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 Falls/leaning 
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Joined: Thu Aug 30, 2007 6:15 pm
Posts: 231
Location: Charlotte, NC
Post Falls/leaning
I have done a search on this topic and am wondering if anyone has any words of wisdom on this subject. Tony has fallen twice this week and is leaning to the right severly. Also, falls trying to get up. I have been speaking with the facility about my options on this, other than for them to watch him (and others) more closely. He is safest in his recliner, but not allowed in the TV room for safety (?) reasons. Would a wheel chair help this? I know when my Mother (alz) had this problem they put her in a wheel chair, wheeled her up under a table and locked it. She was very slight and not strong, but Tony is small but strong. I prop him up with pillows. Any advice?? Therapy is going to work on this but I don't hold out much hope with them. I really get more useful info from this site.


Fri Nov 13, 2009 9:20 am
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Joined: Fri Aug 11, 2006 1:46 pm
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Location: SF Bay Area (Northern CA)
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Having someone in a wheelchair, assuming he stays put, is certainly the best way to guarantee he doesn't fall.

Many with dementia who are still capable of walking must be closely monitored.


Fri Nov 13, 2009 10:48 am
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Joined: Thu Aug 30, 2007 6:15 pm
Posts: 231
Location: Charlotte, NC
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That is the problem...he can still walk...but must be assisted due to his lack of balance and lean...he just doesn't understand that. I guess putting him in a wheel chair will be coming shortly. I am resisting because I know they will never walk him and his stiffness from parkinson will just get worse. Seems to be no answer for this. Thanks for your input.


Fri Nov 13, 2009 11:15 am
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Joined: Sat Mar 28, 2009 6:01 pm
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My husband has the same problem. We have to watch that he doesn't get up by himself, but only with someone to help him (a helper or me, as I am caring for him at home.) He needs help both from a chair and from the bed. Once he is up, sometimes he is strong enough to move with a walker, but if not, we put him in the wheelchair and move him.

So far he can walk a little due, I think, because my helper does a series of exercises with him every day for an hour or more. That helps strengthen the connection he needs to make from his brain to his legs. He enjoys doing the daily drills because he can do them, with help, and because it is a social experience. My helper talks to him about every move with explicit directions of what to move and how.

We are trying to keep him in this condition, without falling, so it means constant vigilance. What else is caretaking anyway?

Hope this helps,

Doris

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Bay Area, CA


Fri Nov 13, 2009 6:29 pm
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Joined: Thu Aug 30, 2007 6:15 pm
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Location: Charlotte, NC
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The "constant vigilence" is what is missing at the facility...I have made so much noise over there this week that they are doing better...for now.


Sat Nov 14, 2009 10:07 am
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Joined: Thu Sep 10, 2009 2:29 pm
Posts: 68
Location: Marco Island, FL
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Doris, I'm in exactly the same position with my Bob. He can't transition anywhere, from bed to feet, from toilet to walker or from walker to chair without my being right there. We're using a lightweight wheelchair now for going out, and it's a wonderful tool.

It's so much harder when they're in a facility. Nobody cares like you do! Still, keep after them because falling should not be tolerated--nor should not getting the excercise they need.

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JoAnn

"It's not what you look at that matters, it's what you see.".....Thoreau


Mon Nov 16, 2009 8:56 am
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Joined: Sat Jul 19, 2008 10:29 am
Posts: 126
Location: Italy and Toronto (Canada)
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We had the same problem with Dad (in a facility). Up until April of last year, he was walking by himself, but had little balance and his falls were becoming more frequent. We realized with time that in a nursing home, there is no way that they can watch out for falls before they happen. Despite our continous coaching and instructions, Dad would always get up in the middle of the night without asking for assistance and he would invariably fall.

Restraints are prohibited, even light restraints in bed. Could not even install bed rails (considered dangerous). Therefore, we ended up getting him a wheelchair that is made to his measurements with air-cushion seats, neck rest, all the bells and whistles. There is a seat belt which he can open but as a final measure, we have a slide-in table for the wheelchair which he cannot remove on his own. This table is the only thing that keeps him from getting up without asking for help.
However, we figured we cannot let him sit in the chair all day. Therefore, apart from the usual scheduled physiotherapy (three times a week) and group exercise, we have hired a private caregiver who gets him up and walking for one hour a day.

In addition, the nursing home has recently provided a hi-lo bed which is kept in the lowest possible position and there are mattresses on the floor around his bed, so that if he does get up in the middle of the night, he still has to negotiate the partial bed-rails and if he still manages to get out of bed, he will fall from a very short height unto mattresses on the floor. Meanwhile, the bed alarm will go off as soon as his weight is off the bed and hopefully the staff will hear it and arrive to give him help.

In this way, we are trying to keep him safe from falls and implement movement and exercise into his daily regimen. I hope these ideas can help you too.

All the best,
Shomy (SS)


Mon Nov 16, 2009 10:18 am
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Joined: Sun Oct 21, 2007 4:18 pm
Posts: 835
Location: Acton, MA
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Frank just spent 10 days at a rehab/NH and it was an eye opener. In the end, we may have no choice, but I will try to keep him home and hire help if necessary. He was not with it so not steady on his feet. On a good day PT worked with him for a hour, the other 23 hrs he sat in a chair, at the nurses station, because when they put him to bed, he'd tried to get up. When my daughters came in we would walk him and throw a ball, anything to engage him, a few days he was steady enought that I was able to walk him alone. I stayed with him 10-11 hrs so I would know what was happening, pretty much, nothing.
What a miracle if you do find a good fit, as some here have done.

Take Care, Gerry


Mon Nov 16, 2009 12:41 pm
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Joined: Thu Aug 30, 2007 6:15 pm
Posts: 231
Location: Charlotte, NC
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With three falls in a week, Tony is now in a wheel chair...a big contraption with leg rest, etc. Can be set up to sit like a recliner. I will get him out when I am there every afternoon and walk him around. His knees, ankles etc are getting very stiff, actually "cracking sound" when I move them. Very sad for me but I have to keep him "safe"...I was concerned that a broken hip would be next. Now we just have to keep him in the wheelchair.


Wed Nov 18, 2009 12:26 pm
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Joined: Sat Mar 28, 2009 6:01 pm
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I'm sorry to hear that Tony is now confined to a wheelchair. I am also a little worried that you are going to help him get up and walk. If he is that unsteady, you may need to have someone with you on his other side. Otherwise, should he lose his balance, he could pull you both down, and you might be really hurt. That has already happened to me, and so now I am super careful to have help or at least have the walker there for him to lean on. Sometimes I have to move it for him, and walking goes very slowly, but it is more safe. Who knew that we would have to be the crutches for our once strong spouses?

Doris

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Thu Nov 19, 2009 1:36 am
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Joined: Thu Sep 10, 2009 2:29 pm
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Location: Marco Island, FL
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Also sorry also about Tony, but safety must come first. Doris, you are right about the falls, I've fallen with Bob twice, and am now very, very careful. Before he was quite so bad, when he was still doing most things by himself, Bob fell on his face quite a few times and we were in the emergency room every few weeks for stitches or scans. This is over a period of two years when we still didn't understand quite what was happening! Now I'm there for every transition from chair to walker, and walk with him, too. I can see it will take two people or a wheel chair soon. He's not tall, and he's losing weight and most of his tough guy muscle mass is gone, so it's getting a little easier to balance him, too.

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JoAnn

"It's not what you look at that matters, it's what you see.".....Thoreau


Thu Nov 19, 2009 8:19 am
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Joined: Thu Aug 30, 2007 6:15 pm
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Location: Charlotte, NC
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I have help when getting him up and I always walk him where there are aids within shouting distance. Do not attempt to get him up from shower chair by myself...was doing it myself until a month ago...pulling up his clothes etc. He leans very badly to the right so I walk on his right side with arm around his waist and holding his hand. I had therapy in to evaluate the best technique. The staff is putting him in his recliner after lunch, turning on his TV (white noise) and he naps a little. So he is not in the chair all day. Just very sad for me to see...this sailor, marathon runner all around athlete in this condition....just progression of the disease that I hate!!! Nancy


Thu Nov 19, 2009 10:46 am
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Joined: Sat Jul 19, 2008 10:29 am
Posts: 126
Location: Italy and Toronto (Canada)
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From personal experience, I strongly recommend that you use a walker (the ones that have a little seat) when taking him for his walks. They really help keep him and you safe. With Dad, once in a while, he just feels weak and tends to collapse in a heap and at that point, we just swing the walker around and he just ends up sitting on the little seat rather than falling to the floor. You would be surprised how difficult it is to hold up a person (even a small person) when their legs just give out from under them.

Plus, the walker helps to keep his balance and it allows him to walk for longer periods.

Shomy (SS)


Thu Nov 19, 2009 11:15 am
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Joined: Sun Jan 11, 2009 8:17 pm
Posts: 104
Location: Arkansas
Post falls
I thought I'd post an update on my mom. She has been off exelon for a couple of weeks and now up to 10 mg namenda 2x a day. The constant fainting stopped somewhat but the strong jerks took over so her legs buckle if she tries to walk. The jerks made it very hard to feed herself but she resist our help most of the time. Her dementia and hallucinations are about the same. I have notice somewhat of a pattern; restless,wild talking all night and day,then sleeps for 24 or more hours, then to a couple of "normal" days and nights, then it starts all over. The VA nurse ordered oxygen as mom oxygen level was down to 75% and she held her chest in a arch out way. She slept for 36 hrs. after the oxygen and she is alot more relaxed. I've cut back to 1 trazadone at night only when needed. When ones mention that their LO don't walk anymore is that because they don't want to try or is it because they collaspe after a few steps? Mom still wants to try all the time but hasn't walk more than 5 ft. or so in the last month.


Mon Nov 23, 2009 12:17 am
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Joined: Thu Aug 30, 2007 6:15 pm
Posts: 231
Location: Charlotte, NC
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Tony can walk really well, it is the leaning that messes up the balance and he falls. The other day, his legs gave out on him when I was walking him to his recliner and he went down. I was holding him so I just hauled him back up. He can walk for 30+ min. in the afternoon but I hold on to him. I tried a walker but he could not figure it out. The falls are the reason for the wheelchair. I am also able now to get him outside for a stroll in the fresh air in his chair. Maybe I will loose some of this lewy weight I have put on!!!


Mon Nov 23, 2009 11:46 am
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