Walking in the out-of-doors was so invigorating for us. I loved taking a stroll with Mom down the meandering path with willow branches lightly stroking our faces as we made our way past the Koi pond and over the little footbridge. It wasn’t far – just up the block a few hundred feet – but, every visit to her little cottage brought an increasing awareness that something was wrong.
My mother had not yet been diagnosed with Alzheimer’s, although by that time she was rapidly moving through the later stages of the disease. One of the clues that we completely missed was the decline of her gait. The walk over to the Koi pond used to be a lively stroll, but had become an arduous trek across the street, a few feet down the sidewalk and then a long struggle over the stones to the footbridge. Eventually, we only made it as far as the stone path and had to turn around and head for home, shuffling along the entirety of the way.
Going for walks with Mom had become a test of one’s fortitude. It took inordinate amounts of time to walk with her to the mailbox just a short distance down four houses and back. There were many pauses along the way to just stand still and look around before cautiously proceeding on.
With an arthritic knee to place the blame upon, my sister and I simply thought that Mom’s strange gait was due to the pain of walking on a knee that refused to cooperate. It was increasingly difficult for her to stand up on her own without wincing and she barely lifted her feet off the ground, as if her ankles refused to move her feet up and down. The steps became shorter and shorter and gradually turned into more of a shuffle.
Most puzzling of all was Mom’s tendency to simply stop walking and stand in one spot for minutes at a time. I made no sense out of these frequent breaks to just lift her head and gaze unseeingly around the room halfway between the dining room and the kitchen or in the middle of the hall on the way to the bedroom. Looking back now, I suppose she was trying to make sense of her surroundings and how to will her feet to take her to the next destination – wherever that might be. Sometimes, I doubt that she remembered where she was going because there were frequent times when she simply turned the walker around and aimlessly shuffled along in the opposite direction.
* * *
Mom’s much slower and uneven gait was a warning sign that her mind was not keeping up with her usual active pace and determined purpose. The change in her ability to direct her feet around obstacles, to keep a steady and even rhythm in her steps, and the decrease in the length of the steps all pointed toward Alzheimer’s. While many of the signs of approaching dementia are hidden from all but the most observant, changes in gait are now believed to be an early indication of Alzheimer’s disease.
(For more information on gait problems and Alzheimer’s, CLICK HERE or read the sidebar to the right.)
* * *
“A Bandaid for the Caregiver” is dedicated to all those families who journey with memory loss in their lives and the sharing of hope and joy and new possibilities. In each difficult moment there lies an opportunity for love.
Journey with courage,
Elaine
“Remember when Life’s path is steep to keep your mind even.” ~ Quintus Horace Flaccus (65 BC – 8 BC)
THE BANDAID BOX...
Whether afflicted by disease of the body or weariness of the heart, we all walk at different paces and in different directions. Match your gait to your parent’s, and you will find much pleasure in the communion of your spirits. There is no need to rush. Let your mind relax into a more peaceful pace.
“Thy word is a lamp unto my feet and a light unto my path.” ~ Psalm 119:105
ABOUT ALZHEIMER'S...
Recent findings from three studies of walking disorders in the elderly have determined that changes in gait may be early indicators of Alzheimer’s disease. As a neurological illness advanced, the pace, rhythm and the size of steps also changed. Even those with mild cognitive impairment – a pre-Alzheimer’s condition – walked more sluggishly and variably than the normal elderly.
(http://www.businessweek.com/printer/articles/286466?type=bloomberg)
The Basel Mobility Center in Switzerland under the direction of Stephanie Bridenbaugh used a computerized pad to detect minute variations in gait to test the individual’s cognitive abilities to double-task, thus delineating those patients that had affected gaits due to pain from those who had experienced cognitive changes.
In a study conducted at Erasmus Medical Center in Rotterdam, Mohammad Ikram learned that the rhythm of a person’s stride is associated with the speed of processing information. A loss of executive functioning – the ability to control and regulate behavior – was associated with a decrease in length of
stride.
All of these indicators are signals to the observant primary care physician that a patient needs further evaluation. Noticing changes in an individual’s gait is a tool in early identification of those most in danger of developing Alzheimer’s. Rodolfo Savica with the Mayo Clinic conjectures that motor and cognitive functions are part of the same disease process, and this is important because motor changes are more quickly visible than memory changes.
CAREGIVER TIPS...
As Dad’s ability to freely walk at the pace and in the direction he wishes to, help him remain mobile as long as possible by clearing his most traveled pathways. De-clutter the floors and remove obstacles that he must negotiate around. Remove rugs that may catch a foot that remains close to the ground; tie up cords out of the way; shorten the length of tablecloths; and hem up long robes that might cause him to stumble.
When going on errands or to appointments together, allow enough time to reach your destination. Dad may become flustered and hesitant to walk if hurried. Take all the time he needs. There is no reason to rush.
Family caregivers face many challenges every day and the level of stress can mount up. Here are ways to cope and stay upbeat.
Be realistic.
While the care you give Mom does make a difference, it may be hard to see. Realize that many of her behaviors she cannot help. Acknowledge the loss of her ability to take long walks with you, grieve over that loss, and move to on to enjoying those times as memories.
Give yourself credit.
You need not feel guilty when you lose patience over Dad’s hurtful words and actions. Your emotions are also important in this journey together. Give yourself credit for all the wonderful things that you do accomplish and forgive yourself for the feeling like you could have done more. You are, in fact, doing a marvelous job of taking care of your parent!
Take a break.
Schedule some “me” time and get away. Sometimes, YOU are priority #1.
( http://www.alz.org/care/alzheimers-dementia-healthy-caregiver.asp)
TREAT YOURSELF...
We live in a fast-paced world with so many pressures to be everywhere at once. Our calendars are overbooked and we find ourselves constantly rushing through our days before finally reaching bedtime almost too tired to sleep. Adopting Mom’s slower pace may be a healthier approach to our day in some respects.
Treat yourself to the luxury of time. Pause to admire the sunset. Spend an extra ten minutes actually enjoying your meal. Linger a bit longer in the shower massaging sore muscles. Read one more chapter in that new book. Invest more time with your child in the morning before seeing them off to school.
Gentle Reminder: There is time enough for everything.
IN THE NEWS...
No comments:
Post a Comment