn > if you are *always* that fatigued, your health must already be > suffering. for your own sake, get her into a day care program so > that you have some recovery time, or get some home care help. you > won't be much help to her if you end up seriously ill or > disabled. Day care would involve driving her 60 miles round-trip a day which is a lot more aggravation than just keeping her at home, and we couldn't afford the gas to do it anyway. I'd like to get someone to stay with her so I can get away once in a while, but we can't afford that either because she gets too much from Social Security to qualify for any assistance. > Day care would involve driving her 60 miles round-trip a day which is a > lot more aggravation than just keeping her at home, and we couldn't > afford the gas to do it anyway. I'd like to get someone to stay with her > so I can get away once in a while, but we can't afford that either > because she gets too much from Social Security to qualify for any > assistance. probably only because she is living with you. given the distance you are from anywhere, you really, really, do need to start looking now for where she will live when you can no longer care for her. notice that i said when, not if, because if you are that isolated you probably will need to place her when she reaches the later stages, unless your entire family wants to pitch in 24/7 to care for her. you will not need to worry about the cost. if she has assetts they will have to be spent down before medicaid picks up the cost of assisted living or nursing home care, and the facility will probably take the entire social security check. remember, it's HER income and assets that control when medicaid kicks in, not yours, AS LONG AS SHE DOESN'T LIVE WITH YOU. Don, having been through this - you have to figure out a plan. You are putting up barriers to help in every direction, mostly because of the way you are looking at the situation. I know this is hard - but if you are on your knees now, imagine what is coming your way. Start shopping around. You need help, and things will get worse and worse - you have to look at every option with an open mind - even moving closer to services and facilities. Have you been in contact with geriatric service and Alzheimer's organizations in your area to find out what is available, and how it can be paid for? As Dennis has said, its her income and assets that matter. She needs you in one piece - and if you run yourself into the ground, destroy your life, health, relationships, career etc. trying to look after her alone, everyone loses - because then the options really are limited. If you got laid up from exhaustion and stress (and it does happen, since you become really vunerable to illness when you are under so much stress), you won't be able to look out for her interests (never mind physically look after her, which I don't necessarily think is your duty - your job is to love her and make sure she gets good care, not do it yourself). Give yourself permission to think creatively about this. M. >> if you are *always* that fatigued, your health must already be >> suffering. for your own sake, get her into a day care program so [quoted text clipped - 8 lines] > because she gets too much from Social Security to qualify for any > assistance. Don, please listen to Mary and to Dennis. We have all been through this with our loved ones. We know how you feel and we know how bad it is going to get. Believe me, we all feel for you. You need to get a plan in place very soon. Consulting an elder law attorney would be very worthwhile, to guide you through the best way to use her assets to get care for her. Ours was worth his weight in gold. He even helped us with the medicaid paperwork. We were both of us so burnt out by then we barely knew our names anymore. SignatureBest Regards, Evelyn >>> if you are *always* that fatigued, your health must already be >>> suffering. for your own sake, get her into a day care program so [quoted text clipped - 18 lines] > worth his weight in gold. He even helped us with the medicaid paperwork. > We were both of us so burnt out by then we barely knew our names anymore. I'm going to second the elder law attorney advice. My MIL was so exhausted she had no idea what the next step was, much less how to go about taking it - and the doctor was refusing to release my FIL back to her care - only to a nursing home (the greatest kindness this doc ever did - before the hospitalization, he was denying my FIL had progressed as far as she had been reporting). The attorney, helped them know their rights with the nursing home applications and placement and how to deal with Medicare and Medicaid (plus filled out all the applications), how to shelter money they'd put aside for the care of a disabled child which they had not put in a trust so was technically still part of their assets, POA's,.... I can't stress how much having knowledgeable legal advice will help you to get a clearer handle on the whole picture. My MIL wound up driving 30 miles each way to see my FIL once he was moved into the second nursing home (not a good fit at the first one). Sometimes we have to stretch a bit to get the right services for our loved one. Mom insisted on taking care of her husband at home. And his kind of dementia left him prone to angry outbreaks when he didn't get his way on things - including driving. She took major risks with their own safety, and the safety of the public because she loved this man and wanted to respect his wishes, and their own code of being self reliant. It all blew up in her face. She wound up having to place him in a facility with the first opening. It was a place with a fantastic reputation, clean looking and happy atmosphere. But they were terrible at keeping FIL's depression and antipsychotic medications on schedule - important to avoid outbursts. Well, they wound up refusing to keep him (because of a couple of incidents), and he spent 6 weeks on a psych ward (5 longer than needed) because my MIL thought the social worker was looking for a new place for him, and the social worker thought my MIL was doing the searching. Things aren't 'normal' and you can't keep going on as if her illness were one where you can juggle everything. Dementia patients need frequent mental stimulation (games, dolls, activities) or the brain seeks to fill that void, like having delusions, reliving old memories, or even shuts down (sleeping). Its so exhausting for a single person to do all this - which is why the day programs are important. Is there a senior companionship program in your area? The senior center in our little town runs a day program (healthy seniors helping less healthy ones), but will send people to your home if your loved one cannot get out. How about thru a place of worship? My MIL learned the hard way, sometimes you have to go outside your comfort level to do the right thing for your loved one. And the right thing may be the one thing you thought you'd never do,. Even something you swore you'd never do. A sign of being stressed and depressed is only seeing the negatives and barriers of a situation, and not seeing options and possibilities. Before things get worse for you, please start exploring placement options. Please don't wait until you both are in a crisis situation. Look for help on an immediate basis, and one for long term. There is only so much a single person can do on their own. It takes a whole village to raise a child, and senility is second childhood but with many more medical issues. Adelle don wrote in part - I'd like to get someone to stay with her > so I can get away once in a while, but we can't afford that either > because she gets too much from Social Security to qualify for any > assistance. What everyone else said - - And to repeat what I posted on this group a few months ago - an attorney skilled in elder law and eldercare issues is not a cheap alternative, but virturally all the time is the best possible use of your funds (or your mother's) This is an area of financial planning full of traps for the unwary, but still holding the best possible hope for a manageable financial and caretaking situation. To quote from Adelle's reply - "A sign of being stressed and depressed is only seeing the negatives and barriers of a situation, and not seeing options and possibilities. Before things get worse for you, please start exploring placement options" The comments you have heard here may seem quite harsh and unfeeling, yet virtually everyone has walked down the road you are on, or on a road very similar to yours in a great many ways. What your mother needs most of all is a loving, healthy, RESTED, informed son to provide the best possible care for her in the extraordinarily difficult situation you and she are in. Turning aside suggestions from those who have been there, and playing a game of "yes, but" will only delay the days when your mother will have what she needs. Read all the responses again, and think about what everyone has said. Stay in touch, and vent here as often as you need to. This is a very safe place to let off steam, and a marvelous source of truly valuable advice. Stick around, everyone understands, the way others cannot, and truly want to help. SignatureA R Pickett aka Woodstock "Sometimes the facts threaten the truth" Amos Oz, prize winning Israeli author Read my book reviews at: http://www.booksnbytes.com/reviews/_idx_ws_all_byauth.html Now blogging! http://www.journalscape.com/woodstock/ Remove lower case "e" to respond |
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