Over the last few years I have been spending increasing amounts of time working with people with advanced dementia and their carers and I am surprised at how often I hear people say they can’t do something because of Dementia. Physiotherapists as AHPs actively promote what people CAN do – and it is exciting to be part of a community that helps people with Dementia to live well.
With Physiotherapy you CAN……….Stay mobile for longer.
As Dementia progresses, it can affect a persons ability to move in many ways. Take for example a task such as standing up from sitting – A day to day activity many of us take for granted, which includes several processes including:
- hearing, understanding and processing the task
- deciding to stand up
- sending a message from the brain to the muscles and joints to move and carry out the task.
Dementia can interrupt any one of these processes making the task difficult to complete. But we want to keep people mobile – and the following tips can help.
- Instead of asking someone to stand up, show them – through gestures such as sweeping a hand up their back
- Keep requests short and positive – “stand up” or “come with me”
- Ask someone to do something – or go somewhere – they may stand up automatically.
A Physiotherapist can help by determining whether the person is unable to stand up due to physical or cognitive reasons and can then develop a plan to make the task easier which could include communication hints and tips, exercises, or advice on moving and handling.
With Physiotherapy you CAN……….Improve your posture.
As dementia progresses, people may begin to find it difficult to stand or sit up straight. This can be caused by pain, fatigue, lack of muscle control or mood. Some things you can try to help someone maintain a good posture include:
- Making sure that chairs are not too deep or saggy – they may look comfy, but they will not provide any back support and can be difficult to get out of.
- Doing some simple exercises every day – try rolling your shoulders in a circle backwards and stretching your hands up over your head.
Physiotherapy can help by assessing for specialist supportive seating, providing stretches, exercises and massage to reduce muscle tension and improve posture, and linking with orthotics services to provide any splints required. As they have a strong understanding of the physical causes of postural changes, they can help to ensure people are able to sit and lie comfortably.
With Physiotherapy you CAN……….Remain physically active for longer.
Physical activity is an important part of keeping well. Whatever you enjoy be that walking, dancing, swimming or football, finding a way to continue to take part can be a good way to maintain health.
- Check out your local area for activities such as walking football, tea dances and walking groups.
- If these are no longer possible, consider dementia specific groups such as sporting memories and groups run by Alzheimer Scotland for more tailored activities.
A Physiotherapist can assist you to find exercises or activities that you enjoy, and find ways of adapting activities to make taking part possible. They may run specific classes you can attend as well!
With Physiotherapy you CAN………..Manage your pain.
People with dementia can show signs of distressed behaviour due to pain, yet be unable to tell others where it is coming from. So if you are concerned that a person with dementia may be in pain, consider trying the following.
- touch an area you think may be causing a person pain and ask if it hurts.
- Watch for changes in facial expression throughout the day – this can indicate what is making them sore.
- Consider ways of easing pain without pills– heat packs, movement or rest can be helpful.
A Physiotherapist can assess a persons pain using movement, special tests and pain scales to determine the cause of pain and then help reduce it using techniques that may include electrotherapy, heat, acupuncture, stretching, treatment specific injuries techniques or advice.
With Physiotherapy you CAN………..Reduce your falls risk.
“Older people with Dementia experience 8 times more falls than those without Dementia” – This was highlighted by Lynn on her previous blog on Dementia and Falls https://letstalkaboutdementia.wordpress.com/2014/07/11/dementia-and-falls/ – where you will also find some top tips to reduce those risks. A Physiotherapist can help identify personal risk factors, and will aim to reduce these with strength and balance exercises, adapted physical activity and motivational support, all of which can affect mood. They can also provide walking aids and link with other AHPs who can provide additional support.
With Physiotherapy you CAN……….Continue to do the things you enjoy.
So if a persons physical health is changing, consider a Physiotherapy assessment- Dementia can and does affect peoples physical abilities but for many people it does not mean that they need to stop moving – risks may be present, but sometimes they are worth taking and even little changes can have a big impact.
- When a task becomes difficult, do you stop doing it completely or try to find an alternative way to do it?
- What are you top tips to keep physically active?
Contributors: Claire Craig
I am a Specialist Mental Health Physiotherapist in Greenock. I am passionate about promoting living well with Dementia and other Mental Health conditions and want to celebrate the role Physiotherapists can play in this. Oh and I also love to dance so I share this skill widely and promote the value of dancing anytime I can!