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I know she has some contractures, but it isn't that she physically can't, but that she won't. I know she can because I had her walking just yesterday, but increasingly when I need her to stand by the toilet or the help transfer she keeps her knees bent at a right angle and says she can't stand. Well of course you can't stand if you won't straighten your legs mom!

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This if very informative. Thank you. My husband with LBD has only recently started this. I have given him bananas for potassium and used magnesium spray. Hasnt helped so far but I will continue to try and find a way.
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Ferris, I agree just trying to show in a child what he was told with how the brain works and Dementia makes it worse.
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In dementia, there is very little "rewiring" and the destruction continues until death. Not the same as a congenital abnormality...
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My nephew was born with joint contracture problems. He walks with knees bent. It all has to do with the brain. Because he walked like this for a number of years he was told he had to consiously had to straighten his legs. The brain was used to his bending. He had to rewire his brain. Your Mom being her age just may not know how to do what ur asking.
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When one has dementia, the messages are not getting from the brain to the muscles. Don't blame her, she really cannot. Time to accept her contractures will get worse and help her as she is.
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You are also right about getting O.T or P.T. to come to you. Please be sure they are gentle, not too aggressive.
Wish I knew more. Have you already been instructed in using proper body mechanics for yourself, as well as transfer techniques to save your back and keep the patient safe? Try Youtube?
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Epsom salts for external. Magnesium pills or powder in a drink for oral ingestion, only if doctor recommends this for palliative care.
You will read also that Epsom salts can be taken internally for constipation, but don't do that for your Mom. It would be too harsh. Ask the doctor, the doctors do know how to keep her more comfortable, or the hospice nurse.
Keep her moving gently, as long as possible.
Keep your courage up. We care.
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Cwillie, it is the contractures, which can be very painful. "I can't" is exactly what I say out loud when I cannot walk without pain-legs, knees, hips, ankle, feet. This comes and goes, and I don't have contractures of the muscles. The sharp pains surprise me-I have wondered if I am faking when it just gets better all of a sudden.
Massage can help. Online recommends stretching to prevent it from getting worse sooner. And the Epsom salts. I take 500 mg. of magnesium to help leg cramps.
So sorry you have this worry and difficulty caring for Mom. Yes, you had her walking yesterday. Keep trying, and don't over-exert her when she can walk. The next day is brutal-three steps back kinda thing. Can she stand in the shower so you can get warm water on her legs? Ten minutes?
Or, ask the doctor if a warm towel can help, but don't use a heating pad on the elderly. They cannot tell if it is too hot, and forget to turn it off. The pain often originates from the lower spine, heat, ice, massage there. (Almost no heat-just warm.)
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I agree with Pamstegma about the Epsom Salt. You will be helping with magnesium, which is what epsom salts are. Magnesium is responsible for muscles (prevents leg cramping), and nerves. Applied topically, whether in a soak or as a cream, it helps the pain by somehow relaxing the muscle.
Balancing the electrolytes is important. For example, bannanas. Or even oral magnesium. These treatments are palliative.
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Cwillie, This decline is progressive like you have explained. But I offer this, a technique from a book on Parkinson's For Dummies. When the brain cannot signal the legs)-may work for other issues:
We drew the shape of an adult-sized shoe on brightly colored non-slip cloth and placed it near the foot in the direction of where the patient is headed. Then, the patient focused and went forward. Give the person time, much time. Sounds like the hug would help to get her up.
Using distraction may help. The pain may prevent them from wanting to move.
If they think they have dropped something, they may move to pick it up-and one can use the forward motion to propel them onward. (You would throw or place the object near them without them knowing.) Try placing a silver dollar?
This may not work in your Mom.
Will be looking some stuff up for you which may cover your situation.
Don't give up.
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Mom's 96, she's never gotten a formal diagnosis but I have no doubt that she has advanced VaD. Add to that multiple compressed vertebrae, osteoarthritis, and a history of hardening of the arteries resulting in a coronary by pass decades ago and more recently multiple TIAs and perhaps one small stroke. Oh yeah, and an atrial flutter. We are currently treating her palliatively, so there will be no investigations into the root causes. I think that this is just another big decline that I will ultimately have to learn to adapt too.
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Of course, it could be anything, including arthritis or something else. My cousin doesn't report any pain, except when she had her fractures. She reported pain with that, but said they stopped hurting after they healed. From what I have read and seen in Memory Care facilities, those with advanced dementia often lose the ability to walk and/or use their limbs or even sit unassisted.
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Get her a neuro and/or PM&R and/or geriatric eval. This could be ortho or neuro or rheumatologic that has progressed gradually and just now reached the point where she can't do it or it hurts too much. There is no way to tell from the description which is it and whether it can get better or whether you have to learn ways to cope with it.
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I think you are right about the mixed signals Sunny and that soon she will not be able to stand at all. She has had episodes of this before, but if I was able to catch her at a good time I could get her to stand, walk of transfer, I guess the muscle memory was still there. I am afraid that the longer she goes without being able to do it the more her muscles will deteriorate, and she will never have the strength to recover. One more step down the road.
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There are good suggestions above.

I have noticed that with my cousin, who has dementia, she has progressed to the point were her brain signals don't get to her limbs. She can move her hands and fingers, but she is no longer able to reach into a gift bag to get her gift out. She looks at it. She wants it, but her signals don't work. She can't do it. On some days she may be able to do it, but most of the time she can't. It's funny that way.

I've noticed the same thing about her legs. She is able to move her legs and feet as she propels herself in her wheelchair, however, if you stand her up to transfer or get weighed, her legs are frozen and she is not able to move them. It's like they are jelly and she has no control of them. It's the brain signals that get mixed up. It's not that they don't want to move the muscle and it's not that the muscle is paralyzed. It's that the signal in the brain is not firing right. At least, that's how it was explained to me. Normally, when she is not able to move the way we are trying to get her to move, she gets scared and is unhappy that she has disappointed us. Of course, we reassure her that all is fine and that we got through it together. I can see that eventually, she will not be able to transfer from the chair.
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JG, I tried the "hug" this morning, I'm not sure it helped with the transfer but it seems nicer to give a hug than to always be so clinical... put your hand on the chair mom, NO, reach across... grab the waistband and... stand, no stand, NO STAND... swing into chair, hopefully not bruising anything along the way. Maybe with practice it will work, mom wants something to grab on to and I don't have handles :)
I may soon need to get OT to come in and give us some tips. Or maybe she will soon become altogether bed bound, another one of those lines I said I wouldn't cross.

Pam, I'd never heard of epsom salts in a lotion, I'll have to look for that.
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This is advice that I know often works pretty well in LBD, but I have no idea if it would apply to your mom. Instead of giving directions that the brain has to interpret ("unbend your knees") try a cue to an action they can do from muscle memory.

For us, for example, when Coy was stuck sitting on the edge of the bed the best thing to do was stand immediately in front of him and say "give me a hug." He knew instinctively how to do that and as he complied with that I helped steady him and he was standing! He might not know how to lean forward and put some of his weight on his feet, etc. but he did know how to hug! (My son started doing this first, and later I saw Teepa Snow recommend this.)

MAYBE (just maye) you could stand beside her with your arm around her shoulder and say something like "OK Mom, now we are going to the wheel chair" and if she starts to stand use the arm around her shoulder to help her. Maybe. Don't mention standing, or walking, or unbending her knee. Too complicated. Just "here we go" (for something her muscles remember how to do but her brain is confused about.)

This was helpful for LBD. If you try it, let us know if it has value beyond LBD.
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cwillie, get some Epsom salt lotion, rub it into the feet. It will help the leg spasms and associated pain. Keep her electrolytes balanced. Every little bit helps.
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I find that this is common with my mom from time to time. (The " i can't " thing i mean). I think it's symptomatic of the malfunction of the brain with dementia.

It's like the signals that are generated in the brain to straighten aren't making it to the muscles. I don't think it's volitional.
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