She has been diagnosed as having Frontal Temporal Dementia since 2010. Eight months ago, she had a stokes. She longer can recognize us anymore. She was in a long-term care facility since her release from the hospital. She can no longer walk, can only eat mashed food and her arm and leg muscles are diminishing. We assisted her on arm and leg strengthening exercises by strapping her hands and her feet on the exercise equipment using velcro straps. We would then sit opposite her and do the exercise. When our hands and legs move, so does her arms and legs. About a month ago, she starts dozing off regardless of time of day. About 2 weeks ago, she starts closing her eyes all the time, even when we are feeding her. I did some research on these symptoms and found that it mostly related to late stage dementia. I am wondering whether I am correct in guessing that she is at her last stage. In addition I want to find out what can I do to make this late stage more comfortable for her. I bought a TENS machine with the intention of stimulating her muscle strength and am afraid to use it on her. Should I? Anyone has experience with their love ones close their eyes all the time?

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Thank you all for the advice. I am not going to use the TENS machine on her now. I just checked with the doctor about acupuncture. He said if we want, we can try it. That's what I am going to do. I am going to have a registered Chinese herbal doctor and acupuncturist to check her out first. Then decide whether she is fit for the treatment. As for the exercise, it is monitored by the therapist who works in the long term care facility, I am going to change to just moving her arms and legs, and wait for her comments before deciding what to do next.
Compared to 2 years ago, the care taking job is much easier for me. At that time, my 95 year old mother was in long term care, and my mother-in-law was staying with us. I need to find time to visit my mother, and take care of my "not so quiet" mother-in-law (feeding, cleaning, and "slightly force" feeding her medications while she resisted every of my moves and yelled at me every time I do these thing to her).
My mother passed away last year and my mother-in-law entered into her late stage of FTD. She cannot talk (therefore no screaming any more). She cannot move (therefore no hitting me anymore). She is very cooperative when I feed her now. She actually smiles at me now when I feed her. So to me, the worst is over. I feel sad that eventually she will join my mother in heaven but also realized that's life. Some of you may ask why doing all these useless thing on her. But to me, if I can prolong her life by doing all these, I will. She is an angel before she has FTD (she is very nice to me and she looks after my wife for so long with love) . The least me and my wife could pay her back is to look after her the best we could.
Thank you all!
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When I applied some to my back yesterday, I noticed the correct name is Lucky Tiger, not Tiger Balm. Did a quick check, and it might or might not be the same product. I'll have to check out the ingredients later.

So I might have made a mistake and it's Lucky Tiger, not Tiger Balm that I use. On the other hand, those names might be used interchangeably.

Your experience is interesting though. I think you're right that the neck skin is more sensitive. I hadn't even thought of that.

Have you tried an herbal heating pad, heated in a microwave, then wrapped in a towel? It's hot, but you can (a) not heat it 1.5 min. as I've done, or (b) add another towel until it cools down. The benefit is not only the direct heat, or cooling as I also chill the pad sometimes, but the herbal combination of geranium and cinnamon is soothing in and of itself. When it's released through heat, you get the benefit of aromatherapy, which soothes me instantly.

Thanks for sharing your experience, and I apologize for any misinformation in my previous post.

ETA: I just realized that I have experienced some uncomfortable feelings when I apply the balm above my lip. I've found that the menthol helps clear my sinuses. But I do recall there's a slight tingling if I apply it too close to my nostrils.

So, you've just enlightened me! And thanks for that!
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I massaged mom twice today with a lovely unscented coconut oil and played her some lullaby music - she's been sound asleep for two hours
This is the best I think we can hope for now
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Hi Garden Artist,
I just tried the Tiger Balm for the arthritis in my neck. I applied it near the hairline and it took 5 minutes for the burning to dissipate. After that it relieved some pain but it's just getting through the hot first part. Maybe I'm not as tough as I thought! Or maybe I rubbed it in too much. I guess I could try a small ice pack after applying it.

Foot note;
I just applied some to the top of my right thigh and I can't feel a thing! It must be the skin on my neck that's so sensitive because it happens every time I apply it there.
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TENS is contraindicated in patients with a pacemaker, diabetes, heart conditions, high blood pressure and other conditions. Especially if the patient is non-communicative and could not tell you if there is pain, just as SueC has said. And, it can burn the skin.
Avoid TENS therapy if you are pregnant or have diabetes, metal plates or pins, or a demand-type cardiac pacemaker. If you have heart disease or high blood pressure, consult with your naturopath or other health practitioner before undergoing TENS therapy.
Do not place electrodes near the eyes or carotid sinus nerves. Electrodes should not interfere with or induce blood flow through the head (transcerebrally).
EKG alarms, EKG monitors, and sleep apnea monitors may not function properly when a TENS unit is in use.
Skin irritation may result from long term stimulation at the same electrode site. You may also experience skin irritation from the tape or gel. It is possible for the electrode to burn the skin." end online advice.
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Sue, I use Tiger Balm for back aches and have never experienced a burn. In fact, it's mild compared to another muscle balm I used to use.

I think someone with very sensitive skin, such as an older person, might experience discomfort or a burning sensation, but even though I'm not young, I've found Tiger Balm to be very comfortable when applied, and wonderfully soothing.
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First and foremost, NEVER hook up any electrical or battery powered device to a non- communicative person! They have no way to alert you to any pain this is causing or if the setting is too strong.

A TENS (Transcutaneous Electrical Nerve Stimulation) unit is a machine used to block PAIN from 'nerves'. It sounds like you are trying to stimulate muscle regeneration.

This machine works on NERVE PAIN. It does NOT grow new muscle. It is used to disrupt the pain pathway of nerves. You place the electrodes on both sides of the pain and the electrical stimulation is supposed to block the route of the nerve pain.

Physical Therapy has used a device similar to a TENS to 'awaken' otherwise healthy muscles. When my husband was in a coma for 15 days and bedridden for another 15, he lost all function of his muscles. They used a similar devise on his leg and arm muscles, to stimulate the movement of muscles that had "gone to sleep" during the time in the coma. This treatment is COMPLETELY different on a (then) 45 year old man who was in good health and your mom, who is elderly and has suffered multiple illnesses (strokes, dementia). It was preformed by a Physical Therapist. You are not trained to do this procedure.

Forget the idea and return the unit to the store.

I would also caution you against using ointments like Tiger Balm. The ointment is so strong that it burns on the skin for the first 5 minutes (and I'm a tough cookie!)

Your intentions are good but only move her arms and legs with your hands and only to the point they will go. Do not force the extremely to move past its stopping point. This hurts and she can't talk. Gentle range of motion exercises a couple of times a day should be sufficient. You can contact her doctor for a Physical Therapy referral. They can recommend splints and orthopedic devices to prevent contractors from forming. Leave it to the professionals.
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I share the concern about using a TENS unit. It has to be set specifically for an individual, and often has to be adjusted incrementally to find the correct level. If not, and the level is too high, she could be very uncomfortable w/o being able to express it.

During my own therapies, a few times the level was set too high as we worked to find the correct setting, and it was very uncomfortable.

It was a good idea, but not appropriate for your MIL at this stage of her life.

I am impressed though by your care and attention and attempt to ease her challenges as well as address muscle loss.

During one of my father's therapies, the therapist had him lay down on one of the benches, sat on the edge, and gently moved his legs back and forth, similar to the kind of machines that can provide automatic movement back and forth for post-knee replacement patients.

Now is also an excellent time for outdoor walks. Perhaps the changing colors might soothe her, even though it's probably difficult to tell if they are.

You're very proactive, concerned, and willing to devote time to help ease her situation. I compliment you on that; it's refreshing to read a post from someone so involved and committed, especially during what probably is the most challenging aspect of her and your lives.

I don't know if the Alzheimer's Association has suggestion for dementias other than Alz, but you might check with them as well.
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It is hard to hit that point when someone you love is really just past "fixing". Sounds like she has a full day of PT---and for what purpose? To sustain a life that must be miserable and sad. Perhaps even painful.

When daddy got to this point, we let him be. Calm music, calm conversation, if he felt he wanted to join in, he did, but he laid in bed, eyes shut for most of the last month of his life. I think he was gently transitioning to the next world. We massaged his legs and arms as much as he permitted and he received only palliative care once he no longer could swallow easily. Yes, it was hard, but it was calm and beautiful.

BTW--NH's will work their hardest to keep patients "up" and moving. That's their JOB. Listen to your heart--what is it telling you?
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I understand, my mom is very similar. Try googling passive range of motion exercises, they would be more gentle and hands on then strapping her to exercise equipment. At this point you are working to keep her joints from stiffening and freezing up, you will never regain muscle. And bone density is related to weight bearing exercise, if that is your goal you are working from a flawed premise.
I think getting her up and out for walks is a lovely idea, and sitting her amongst the hustle and bustle of family life rather than leaving her in her room lets her feel part of things, even if she seems to be asleep most of the time. My mom also enjoys music, and even though she usually dozes off wearing her headphones she will tell me it was "very nice".
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I understand whatever we are doing will go for not. We just cannot watch her lying in bed and do nothing. The idea is to slow down her muscle contraction so that her bone will not break as easy. We usually take her for a walk on wheelchair daily and perform the exercise 2 or 3 times a week. We do not want her to confine to her bed all the time because we are afraid that the bed sores that she had when she was at the hospital will reoccur. The velcro strapping is suggested and taught by the therapist at the long-term care facility.
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Can you discuss her progression with her doctor? I'd be very wary of using any kind of electrical device on a person who is noncommunicative. Besides, it seems that she may be unable to continue to be mobile. I'd ask her doctor for advice on how to tend to her as she progresses.
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There comes a point when they are never going to regain their abilities, what are you trying to accomplish with all this exercising? At this stage focusing on simple range of motion movements to prevent contractures is worthwhile, I question the rest. The poor old soul is tired, mind and body. Let her be.
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