Dementia: Loss of Mobility

We see it coming — mother’s loss of mobility.

At first she took smaller and smaller steps. Gradually those steps turned into larger shuffling steps. We bought her a cane, but she did not have the focus to understand how to use it. Little by little the big shuffles turned into tiny ones. She has a walker, which she does not like to use, though when she walks with her caretakers or with one of us, she pushes it along. Once we get her started she can move along slowly.

The Alzheimer’s Society of the United Kingdom has a good fact sheet about the later stages of dementia which also addresses mobility issues.

In her apartment mother will grab onto whatever piece of furniture is nearby. We’ve removed anything that might move when she reaches for it.

When we, her caretakers, and her nurses noticed that she constantly bumped into the coffee table, we removed that. Most of the smaller rugs are gone, but her favorite in the living room is of fairly good size so we thought it would be just fine. However, mother’s shuffles are so small that she almost always gets one foot or the other under the edge. Fairly soon it will also have to go. We find it so difficult to take apart the possessions that she loved so much, though these days she does not seem to notice

We’ve consulted this dementia check list.

Mother’s caretakers make sure that each day the activities include least one walk in addition to walking to meals.These trips, and they are her only exercise, sometimes include a rest stop in the middle.

An interesting mobility test is in pdf from the Society of Hospital Medicine clinical toolbox for geriatric care. The basic test:

Performed with patient wearing regular footwear, using usual walking aid if needed, and sitting back in a
chair with arm rest.
On the word, “Go”, the patient is asked to do the following:
1. Stand up from the arm chair
2. Walk 3 meters (in a line)
3. Turn
4. Walk back to chair
5. Sit down
Time the second effort.
Observe patient for postural stability, steppage, stride length and sway.

Sometimes mother will not want to get up and walk, and we need to get a wheelchair. So far this has only happened on occasional days and never more than once a day. The wheelchair is not in an obvious place so that it only comes out as necessary.

All of us are afraid that even one day of not walking will mean that she forgets how.