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Mom's leg


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Old 04-01-2013, 11:13 AM   #1
ninamarc
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Rehab.

Mom had a trip with my sister and Dad in the past winter in Las Vegas. After that, her left leg felt weak and so she has trouble walking. In March, she went to the physiotherapy, but they pulled her leg and she is now kind of crippled. She cannot go downstairs quickly now in her home. She goes down very slowly holding onto the side. So she quit the therapy. She is seeing rehab doctor today to see what is wrong. It could be that therapy that was too much.
I have one question. Since my sisters suspect my Mom has dementia, how do you know this is not from dementia?
I know my late FIL with AD stopped walking with balance and needed a cane since 2008 and it lasted 3 years until he needed the wheelchair.
There is no diagnosis, so how do I know? It could be just the twist on the leg, or it could be dementia? Now she needs a cane.
Also, my oldest sister bought a hiking cane for her in the web some time ago. Shouldn't Mom use the medical cane from the pharmacy or health store?
Would hiking gears hurt her more? She cannot use the stick nicely now so she decided not to go to church Sunday.

Any thoughts?

Nina

Last edited by ninamarc; 04-03-2013 at 08:58 AM.

 
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Old 04-01-2013, 04:11 PM   #2
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Re: Mom's leg

She will need a medical work up to find out what is going on with her leg. There is no way to tell what it can be from just looking. So it is a good thing that she is going to the doctor to see what is going on. She also needs a diagnosis for her dementia. For without that it is difficult to connect any behavior to dementia. Basically what they do is investigate the possible causes, and if there are no physical reasons for the symptom, then it is probably caused by the dementia. They also look at the stage of the dementia, if the symptoms came on suddenly, and if they last.

As for a cane, it doesn't matter where it comes from as long as it is functional for her. I do know some, especially those that have enjoyed hiking in the past, that use hiking sticks rather than medical canes. It is not what it looks like, or where it comes from, it's the functionality of the cane and how well the patient uses it. As long as the length is right... it is not going to hurt her... and most hiking sticks are adjustable.

Pride does not go away with dementia. It is not unusual for someone with dementia to refuse to go places with canes, walkers, etc. Mom refused to wear her hearing aids. She also refused to let Dad have a wheel chair when in her mid stages. Appearances are important to them. So if she does indeed have dementia, it might just be a matter of pride that Mom doesn't want to be seen by others with the cane/walking stick. Beyond that she may be confused as to why she needs it or how to use it. This is also very common.

At least Mom is headed to the doctor for a check on that leg and hopefully the doctor will be able to give you some guidance. Then you need an appointment to have your Mom tested for her suspected dementia. I say this because it could be a result of one of the many causes that can be fixed. It is better to know

Love, deb

 
Old 04-01-2013, 10:11 PM   #3
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Re: Rehab.

Thanks, Deb!
Well the rehab.doctor thinks it is the nerve from walking too much on the trip. He said stop the therapy and don't walk on pain. Rest and breathe deep for the hip area. Reach the floor. Just 2 exercises. Don't try so hard going downstairs so she won't. Just hope the doctor is right. He said she will get well on this.
She did say she is not used to the cane - not sure how to use it so she prefers to use it at home. But now she seems to get used to it.
About the diagnosis, I am afraid it is not for my family unless they run into the doctor to tell them they get dementia... My sister likes to make a guess out of her professional knowledge (a PhD in medical research.) Mom won't do this MMSE again.
Dad seems to be older but no diagnosis either. Who knows maybe it was accidental that no one put the plug back for the fridge but it had never happened for 10 more years...
The fortunate thing is my parents still sound logical very much unlike my late FIL. So it is tricky.
For many family members, they don't see long-term memory and short-term memory are different... Dad and Mom are OK on long-term memory and even some short-term memory.
Possible it is aging. I just don't think it helps to speculate or guess. Dad and Mom will make a short trip to Asia again for 1 month. It is their hometown place... In the long run, they will be in the States because the family are all here.

But my folks stopped at the GP about the dementia and MMSE. They need to see a specialist.
Guess we just cope with it as things happen.

Hugs,
Nina

Last edited by ninamarc; 04-03-2013 at 08:59 AM.

 
Old 04-02-2013, 08:34 AM   #4
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Re: Mom's leg

Hopefully the leg problems are a result of overuse from the trip and all will be well soon. Time will tell )

A diagnosis is not for your family? What if the cognitive decline is caused by something that can be treated? No, I do not think it helps to speculate or guess. You need to know what is going on. That is why a good diagnosis is needed. Please do not fall into the misconception that cognitive decline is a part of normal aging. It is not. From your statements here, Mom has already had a MMSE. Her refusal to take the test again tells me that she did not do well on the test. Remember that it is not only a memory issue. There is also poor judgement, inappropriate behavior, inability to follow instructions, staring, isolation, depression, loss of empathy, loss of knowledge, compulsive behavior, hording, inability to handle money, difficulties speaking or understanding... and so many other symptoms. If there is cognitive decline present, she may not be able to make the important decision to seek treatment. Then it is up to you, the family, to seek that treatment for her. Trying to play catch up after something happens is not a good.

Please remember that changes in normal routine can cause symptoms to be enhanced. Is someone going with them on their trip?

Love, deb

 
Old 04-02-2013, 09:48 AM   #5
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Re: Mom's leg

Yes, my sister now always flies with them on the same plane (she has some work in Asia too.) My other sister who is there now was the one that went to fix their condo first and found the fridge issue. (Lots of rotten stuff were thrown out and they set up the electronic stuff in the house again.)
Now it takes 2 sisters to deal with this trip annually. We wanted them not to go but they have some stuff in Asia to deal with.
For sure my sisters know that something is wrong. My sister even said they cannot be alone. But they will be home alone for a short time. In the States, they live alone but sisters all live nearby.

The thing is, it is the same for everyone else, the demented elderly won't see the specialist, not my sisters.
Also their GP is very strange: he ignored the MMSE and said no drugs are needed. He didn't even say try to see a specialist. The GP was quiet about it.... Why can't the GPs admit they cannot do it???

Hugs,
Nina

Last edited by ninamarc; 04-02-2013 at 09:49 AM.

 
Old 04-02-2013, 12:53 PM   #6
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Re: Mom's leg

Nina... it's misinformation, lack of knowledge, and denial on the subject of dementia that is the problem. Not only on the part of the doctor's but also on the part of families. Even those that seek diagnosis have a difficult time getting them. But that is no reason not to try when we KNOW something is not right with our loved ones. Because this disease affects all levels of cognition, it is imperative for the safety and well being of the person with dementia and those who come in contact with them.

I wish I knew how many times I have heard or read... "I thought my loved one was ok!"... after a disaster. In the last year... a lady came home from the doctor, wandered away while her son was out picking up her prescription, and was killed when hit by a car on a major 6 lane loop around my city. He though she was ok to be left home alone. Just down the road from me there was a silver alert for a missing man with Alzheimer's. I got the reverse 911 call. He was found 2 days later deceased in the woods a few miles from his house. His crying daughter said she thought he would be ok home alone. Just this week a silver alert was issued in a near by city for a missing lady. She was stopped by police but got out of her car with a gun, started towards officers, and was shot to death! She did have dementia. The family thought she would be ok. A lady ran her car into the front of a local restaurant here. Luckily it was cold weather and nobody was eating in the outside porch area. She had dementia but the family thought she was ok to drive. These are the possibilities... they can and do happen.

There is an interesting law suit that has been filed in California. One of his patients with diagnosed dementia was allowed to continue driving. The doctor didn't notify authorities to her impairments. She drove into the path of oncoming traffic and killed her passenger. The deceased family is suing the doctor for not taking appropriate steps. There have also been law suits against families. Recently a family was found guilty of elder neglect when their demented loved one was injured, at home alone.

Dementia patients, for the most part, do not understand the extent of their impairment. No, they do not want to see a specialist who is going to tell them that they have terminal illness which has no effective treatment. But is it up to them to make the final decision, considering their impaired thinking? A crisis is always just around the corner and why we need to do what needs to be done to keep them safe.

Love, deb

 
Old 04-03-2013, 07:34 AM   #7
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Re: Rehab.

I sometimes think the GPs really are doing it all wrong. How can they tell the family that the person has dementia and yet no diagnosis/typing and tell them the person can drive? How can a doctor think he can replace caregiving? A doctor is not there everyday. If the GP doesn't even understand rehab. about the leg, how can he tell you he will ignore dementia and do nothing?
30 years ago, a GP may not have the understanding or tool to tell the family there is possible diagnosis by the specialist. Today, it has become common knowledge, and yet it requires the GP's personal experience to do the right thing.
It is like cancer, only oncologist can diagnose it. Dementia is the same thing. Just because some dementia are not curable, it doesn't mean the GP should mislead the family.
I strongly feel that my parents' GP misled my sisters and all.
That is why now there is no diagnosis or action for that.

I believe many families are told by the GP like this. Also it is difficult to make the patient see the specialist. If it is up to my sisters, how do they haul her into a place for more tests without any signs of "illness"?
Many people trust GPs so it makes it harder to see what is going on.
In the meantime, it is caregiving that matters. Being with the "demented" persons at all time or most of the time is another alternative.

Hugs,
Nina

Last edited by ninamarc; 04-03-2013 at 08:59 AM.

 
Old 04-03-2013, 09:21 AM   #8
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Re: Mom's leg

I totally agree and why I encourage the family to go to the next step and get the correct diagnosis.

Mom MMSE score was a 24. No problem according to her GP. It had dropped from a 27 a few short months ago. No problem said her GP. But she has this long list of symptoms. The GP said she just needed to concentrate more and it was probably stress. Let's call it depression and give her an anti depressant. It went down hill from there and she overdosed Dad on a new medication landing him in the hospital for a week. Please doctor, I need a referral to a specialist. Doctor didn't think she needed one! I just told him I was taking her with or without a referral.... and that is what has to be done when you suspect something is horribly wrong. Mom did go to the specialist and came away with a diagnosis of moderate to sever dementia consistent with Alzheimer's. Back to her GP with the diagnosis... and his recommendations were to take this pill, go back home, and continue driving. ARGGGGG If I didn't have the knowledge and persistence that I had, if I had listened to the GP, I often wonder what could have happened. That is why I feel it is so important to use my voice to warn, in those mid stages, that the profession information may not be the best.

GPs are not informed relative to this disease. There is no hope they can extend to the patient or the families because it is incurable and untreatable. They do not understand the extent of the symptoms. They do need our help. We have to tell them all of the symptoms we witness and impress on them that these are unusual and problematic. If they do not come on board, find a new doctor who will. I did switch Mom and Dad to a Geriatric GP with extensive knowledge of dementia. Made life a little easier. There is nothing wrong with interviewing a doctor

The ER is another problem. Never ever leave a dementia patient alone in the ER or the hospital. They do not have a clue what to do with a dementia patient. It is so sad to see a nurse grilling a dementia patient over their medical history and medication regime when they don't even know where they are or why they are there. Not to mention the patient is labeled as uncooperative. A good assessment can not be made because the patient can not discuss the symptoms realistically. It can all go bad quickly.

Love, deb

 
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