Mobility concern

vhthomas

Hello everyone. My mother is 75 years old and was diagnosed with Alzheimer’s and vascular dementia officially in 2020. Lately, my mom has been needing more help with walking around the house. Last week, she fell in the bathroom; she was looking in the mirror and just fell backwards. I’ve also noticed that she leans to her left side when sitting. Tonight, as I was helping her out the bathroom, she could barely keep her legs straight and fell to her knees before I could get her in the bed.

My question is, what are the signs that she may have mobility issues where she can no longer walk? Any suggestions would be helpful. Thank you.

harshedbuzz

@vhthomas

It's hard to say. Where would you say she is in terms of staging?

Difficulty with coordination/motor-planning often starts in stage 5ish and fall risk increases in stage 6. If the onset has been gradual, progression may be what you're seeing. Some caregivers start using a wheelchair for safety reasons around this time. Dad was given a walker, but given his poor short term memory and anosognosia, he didn't use it consistently and being reminded triggered agitation. A transport chair was simpler.

If onset seems sudden, she should probably be check out by her PCP. A number of caregivers report that physical weakness and lack of coordination can be a symptom of infection. It is fairly common with an otherwise silent UTI and I know folks whose LO had this happen with respiratory infections. The PCP can also R/O a drop in BP. Dad's formerly elevated BP dropped as his dementia progressed. In late stage 5, he had some falls and his PCP lowered the dose of his BP med. By mid-stage 6, he'd lost considerable weight and his BP dropped further and his PCP took him off his BP med.

HB

mommyandme (m&m)

Possibly a walker with a seat? My mom used a walker but when her episodes of syncope started the walker couldn’t help. They would usually happen when she felt some sort of stress or from standing too long, meaning too long for her which wasn’t necessarily too long. Sometimes after she’d get up from the toilet and stand in front of the sink it’d happen. I thought maybe her circulation got disrupted from the seat pushing behind her legs for too long. This was not a “head rush” thing, just saying. I was mostly aware of possible triggers so I learned to be proactive to help alleviate those instances. Mom was well into 24/7 supervision when this started. Your mom may need 24/7 now? Taking her BP and Pulse/ox helped to know what was going on in an episode. Getting a transport chair was a big help. We started to only use the walker to help her stand and pivot to her next seat.

If your mom doesn’t have a silent UTI or some inner ear problem or another infection or virus I’d say it may be time to look at it as she lost some ambulation. If so, I know it’s hard to watch and accept the milestones of decline, I’m really sorry.

vhthomas

https://alzconnected.org/discussion/comment/196210#Comment_196210

Yes, Mom has had 24/7 care since May of last year. Thank you for your suggestion regarding the seat walker. I will look into that now.

eaglemom

I was going to suggest you look into a seat walker also. Very easy to "move" her throughout the house when she's seated on it. Make certain to get one that has locking brakes. That way when your helping her stand the walker is secure behind her.

eagle

vhthomas

https://alzconnected.org/discussion/comment/196191#Comment_196191

Hey. Yes, Mom is probably in stage six. She was diagnosed with a bladder infection Friday so yesterday she had a full twenty-four of antibiotics in her system.

I’m going to look into getting her a seat walker that will help the days when she is weak or is experiencing mobility issues.

Thanks!

vhthomas

https://alzconnected.org/discussion/comment/196218#Comment_196218

Yes, you are the third person who has suggested this. I will work on it. Thank you for your response.

BassetHoundAnn

My mom started falling when she was in Stage 5 about 4 years ago. She'd be standing at the sink and suddenly would topple over. She would stand up from the dining table and fall over. She would be walking along and would go down. She would typically have one fall a day. This lasted for many years. It was only recently that she lost all ability to walk. A few months ago she was still occasionally walking the halls of her memory care with her walker.

We got her a walker and a wheelchair about 3 years ago, but she refused to use them. With the walker she would forget to use it. In spite of lots of PT sessions and daily reminders and signs, etc. she often could not remember what the walker was or what it was for. She outright refused to use the wheelchair and would push it out of her room. Aids in her memory care have been very persistent in the last year about keeping an eye on her and insisting that she use the walker or else they put her in a wheelchair.

She recently graduated to a Broda chair which tips her back, making it difficult for her to bolt out of the chair and fall, and supports her so that she can sit upright and won't slide out of the chair.

At one point she was diagnosed via CT scan with low-pressure hydrocephalus which can cause balance problems. We decided not to pursue having a shunt put in, which can restore balance, because of her late age and dementia.

For my mom, losing her ability to walk has been a long progression since the falls started 4 years ago.

The most dangerous times for her fall-wise are when she wakes up at night and wants to go the bathroom. There is now a cushioned fall mat beside her bed in case she tumbles.

mommyandme (m&m)

https://alzconnected.org/discussion/comment/196217#Comment_196217

I want to mention that mom’s walker with a seat was a hand me down from her own mother. It was a little old/outdated to say the least. it was a bit difficult for mom to use because it was kind of narrow, therefore she couldn’t walk naturally or she’d hit the wheels with her toes, if that makes sense. That was early in her diagnosis. She also couldn’t figure out the brakes. She was more comfortable throughout her journey with the regular bland metal one that you put tennis balls on to scoot around with.

Just saying this to emphasize one size does not fit all. I took mom to shop for wheelchairs cause comfort was so important to her. You might want to try some out if your mom is agreeable to that.

Hope you find a solution soon.

Quilting brings calm

My mom has a rollator( the walkers with the seat, four wheels and brakes). Although they are common among older people due to the seat and the storage underneath, physical therapists don’t really like them. They can roll away from the person if the brake isn’t set ( or working properly). Mom has fallen multiple times recently while leaning over to get her shoes or after getting out of bed and the walker is ‘next to her’. I’d suggest the standard walker with the tennis balls. The tennis balls protect your floors. You can find tennis balls in pet supply aisles. You can order pretty bags/purses that will strap onto the front of the walker.

vhthomas

https://alzconnected.org/discussion/comment/196225#Comment_196225

Thanks for sharing your experience. I’m going to look into getting her a seated walker and see how that works.

harshedbuzz

@vhthomas

Keep an eye on the UTI. If it's deeply entrenched or she was prescribed the wrong abx because the culture results aren't back, it could be a couple day for her to return to a baseline.

People here seem to be very attuned to UTIs. I was not because dad didn't get them, so imagine my surprise when I took mom in the ER with sky-high BP, rapid HR, borderline O2 and change of mental status. It took her several days for mom, who doesn't have dementia, to return to her normal and the culture indicated she'd been on the appropriate abx.

HB

SusanB-dil

Hi vhthomas - mil also has Vasc + alz. She has had 2 rather serious strokes, but also will have a 'tia' on occassion, similar to a mini-stroke. Do check for UTI, but 'leaning to one side', could also indicate a tia or small stroke. We can sometimes tell because she will have another 'step down', or yes, will slightly lean to one side for a few days.

MIL also has some trouble getting around, and has fallen a few times. Absolutely refuses to use even a cane, let alone a walker, since she has anosognosia. "There's nothing wrong, so I don't need that and it makes me look old". uuughh! And yet, she will 'furniture walk', hanging onto various things until she gets to her usual chair. It is usually worse in the morning.

vhthomas

https://alzconnected.org/discussion/comment/196295#Comment_196295

Thank you. It was indeed a UTI infection and she has bounced back from it.

mommyandme (m&m)

https://alzconnected.org/discussion/comment/198772#Comment_198772

Great news!

H1235

If I remember right mom’s doctor wrote a prescription for a walker and I think it was covered by Medicare. Something you might want to look into.