My dad fell in the shower at his AL on Thursday. He choose to take an early shower alone and did not ask for help. He had no injuries except bruises but didn't seem quite right. Sent him to the hospital and met him there and was there all day for tests. He was able to walk as he normally does: slowly shuffling with a cane. All the tests back negative and I took him back in the afternoon.
However, walking back to his room, he started to hunch over more, bend his knees more, and go faster. He seemed unable to slow down, even with me telling him to and holding his arm. He got very weak and I had to half help him to the bed where he just fell with his torso on the bed and knees on the floor. I could not pick his dead weight up and had to call for help. He is about 210 lbs.
He seemed to recover after napping, drinking a bunch of water, and eating a snack. His vitals were checked and all that was out of wack was his blood sugar. So he was given insulin. His Dr. ordered him to start PT again. He had a similar weird fast gait going to dinner. He got weak again and I took him back to his room with a wheelchair.
Has anyone had something similar happen with a LO with AFIB and dementia? I'm thinking it might be mini-strokes or his dementia affecting his movement. I am worried if he stops walking or cannot get up, he will lose what muscle strength he has and be stuck in a wheelchair.
After some fluids, a bit to eat and a snack and a nap I am sure he felt "better"
Mini strokes is (are?) a good possibility. did he have tests at the hospital to rule out a stroke or strokes? And does he have a base line so that they can compare from a previous test?
There is a good possibility that after the fall he may be frightened that he will fall again so he is compensating with a gait that he may think is "safer". If this is the case PT might help but if he has any sort of dementia this might literally be an exercise in futility. He will "forget" that he can walk with a "normal" gait, all he may recall is the fall. It is possible that a wheelchair may be safer for him than walking. The trick then is that he may "forget" that and he may try to stand and walk. The stage before the wheelchair may be giving up the cane in favor of a walker if you can transition him to one. Might be something to discuss with PT.
Freezing of gait – Freezing of gait is characterized by a hesitation before stepping forward, or difficulties when initiating walking. Some people with PD report it feels like their feet are glued to the floor. The freezing is frequently temporary, and the gait may be at a normal pace after a step or two. Freezing may occur only in specific situations, for example: when starting to walk, when turning, or when walking towards a particular goal, like a doorway or chair. It can also occur when walking through a doorway or when changing directions. Freezing may also occur when a patient feels like he/she is being rushed or trying to cross a busy street. Freezing can be a potentially serious problem for people with PD, and it may increase the risk of falling.
Shuffling gait – Shuffling gait appears as if the person is dragging their feet as they walk. Steps may also be shorter in stride (length of the step) in a shuffling gait. The shuffling gait is also seen with the reduced arm movement during walking.
Festinating gait or festination – A quickening and shortening of normal strides characterize festinating gait. While the steps are quicker, the stride is shorter, causing this to be a very inefficient gait, which can be frustrating and tiring for the person experiencing it.
My old client with PD walked the same way with her walker. Like she got her sea legs under her and then she'd take off---we never did solve that issue, sadly.
Also, I'd discuss the odd walking with his doctor too. I know that Parkinson's does usually involve a distinctive gate. But, my LO has Vascular Dementia and early in her progression her legs became so weak that she could not walk. It was like they had cement in them. I suspected Parkinson's but, she never had any other symptoms and her doctors never thought she had that either.
Early in her dementia, she went to a wheelchair and was able to move her feet sufficiently to propel the wheelchair around the MC. She was able to function in the wheelchair for over 5 years, still able to propel with one foot. We believe it was caused by the mini strokes or vessel disease. One positive thing is that she didn't fall as much. AND, her mobility was much better as she was able to scoot all over the MC in her wheelchair. (They remove the feet to the wheelchair to make it easier to push with feet.) In her case, the wheelchair improved her mobility, as before she would sit afraid to get up for fear of falling due to her weak legs and poor balance.
I hope that you can find some answers. It's so troubling when they are falling so much. So scary. I know.
https://www.bcm.edu/healthcare/care-centers/parkinsons/conditions/vascular-parkinsonism