If you’re caring for a loved one with dementia, then you know that you are their strongest advocate. Sometimes, you have to be their voice when they have trouble communicating. When they cannot take care of themselves, you give them the support they need to stay healthy. If your loved one ever needs medical intervention due to an injury or illness, it’s up to you to make sure they are cared for in a way that meets their specific needs.
“Loved ones with dementia who require physical therapy pose a unique challenge to those involved with their care,” says Lonette Bentley, Executive Director at Clarity Pointe™ Pensacola, a memory care assisted living community in Pensacola, Florida. “Sometimes, physical therapists are not trained in dementia care and do not realize the extent of their patient’s cognitive, verbal and physical limitations. Caregivers can help by explaining their loved one’s current abilities, as well as communicating their common struggles. Explicitly describing your loved one’s condition and specific needs before a physical therapy intervention can help everyone reach their health goals.”
In honor of Physical Therapy Month, Clarity Pointe Pensacola would like to share some information and strategies caregivers can utilize to make sure their loved ones are receiving the best care they can in a physical therapy setting.
Unique Reasons for Physical Therapy
Just like any older adult, those with dementia may require physical therapy after suffering from an accident or injury that was completely unrelated to their cognitive disabilities. However, memory loss makes it more likely for older adults to experience such accidents. Loved ones with dementia are more likely to experience falls and other physical injuries for reasons such as:
Impaired vision – One symptom of dementia is loss of peripheral vision. In addition, those with dementia often cannot process the things they see, resulting in poor spatial reasoning and judgment. A loved one is more likely to fall down the stairs when they can’t process the wideness of each step.
Poor coordination – As memory loss progresses, a person is likely to experience difficulty moving due to the damage that’s occurring in their brain. This can result in decreased control of movements and a general loss of precision when it comes to muscle coordination.
Loss of executive functioning – Executive functioning is a person’s ability to coordinate their thoughts and their actions, choosing the appropriate behavior for what they are thinking. This skill goes away as dementia progresses, so it can be difficult for a person to get their body to do what their mind tries to control. Conversely, they may not be able to clear their thoughts while their body acts automatically.
Mood shifts – Studies of falls in nursing homes show that patients with dementia are more likely than other residents to fall during the early morning and later evening hours. Evening falls could be a result of a phenomenon called sundowning, in which dementia patients experience increased confusion, agitation, and disorientation during the late afternoon into the evening.
Physical Therapy Benefits
For these reasons and more, your loved one’s doctor may recommend physical therapy to simply manage these symptoms. A physical therapist can also design an exercise plan specific to your loved one’s physical abilities. Research shows that regular exercise can help to manage some of dementia’s more challenging symptoms, such as loss of appetite and sleeping problems, as well as slow down the progression of cognitive impairment.
Advocating for Your Loved One During Physical Therapy
Simply telling your loved one’s physical therapist that they have dementia may not be enough to help them adjust their intervention plans. Before your loved one begins therapy, be sure to fully explain what they can and can’t do. Stay with your loved one during their therapy sessions, and be ready to offer some alternative suggestions if they are struggling to understand directions. Without telling the physical therapist how to do their job, try to help them understand what the mind is like with dementia. Here are a few ideas inspired by Physical Therapist Jeannie Cushman, DPT, MS:
- Explain the stage of your loved one’s dementia – How someone cares for a person with early dementia is significantly different from caring for someone with late-stage dementia. A patient with early-stage memory loss will still be able to communicate effectively with the therapist on his or her own. Yet, someone in the later stages may not be able to respond verbally or at all. Prepare the therapist for your loved one’s level of engagement.
- Note your loved one’s vision problems – Therapists and exercise coaches typically stand off to the side when helping a patient. However, if your loved one has trouble seeing with their periphery vision, they may need the therapist to stand directly in front of them. If your loved one’s vision is very poor, ask the therapist to give them directions verbally, as well as visually.
- Understanding pain responses – A person with dementia may not respond to pain the way a healthy senior would. They often express pain with anxiety or distress, which can make it hard to know how much something hurts. Their physical therapist should be able to adjust their technique according to your loved one’s body responses.
- Express your goals – Let the therapist know what kinds of help your loved one needs. Therapy sessions could focus on retaining your loved one’s remaining abilities, or learning adaptive strategies as their abilities change. If your goal is to help them decrease their fall risk, let the therapist know that balance training is important.
- Realize dementia’s complexity – For someone with memory loss, physical therapy is not just a physical task. The success of a physical therapy session depends on your loved one’s neurology, psychology, social attitude, musculo-skeletal health, heart and lung health, and more.
- Add a new element – Suggest adding conversation to the therapy or exercise for an additional social benefit. You may also suggest adding music to the sessions, as people with dementia respond well to music and rhythm.
- Suggest multi-modal exercise – Multi-modal exercises work multiple parts of the body and address multiple skills with the same movement. These types of exercises are good for dementia patients because they only need to comprehend one set of directions and focus their attention on a single movement. Patients with a decreased attention span who are often overwhelmed by lots of talking or transitions between tasks can benefit greatly from simplified exercises.
Helping You Give Your Best Care
At Clarity Pointe Pensacola, we’re committed to helping family caregivers provide the best support for their loved ones with dementia – at every stage and in every setting. If you would like to know more about acquiring physical therapy or advocating for your loved one’s needs in a therapy setting, contact our team for guidance. We’re always glad to support caregivers and families living with memory loss.
Clarity Pointe™ … Our Difference is Clear
Clarity Pointe™’s Specialized Memory Care “Living” Neighborhoods are truly changing lives for those with Alzheimer’s disease and other dementias – and for those who love them. At Clarity Pointe, our mission is to ensure our residents lead connected and rewarding lives.
Unlike other providers that offer a secure memory care wing in a skilled nursing or assisted living center, Clarity Pointe Pensacola offers three free-standing, purpose-built memory care communities that are solely and entirely dedicated to memory care assisted living. Our communities blend luxurious surroundings with specialized care that is individualized to each resident and delivered by a compassionate, expert team of professionals.
We stay current on the latest trends and advancements in Alzheimer’s care and implement them into our residents’ care plans. Always moving forward, we combine the latest in evidence-based programming with luxurious, residential living and compassionate respectful care.
For each of our residents, we offer a life that is engaging, fulfilling, inspiring and meaningful.