Mobility Preservation of People in Advanced Stages of Dementia

Even in early stages, dementia may pose substantial communication problems, memory loss or difficulty identifying family members, as well as considerable damage to cognitive abilities. Nevertheless, there are measures to be taken to try and preserve the patient’s functions and maintain both their and their family’s quality of life.

What can you do for someone with moderate dementia

It is important to encourage a patient to function as independently as possible, both at home and outdoors, naturally, with the assistance of a caregiver. For example, when a person struggles to choose suitable seasonal clothing, you can do it together and encourage them to dress themselves while keeping safe (for example, by putting on pants while seated).

Another example is the shower: when a person needs assistance in taking a shower, motivate them to apply soap and attempt to dry themselves as much as possible, all while prioritizing their safety (including a handrail, non-skid mat, and if required, a solid shower chair for showering and drying while seated).

Motivate the patient to go to the bathroom proactively to promote control over the sphincters while providing supervision and guidance, if required. Preserve the patient's dignity and maintain a sense of control in their life. It is important to provide the patient with choice options, for example, where they would like to go. Encourage the patient to participate in household tasks such as folding laundry, sorting socks, and arranging vegetables to help promote basic cognitive skills, such as sorting and organizing.

Creating a map of potential hazards in the home environment can expand the patient's scope of independence.

Coping with mobility problems in moderate dementia

To promote daily function performance, such as transitioning from lying down to sitting or standing up. etc. it is recommended to incorporate regular physical activity into the patient’s routine, to help strengthen the muscles and to improve their posture.

At this stage of dementia, you may identify changes in walking patterns, posture, and balance. Mobility devices may be required (walker, cane, etc.) to enhance walking safety.

Consult a physiotherapist about adapting treatment or mobility devices for the patient, as required.

What can you do for someone with severe dementia

During this phase, the patient with dementia may experience a significant decline in their functioning, have mobility issues (such as difficulty walking), and require assistance to complete daily tasks necessary for maintaining a proper daily routine.

It is recommended to motivate the patient to preserve their functions as much as possible, to encourage them, and to help them perform tasks independently, for example:

• Give the patient a hairbrush to comb their own hair
• Prepare finger food to encourage independent eating
• Motivate the patient to help with daily tasks, such as transitioning from lying down to sitting in a chair with the required assistance). It is recommended to consult a physiotherapist about transitions and mobility
• It is recommended to enrich the daily routine as much as possible with leisure activities and games suitable for the patient’s culture and values. It is advisable to consult an occupational therapist that will help create a meaningful routine especially in situations where cognitive decline may be worsening
• Listening to music, familiar game routines, etc. may help promote both the patient’s and the caregivers’ well-being

Coping with mobility issues in advanced stages of dementia

During the advanced stages of dementia, as the patient loses the ability to walk and stand, it is essential to enable mobility with a wheelchair and other devices to prevent pressure sores. Mobility devices will provide the dementia patient and their family with a better quality of life.

During these stages, the patient may struggle with transitioning from lying down to sitting in a wheelchair and vice versa. A patient lift, specifically designed, may be utilized to transfer them from their bed to a wheelchair to facilitate sitting (sitting is crucial for the proper functioning of various body systems and to prevent damage caused by prolonged lying down). Participating in social or family activities both inside and outside the home, spending time sitting on the porch or by a window (while maintaining safety) are all very important, as well as being exposed to the sounds of nature and the city, which provide a sensory boost to all senses.

It is recommended to consult health care professionals and a physiotherapist for professional counselling and for adapting a treatment for the patient according to their specific condition.