4 Options to Overcome Mobility Barriers
by Carolyn Lukert, MBA, CGCM,
PAC Consultant and Mentor
As a consultant working with PAC, and as a family care partner, I often get (or have) questions about the topic of changes in movement and mobility. The most common include; What are the changes I might expect, and/or how do I change the way I support my loved one as I notice a particular change?
As with most dementia-related questions, the answers are not short ones. So, I will provide some thoughts for consideration so that you can apply what is relevant to your own situation.
Changes will relate to several different variables:
· What type of dementia is onboard? Different dementias affect movement and mobility in different ways. For example, Lewy Body dementia or a Parkinson-related dementia often affect a person’s ability to move much earlier than other dementias.
· Where is my person in his/her dementia experience? If you are familiar with Teepa Snow’s GEMS States Model, you likely have noticed changes that commonly occur as GEMS States change. A great resource to explore these changes is the Seeing the GEMS Workbook.
· What other non-dementia related conditions are present that could impact movement and mobility? Oftentimes, other conditions coexist - arthritis, peripheral neuropathies due to diabetes, deconditioning due to acute or chronic conditions, just to name a few.
· What environmental conditions could impact a person’s ability to move safely from place to place? The presence of obstacles that could easily be out of visual range (like a pet or a piece of furniture) may play a role, as might specific flooring surfaces (carpeted areas, non-carpeted areas, steps, and changes from one to another).
· Is my person able to use assistive devices as intended? Canes, walkers, and wheelchairs can help in certain situations. That said, the ability to remember to use them, and to use them correctly can change with brain change.
So, what do we do? How do we change support? The short answer – it depends.
There are several options to consider depending on the source of the changes.
· Physical Therapy – could be helpful to get the person back to a prior level of function (called restorative therapy) in the case of a deconditioning event, or to maintain a particular level of function (called maintenance therapy) for certain GEMS States.
· Assistive devices – implementation/introduction of a walker (for example) during a time when a person is able to use it as intended. Note: There will likely come a time when this is no longer a viable option. That said, with the appropriate guidance and support, assistive devices can help.
· Environmental changes – changes to flooring surfaces such as changing carpet patterns to solid colors. Patterned flooring is a frequent cause of falls as the person’s depth perception and ability to maintain balance change with dementia-related vision changes. Removal of obstacles to create clear pathways can be a simple modification. These are just a few of many possibilities.
· Human interaction – supporting a person by offering gentle visual, verbal, and touch guidance to get from point A to point B. This may come in different forms, from simple verbal cues, to walking side by side using Hand-under-Hand® (HuH) for guidance and support, to providing more substantial support when assisting with transfers from one surface to another.
To explore strategies specific to your situation, and get connected to appropriate supportive resources, please reach out to us by email to schedule a free 30-minute consultation. We would love to help.