Mobility concern

@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

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.

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

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

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.