Posted 4-6-20
Happy Monday to all in this Holy Week. I trust that your week will be as fulfilling as it can be while dealing with dementia issues and the CoronaVirus. Remember, although it sounds like a cliche, God is absolutely Sovereign. He knows every aspect of our condition and He will work all things out for good for those who love Him and are called according to His purpose. (Romans 8:28)
Today marks the beginning of a new, week-long (?) series about dementia’s lesser-considered issues and/or side-effects. We are stuck outside of the prison walls, rightfully so, so we might as well study and learn some about our little topic. Never being one to mindlessly follow tradition for the sake of tradition, I will start our little series from the ankles down.
Several things come to mind when it comes to feet and folks with dementia, although I would welcome your comments below or by email if you disagree or have other considerations I missed (likely). Off we go:
- Gait. If you are young enough to not know that Oliver ruined the Brady Bunch (and if you aren’t in the medical field), you have likely never considered the word gait. Gait is a complex word that considers everything about how someone walks, in, say, sequence, whether you drag your feet, etc… . As we age, often our gait suffers for a variety of reasons, and this is a significant problem because falling is a very, very bad thing if you want to live a long, fulfilling senior life. In fact, according to the National Council on Aging “Falls result in more than 2.8 million injuries treated in emergency departments annually, including over 800,000 hospitalizations and more than 27,000 deaths.” Big problem! With dementia, balance and coordination are often already compromised. Add gait problems, most commonly dragging your feet, and these damsels in distress and wounded knights in shining armor often fall into a pattern of falls that quickly leads to their downfall. My mom had about 10 (?) significant falls in her first several months at her memory unit. “Fortunately”, today, she sits in a wheelchair, only leaving to be flopped in bed or over for bathing time. However, falls are a huge deal and the feet can be a culprit.
- Temperature and/or numbness. Temperature gets completely out of whack for many patients during certain portions of their dementia-hindered life. The hypothalamus in your brain controls temperature (and many other things) and the disease can certainly damage this critical piece of brain. Plaques and tangles, thought by many to be a cause of dementia, are not as common in this part of the brain as other parts. Interestingly, exercise seems to help in this area as well as other areas of dementia prevention and “treatment”. There are other causes of numbness and cold extremeties that may not be directly caused by the dementia, but certainly cause problems with it. Diabetes, neuropathy, circulation problems and the like come to mind, although there are more causes even yet. Bottom line: this is a bad combination and causes significant stress, fall risk, and anxiety. If your loved one tells you they have numbness in his/her feet, tell the doctor to be sure it isn’t just a sort of normal part of aging.
- Foot care. Foot care in many seniors is neglected. SeniorAge, the non-profit for whom I work, runs foot care/nail care clinics in many if not all of their centers (when pandemics are not preventing them from being open to the public. 🙁 ). In dementia it can be much worse because, especially in later stages, they may not tell you it hurts. Infection, sores, blisters and the like can be present and you may not know it. Keep a close eye on those tootsies! Look between, under and all around, especially around the nails. Remember, we have to feel pain for them sometimes. Mom had a stretch a year ago where her gait was messed up (she had the “dementia shuffle” ), her posture was out of whack and she was generally unhappy. We ask her is something hurt and got the standard “No”, but we persisted over time and discovered the corn that caused the problem. Problems there can and will spread upward through diabetes complications, sepsis, and and other conditions. Here is a good piece on general foot care for seniors, but is applicable to our little wing of the group as well.
We could also discuss shoes, socks, propping up feet or or not…lots of feet considerations, but we will stop for today. Keep in mind with me that until we finally defeat this stinkin’ disease, we need to keep an eye on these precious feet.
#EndALZ
Update: No word from mom or the nurses yesterday. I have a Facetime scheduled today with her.
WW Update: Lost another 1.6, which brings my total to just over 50 pounds. What is particularly a blessing is that I lost a bunch a couple weeks ago being sick and it didn’t come back. I am moving in the right direction. 🙂 I fully expect the exponential losses to slow down, but I also expect to start working out more that the weather is breaking this week. It is going to be a solid loss again. 🙂