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LivingSouth Asked November 2018

Dementia and mobility problems; How can you deal with someone who gets panicky and refuses to follow instructions?

How can you deal with someone who gets panicky and refuses to follow instructions? She will freeze and when anyone tries to help her move to a chair, or if she almost falls, she will fight you off and refuse to do what you tell her to do. My dad is getting angry about it because he says she refuses to listen. She will say that he is trying to make her fall. I think that she is getting to the point where she doesn't understand everything we say. Trying to keep her as mobile as possible and out of a wheelchair.

97yroldmom Nov 2018
LivingSouth
why not call her doctor and ask for physical therapy? A therapist can come to her home and evaluate her. They can help you better understand how to assist her when needed. Try to be there for the evaluation so you can make sure your dad also understands what is helpful. He is probably afraid and it comes out as anger. If the therapist models proper behavior for your dad as it relates to assisting your mom, it may be better than your cautioning him.
I notice my aunt (92) must pay full attention to walking. She uses a cane. Does your mom use a cane or a walker?
My aunt will stop if she is spoken to. It’s always best to let her get to her destination before speaking to her as it’s a distraction. She has ongoing therapy in the home and it really helps with balance and continued mobility.

JoAnn29 Nov 2018
This is the world of Dementia. Her brain is dying. She can no longer reason or process what is being said to her. She also can't be conditioned. Her short term memory is probably gone. No way to learn or comprehend. Anxiety is a big part of Dementia. My Mom could not hold a conversation on. She would jump from one thing to another because that is what her brain is doing. Yes, it's frustrating but she can't help it. I believe they end up being like children. I saw my Mom go backwards in her life to the point she cried out for her Mom. She didn't like people touching her.

See if one of the NHs or ALs have talks on Dementia. It may help u and Dad understand Mom better.
Ricky6 Nov 2018
JoAnn29 is spot on the problem. You can try to wait the situation out, or you can ask the Doctor for medication that might help with compliance and minimize anger (like Zyprexa?)

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Countrymouse Nov 2018
Get some training from an experienced PT or OT with a specialisation in elders' mobility.

Your mother is fighting and panicking because she *thinks* she is going to fall, and your supportive arm feels to her as though she is being pushed off balance even more.

In this situation, it is unkind and unreasonable to expect her to listen calmly to instructions. There are techniques for making a person feel safe but they have less to do with what you say and much more to do with how you hold her.

Reassure your father that he isn't doing anything wrong - it's not he who's the problem, it's the difficulty of giving your mother the correct style of support - and encourage him to join you in learning new techniques.

Ahmijoy Nov 2018
How is she being helped? Are you simply physically picking her up and trying to put her in a chair or do you have a lift? Were you both trained on how to do a transfer? Is Dad physically strong enough to do it? Has she ever been dropped and fallen to the floor? If you don’t have a lift talk to her doctor for an order for one. If she feels comfortable with the transfer, she will stop resisting. Get trained.

The fear of being dropped is a real one even when a person doesn’t have dementia. My husband fell off an apparatus called a “sit to stand” in rehab with three aides right there. Ever since, he is very nervous about transfers even though we have a lift that I was trained on. If your dad becomes angry with her for resisting, that makes it worse.

pcgirl56 Nov 2018
The fear if falling is a basic primal fear. I see my mom struggle to stand using her walker and then she has to let the "earthquakes" subside before she starts to walk, often having to stop again when she begins jerking. We are glad she is careful and do our best not to need her to rush. Rushing her makes the anxiety worse as well. If we need to go somewhere that won't accommodate her walker we take her arm. Yes, it feels like pushing a wet noodle uphill sometimes, but adjusting your schedule and pace to hers is a learning curve. Breathe!!

Erinm60 Nov 2018
My mother who has dementia also has become strangely semi immobile. No real reason. She won’t leave the house or the first floor. I have stopped asking why. She just doesn’t answer a direct question about her behavior. However she will ask me any question at least 10 times a day. I’m wondering if this is one of the next steps to transition to a worse stage of dementia

IsntEasy Nov 2018
Your dad's anger may be a sign that he's at his limit. At this point, I'd worry about him more than your mom. I've seen too many cases where the person with dementia outlives their caregiver. The stress isn't good for anyone, but for the elderly, it can be deadly.
Keeping her mobile is a good goal, but not if it means your dad has to manage the transfers on his own.

It may be time to start looking at AL or at least home care.

Glendaj2 Nov 2018
I’m at the same stage your dad is, I am considering a nursing home as I can’t give him the level of care he needs by myself. If she is not already falling out of bed this is next and falling when she tries to get up. This is what I am dealing with and with my age and physical limitations it has become next to impossible. Please talk with your dad and yourself about either a nursing home or if you can afford it and want to keep her home 24/7 nursing care. Save your fathers health.

Tothill Nov 2018
In your last sentence you say you want to keep her out of a wheel chair, perhaps it is time to rethink that option? Or a walker? Isn't her safety and well being more important than keeping her out of a wheelchair?

Llamalover47 Nov 2018
It's scary for an elder to think they may fall so they may be a bit on edge about it or overcompensating lest they do fall.

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