Sudden loss of walking

[Apli]

Evening all

I have only discovered this site today. My Grandmother was diagnosed with dementia ten months ago. Unfortunately on Monday she was admitted to hospital after having a small 'fall'/'tumble' at home. We called the ambulance because she could not walk.

Prior to the fall she was never 100% mobile. She has arthritis in multiple areas of her body and restricted mobility. It was so sad whilst visiting her in hospital as she was clearly confused regarding the environment and hallucinating. I have never seen her so confused as I did this week.

The most worrying thing for me is the hospital has still not found a way to get her walking. We tried shortly this afternoon but she complains that her feet/legs have no strength in them and she feels dizzy. It looks like she is very fearful of falling.

It still has not quite sunk in that she may not ever walk again. Monday morning with the aid of a walking frame she was able to walk around her house, go upstairs (with a stair lift) use the toilet etc. Now we as a family are preparing for the fact she will be in a bed for the remainder of her life..

Naturally I am devastated. She has one carer at the moment that comes twice a day (morning and night) to help aid her in and out of bed, and make breakfast.

Any input or comments would be greatly appreciated. I pray to God that she will be able to walk again it is so sudden and I am so upset for her. She will be 79 in August

Thank you for reading

 

[matchstick]

Hi,and welcome to Talking Point,sorry you had to find us,but welcome..my 1st reaction was to reading your post was UTI,Urinary Tract Infection which can cause all things you describe,UTI's can cause untold mayhem.It can be dealt with by antibiotics,others will be along with more thoughts soon.

 

[Grannie G]

Hello Apli

Your grandmother might walk again, perhaps she is still in shock after her fall.

I wonder if the hospital could arrange for a physiotherapist to see her. There might be something physiotherapy could do to help regain her confidence.

 

[jenniferpa]

I'm assuming they have ruled out not just hip fractures, but pelvic fractures which are much harder to diagnose. My mother was hospitalized 3 times before they found hers...

 

[Apli]

Hi,and welcome to Talking Point,sorry you had to find us,but welcome..my 1st reaction was to reading your post was UTI,Urinary Tract Infection which can cause all things you describe,UTI's can cause untold mayhem.It can be dealt with by antibiotics,others will be along with more thoughts soon.

Thank you so much for the reply. As far as I am aware the hospital have ruled out any water/urine infection. I will double check with the doctor tomorrow to ensure that this is 100% the case.

Your grandmother might walk again, perhaps she is still in shock after her fall.

I wonder if the hospital could arrange for a physiotherapist to see her. There might be something physiotherapy could do to help regain her confidence.

Thank you so much for the reply. The physios have been to see her. The problem is they are clearly understaffed at the hospital and I do understand the situation. The physios will come along at any time between 9-5pm. As soon as my grandmother refuses to walk they are moving onto the next patient. She will need more encouragement I think.

One thing I failed to mention in the first post was her short-term memory is almost non-existant (and this was prior to the fall). I have started to read resources through this website and it is really scaring me regarding the progression of alzheimers and what to expect in the future.

 

[Apli]

I'm assuming they have ruled out not just hip fractures, but pelvic fractures which are much harder to diagnose. My mother was hospitalized 3 times before they found hers...

Hi - thank you for the suggestion. As far as I am aware they have only 'scanned' her legs/knees. I will get this double checked with the duty nurse tomorrow morning. I am sorry to her about your mothers fracture I hope she has recovered

One major concern is this morning the Hospital were ready to discharge my grandmother. They justified it based on the fact medically there is 'nothing wrong with her'. When we asked them how she would go to the toilet, have a shower and carry out basic day-to-day tasks they were unsure. Offering an additional two carers.

I am very keen to exhaust the phsyio route to get her walking again.

 

[FifiMo]

Apli,

Don't let the hospital discharge your grandmother without having a needs assessment done. This should involve her being taken home by occupational therapists who will consider what needs to happen in order for her to go back to her old home. Even once this assessment has been carried out insist that any changes to her current arrangements are put in place before she is discharged! They have a legal obligation to do this so it might help if you let them know that you know this! It might be useful if you as a family consider and make a list of what you think would need to be done before she was allowed to go home. For example, does she have a wheelchair? Wheelchair ramp into her home? Would it help if she had a commode for downstairs? How do they think that she is going to be moved? Will she need a hoist? Is she at increased risk of thinking she can still walk and trying to get up if she is on her own? Does she have a careline phone in her house where she can press a button worn round her neck in order to get assistance? How would she get up the stairs? Where would she sleep?

I think it's a nonsense them trying to send her home and even more so if you feel they haven't tried that hard to find out whether there are any underlying causes for her sudden loss of mobility.

Hope this helps,

Fiona

 

[ggma]

So sorry to read about the sudden change in your grandmother.

My Mum had a fall and ended up in hospital with a hip op. She was totally disorentated in hospital, could not understand where she was, thought people were pinning her down, hurting her and she fought and was totally unco-operative.

Once she got back to familar surroundings (the hospital could not get her out fast enough) she calmed down and made really good progress.

Sometimes, the worst thing for someone with dementia is an unfamilar place, so do not give up hope, things can improve or change, it is just so difficult to know what to do for the best.

The advice to press for an assessment is right, it will help you decide what needs to be done.

 

[lin1]

Hello
I am sorry to hear about your grandmother
sorry to say that often, people with dementia do not do very well in hospital, itsnot only the change of surroundins , its often that staff do not understand about dementia

Please bear in mind I am not a doctor or nurse I can think of a couple of things that may be wrong
I am wondering if your grandmother may have had a small undiagnosed stroke
or maybe pain is causing her inability to walk

In a mo I am goin to put a link here of one of our fact sheets about hospital discharge, whuch I hope will help you

http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=173

 

[lin1]

Hi, me again, I found this factsheet about hospital wards and dementia patients
I dont know if it will be of ant help to you
http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=118

 

[SWMBO1950]

I would also be concerned about some kind of fracture.

My neighbours husband apparently fell when at a day centre. He would not walk and he had 3 leg fractures. As he was fairly far along the path of AD he was unable to articulate what was wrong with him.

Hope you get this sorted soon.

Best Wishes

 

[bunnies]

It can be hard for someone of that age and this illness to start walking again, but it is possible. In my experience physios were rather negative about the possibility and are rather disinclined to persist, saying that someone with alz can't benefit from physiotherapy.

If your grandmother is in hospital and is then discharged you ought to be able to get the services of an 'Intermediate Care Team' for a week or so to help her settle back at home. These are NHS carers and nurses, nothing to do with social services. I found them excellent with my aunt who was in a similar situation, and they were instructed to help my aunt walk every time they came. In the end, my aunt didn't walk again, but I did feel the ICT did give her the chance of recovery.

 

[shauna]

When my mum was in hospital she lost her mobility . I insisted the physio saw her it seems mum refused to walk for him and he was prepared to give up untill i suggested to him that we try mum walking with one of the family present with the physio .She felt more secure and it worked I know its not always possible to be ther at the hospital but it is worth a try. Another thing ive come across is a patient with Dementia / Alzheimer are very frightened to walk on a glossy surface ie highly polished floors or tiles and hospital floors can be like this. Like others have said dont let the hospital release your mum untill you have more care at home. Keep talking to TP and you will get a lot of help and good advice.

Shauna

 

[Apli]

Apli,

Don't let the hospital discharge your grandmother without having a needs assessment done. This should involve her being taken home by occupational therapists who will consider what needs to happen in order for her to go back to her old home. Even once this assessment has been carried out insist that any changes to her current arrangements are put in place before she is discharged! They have a legal obligation to do this so it might help if you let them know that you know this! It might be useful if you as a family consider and make a list of what you think would need to be done before she was allowed to go home. For example, does she have a wheelchair? Wheelchair ramp into her home? Would it help if she had a commode for downstairs? How do they think that she is going to be moved? Will she need a hoist? Is she at increased risk of thinking she can still walk and trying to get up if she is on her own? Does she have a careline phone in her house where she can press a button worn round her neck in order to get assistance? How would she get up the stairs? Where would she sleep?

I think it's a nonsense them trying to send her home and even more so if you feel they haven't tried that hard to find out whether there are any underlying causes for her sudden loss of mobility.

Hope this helps,

Fiona

This is such useful advice many thanks Fiona. You are correct she has had OT's assess her in the past hence stair lifts and disabled facilities within her whole home.

I was quite surprised that the hospital were ready to discharge her without any formal assessment I will strictly insist this is done prior to her being discharged

As you mentioned there are a number of changes that would need to be made to her current setup in her home for her to be able to comfortably live.

 

[Apli]

So sorry to read about the sudden change in your grandmother.

My Mum had a fall and ended up in hospital with a hip op. She was totally disorentated in hospital, could not understand where she was, thought people were pinning her down, hurting her and she fought and was totally unco-operative.

Once she got back to familar surroundings (the hospital could not get her out fast enough) she calmed down and made really good progress.

Sometimes, the worst thing for someone with dementia is an unfamilar place, so do not give up hope, things can improve or change, it is just so difficult to know what to do for the best.

The advice to press for an assessment is right, it will help you decide what needs to be done.

Thanks for your comment. Very similar with my grandmother she is very confused regarding her surroundings the fact that we can only visit twice a day is making her further confused.

We all live very close to her (matter of doors away!) and she is very used to seeing someone every hour or so.

We will not give up hope and continue to press of physio. We have started to search for local private physios that will be able to (potentially) help her get back on her feet with one-to-one sessions in her home. I am praying to God she is able to walk again.

 

[Apli]

Hello
I am sorry to hear about your grandmother
sorry to say that often, people with dementia do not do very well in hospital, itsnot only the change of surroundins , its often that staff do not understand about dementia

Please bear in mind I am not a doctor or nurse I can think of a couple of things that may be wrong
I am wondering if your grandmother may have had a small undiagnosed stroke
or maybe pain is causing her inability to walk

In a mo I am goin to put a link here of one of our fact sheets about hospital discharge, whuch I hope will help you

Thank you for the very useful fact sheet. Actually she is complaining of pain in her left leg but the nurses really do not have any ideas of what tests the doctors have conducted it is quite disappointing. They are clearly understaffed which does not help the situation.

With regards to the stroke this is something we haven't thought of at all. She was conscious and knew what was happening when she was admitted to hospital but I will bring this up with the staff ASAP.

Many thanks for the additional link - any help you can throw our away is MUCH appreciated!

 

[Apli]

I would also be concerned about some kind of fracture.

My neighbours husband apparently fell when at a day centre. He would not walk and he had 3 leg fractures. As he was fairly far along the path of AD he was unable to articulate what was wrong with him.

Hope you get this sorted soon.

Best Wishes

Thank you. Unfortunately as she does have AD she often 'forgets' what's wrong with her. Most of the time (prior to her being in hospital) she would complain of being unwell but could never 'pin-point' the exact reason. So sad

 

[Apli]

It can be hard for someone of that age and this illness to start walking again, but it is possible. In my experience physios were rather negative about the possibility and are rather disinclined to persist, saying that someone with alz can't benefit from physiotherapy.

If your grandmother is in hospital and is then discharged you ought to be able to get the services of an 'Intermediate Care Team' for a week or so to help her settle back at home. These are NHS carers and nurses, nothing to do with social services. I found them excellent with my aunt who was in a similar situation, and they were instructed to help my aunt walk every time they came. In the end, my aunt didn't walk again, but I did feel the ICT did give her the chance of recovery.

We never knew of ICT existence - I have spoken to my Mother about this and we would certainly be interested in pushing this forward. She would need a week minimum to help her settle back especially if she has to live to new processes i.e. not walking and be able to use the toilet!

As previously mentioned the hospital is reluctant to push forward any chance of recovery. The easy option is to give up and push her onto a bed for life.

I am very sorry to hear about your Aunt. It's so difficult to accept I fully can empathise with you.

 

[Apli]

When my mum was in hospital she lost her mobility . I insisted the physio saw her it seems mum refused to walk for him and he was prepared to give up untill i suggested to him that we try mum walking with one of the family present with the physio .She felt more secure and it worked I know its not always possible to be ther at the hospital but it is worth a try. Another thing ive come across is a patient with Dementia / Alzheimer are very frightened to walk on a glossy surface ie highly polished floors or tiles and hospital floors can be like this. Like others have said dont let the hospital release your mum untill you have more care at home. Keep talking to TP and you will get a lot of help and good advice.

Shauna

You are spot on with your advice. We were present yesterday when the physio attempted to get to walk. My grandmother kept complaining of the slippery surface very fearful that her feet would slip.

This morning they managed to get her out of the bed onto the chair for a short period which is pleasing as it's a sign of progression

We appreciate everyone’s help, comments & support - many thanks

 

[Apli]

Update

Evening everyone

Thought I would give you all an update on our darling Grandma!

She is still in hospital - having some very good days and some bad days (today)

Yesterday she did ever so well. Got up without any aid of machinery and walked many steps (we were all so pleased!)

However today bless she was so confused. When we got to the hospital she started to become less confused. She told us how she thought she was at work and wanted to got the hospital as she was feeling unwell - settled down completely whilst we were there and showed good signs

She did very well yesterday with her walking/mobility and we hope we can get this back consistently - fingers crossed

The doctors still don't know why the sudden loss in her mobility - very odd. We are awaiting them to do further tests. My mother is certain she has a balance/ear related problem. Everyday she complains of dizzyness commenting that her 'head is spinning' - if my head was spinning I wouldn't want to walk either

Any comments or advice would be greately appreciated