Posted 4-7-20
Hi all! Happy Holy Week Tuesday! These weeks are probably slow in pace for some of you, but when working with seniors in a time like this we are in a dead sprint from dawn-to-dusk. This week will probably be a great example of this sprint. Without further ado about nothing, we continue your look at dementia from feet upward and we move to the legs.
It is interesting how many of the topics we will discuss, including yesterday’s on the feet, are “typical senior concerns” that are merely made harder by the condition. If I would have known how hard being a senior was going to be, I would have slowed down aging a long time ago!! 😉 So, what of the legs?
- Edema– We recently discussed this problem in regard to my mom’s worsening edema. Edema is swelling caused by abnormal buildup of fluids. It is pretty common in the end stages and can be a sign that the disease is running its course. Here is a useful article on how to treat this condition.
- Corticobasal syndrome (CBS) and Corticobasal Degeneration (CBD), which causes arms and legs to become uncoordinated or stiff. Just think of “CBD” as in the current medicine fad of the day: CBD oil (unrelated)..and that the condition appears to cause the need to have our legs oiled as if they are rusty. We normally think of these conditions as being tied to Parkinson’s Disease and/or Parkinson’s Dementia, but it can be a factor in other forms of dementia. Other side issues in these conditions relating to legs include: cortical sensory loss (no feeling), alien limb phenomena (involuntary movements as if it isn’t your leg), myoclonus (brief, sudden jerking as in sleep starts), apraxia (inability to move parts of the body, including arms or legs), pyramidal motor signs (spasms/twitching), and visuospatial impairment (ability to understand what we see around us and interpret spatial relationships…this comes into play in depth perception. Try walking in the dark with a disco light flashing). These conditions can actually shorten life in many ways.
- Restless Leg Syndrome, especially in Lewy Body Dementia. “A condition in which a person, while resting, feels the urge to move his or her legs to stop unpleasant or unusual sensations. Walking or moving usually relieves the discomfort.” However, with dementia, especially Lewy Body, walking to relieve the discomfort is a challenge, especially in the late stages. Here is another interesting, if technical, piece on the subject.
- Sores, infections and cellulitis. Infection is a killer in dementia. End of life/comfort care manuals always consider managing infections as a critical part of pain management and overall care. Sores on legs, especially when stuck in a wheelchair and super especially if your nurses aren’t prompt on toileting issues, are always a potential problem. Watch early and often and treat accordingly.
Like yesterday’s article, much more could be said. I covet your input and help. If you do this for me, we will all be a leg ahead. (Sorry…digital CORNbread, you know…)
#EndALZ
Update: Had a nice, if short, Facetime with mom yesterday. She seems about the same, but who knows?? 🙁 We shall keep calling and accidentally pestering.