Losing ability to use hands?

BassetHoundAnn

Here's a question for you folks with a family member with advanced dementia: have you noticed that they've lost the ability to use their hands? 

My mom has arthritis in her hands. She blames the arthritis for not being able to do all sorts of things. But I'm been wondering whether the real problem is that she's losing the cognitive ability to use her hands. 

An example: She is no longer able to turn lamps on and off. I installed large paddle-like switches on the lamps so that she can simply push the paddle with her hand or fist to turn the lamp on and off. No finger dexterity required. I tried to teach her how to do it, but it was as if her hand was unable to accomplish the simple motion of pushing the paddle. 

For about a year she was pulling the lamp cords out of the sockets to turn lamps off, and plugging the lamps back in to turn them on. But I've noticed that lately she has stopped doing even this. 

(I've tried all sorts of other tactics with the lamps. Including linking the lamps to big toggle switches on the walls and posting large signs alerting her to turn the lamps on and off with the wall toggle. I've also rewired lamps with toggle switches in the cords and labeled those. Alas her hands have proved incapable of using those.) 

She can still use a fork and spoon to eat, but the food must be cut into tiny pieces. Even the ice-cream. She can no longer use a butter knife. 

Any thoughts about this? I'm wondering whether the link between her brain and hands is shutting down. 

M1

That's an odd symptom isn't it BHA.  Short of a stroke (which ought to affect one side but not necessarily both) it's hard to imagine this being directly related to the dementia.  I wouldn't think it would affect her arms/hands without also affecting her legs/ability to walk.

My partner has rheumatoid arthritis and it certainly affects her fine motor abilities--opening jars, etc. and I can easily see it affecting normal light switches.  I wonder if it's more a learning issue than anything?  Can she still dress herself, for example?

I also wonder if she might be able to use one of those things you see on television that will turn on lights with a clap of your hands.  But again, I don't know if she could learn to use it at this point.

Always something, isn't it?

harshedbuzz

I saw a significant downturn in dad's fine motor skills as his disease progressed. I think a part of it was related to visual and spatial processing. He unplugged lamps and electronics because it was easier for him to grab the cord than making a couple of attempts at landing on the switch. 

In dad's case, he was still quite ambulatory at the time. But then his disease progression wasn't typical- he was still "conversational" and ambulatory when certain symptoms considered Stage 7 appeared- notably swallowing difficulties.

We also found learning new technology- even if it were simpler device, say a Jitterbug phone or a Flipper Senior TV remote- was beyond him. 

That said, my mom 83, who does not have dementia started to lose the ability to use her hands for fine motor tasks. She's an artist, so her baseline fine motor skills were impressive. I noticed she took almost 5 minutes to button a standard blouse and was unable to work the zippers on jackets. I was concerned enough to ask her PCP about it. While she does have osteoarthritis  and does test positive for rheumatoid factor her rheumo doesn't think she's symptomatic, it felt like something else. PCP turfed her to a hand surgeon who diagnosed her moderate carpal tunnel syndrome with symptoms exacerbated by her tendency to sleep with her wrists bent and tucked under her chin. Think praying mantis-style. He prescribed splints which have helped a great deal. She's down to about a minute to button a shirt and can manage a separating zipper about 50% of the time.

Iris L.

BassetHoundAnn wrote:

. But I'm been wondering whether the real problem is that she's losing the cognitive ability to use her hands. 

This is APRAXIA.  It's one of the characteristics of dementia.

Iris

Jo C.

My mother was initially diagnosed with Alzheimer's Disease; but it was later found she actually had FrontoTemporal Dementia; (FTD),she began to lose use of her hands and then arms and legs which was part of that for some patients.

Scroll down this information from Stanford Universty re loss of motor function:

https://stanfordhealthcare.org/medical-conditions/brain-and-nerves/alzheimers-disease/symptoms.html

Loss of motor function is often seen in FTD and also Lewy Bodies Dementia which is often connected to Parkinson's Disease.

You may want to insist your mother's physician not only check her for other medical caises for this condition, and also to have the dementia specialist confirm actual type of dementia.

J.

Cobalt

My son aged 42 has EO but ALSO some FTD.  Because he had neurological conditions since birth, the doctors were unsurprised when he began to have problems with his hands about 5 years ago, before the Alzheimer's diagnosis.  The neurologist says that his brain is starting to not get good connections with his nerves and sensory information.

Since his condition is progressing with Alzheimer's we are seeing more loss in dexterity in his left hand, which was always "weaker".  There are times we saw him drop a glass or mug from his hands because that left hand would suddenly "let go".

He seems to be having more loss in the use of his hands every few weeks now.  So, my answer to you is that if there is any underlying condition such as arthritis, it is very possible that dexterity is getting worse and she is weaker.  My son will try to do everything with just one hand at this time.

BassetHoundAnn

Thank you to everyone who took so much time to kindly respond. Your answers have given me a great deal to think about. 

Iris...Apraxia! That's it! Bingo! There's a Wikipedia page on it and when I googled the term + dementia I found all sorts of research papers. I recall some of the doctors who've evaluated her having asked her to do some of the movements from the apraxia Tulia screening test. Sometimes she's been able to do the movements, sometimes not. 

Jo C: I've been wondering whether my mom is suffering some vascular dementia in addition to Alzheimer's. She had an MRI which diagnosed a small stroke and cerebral small vessel disease, but her PCP says that at her age nearly all patients have cerebral small vessel disease and have had small strokes. So who knows. But it seems like over the years there have been instances in which her dementia has taken sudden turns for the worse which would point to vascular dementia. 

Harshedbuzz: My mom has things in common with your dad. It seems like her fine motor skills suddenly completely blew up. Her vision is pretty sharp but it seems like her hand is often incapable of landing on things. She'll spot some teensy speck of dirt or lint on the floor that even I can't see, but when she reaches to pick it up she has a hard time landing on it. 

M1: My mom still dresses herself but I think it's very difficult for her to do so. When I'm there she asks me to help her and seems genuinely incapable of dressing herself. She has a host of problems with her hands, including arthritis, carpel tunnel, and false gout, yet I see her flexing her fingers and hands repeatedly and rubbing her thighs in what looks like a nervous tic. 

Cobalt: Thank you for sharing the observations of your son. Gosh that must be so difficult watching him lose his dexterity! The other day a friend said my mom sounded weak on the phone and so I'm wondering whether she's experiencing periods of generalized weakness which is compounding the loss of her dexterity. Tonight she was eating her dinner perfectly well. Picking up food, using utensils, drinking without help. Sometimes her efforts are not so good. They say Alzheimer's sufferers like to fold things like laundry but I haven't seen her fold anything in a year. It's all very perplexing. 

Again, thank you everyone for all your thoughts and insights! They're all very valuable to me! 

Iris L.

BassetHoundAnn wrote:

 Her vision is pretty sharp but it seems like her hand is often incapable of landing on things. She'll spot some teensy speck of dirt or lint on the floor that even I can't see, but when she reaches to pick it up she has a hard time landing on it. 

PWDs also experience visual AGNOSIA, meaning the eyes are good but the part of the brain that interprets what the eyes see is damaged so they really don't see well at all.

Iris

BassetHoundAnn

Iris L. wrote:

BassetHoundAnn wrote:

PWDs also experience visual AGNOSIA, meaning the eyes are good but the part of the brain that interprets what the eyes see is damaged so they really don't see well at all.

Iris

That is a really good point, Iris. Visual agnosia may be part of the problem she's having using her hands. She does suffer some profound visual agnosia. She is unable to identify food and drink in the refrigerator and tosses it all out. She can't identify personal care products like lotions. The other day she asked me whether a picture on the wall is that of her mother. That one mystified me as it's more of an art painting.