Ron,

It may be that the decline in mobility is not so much due to gait problems
(memory vs movement disorder as you mentioned below) but more of a
motivation issue. With the decline in memory apparent in dementia maybe your
client doesn't remember the importance or need for these activities. This
could mean that she doesn't see the point in doing them, possibly resulting
in the
difficulties you're trying to address.

Dementia is more than just a memory disorder - it's the gradual death of the
brain. My understanding (from my personal experience with my grandfather) is
that this can then give rise to Parkinson's Disease itself.

Just linking dementia back to occupation, I believe an occupational approach
is still possible even with advanced dementia. The last time I saw my
grandfather, about 4 weeks before he died, he was bedbound in hospital by
the dementia and Parkinson's. I asked him what he thought about while he was
lying there. When he answered me (several minutes later!) he said he liked
looking at pictures (the curtains across the windows). I then encouraged my
family to provide nice, simple pictures for him to look at - occupation
right until the end!

Nessa

----- Original Message ----- 
From: "Ron Carson" <[EMAIL PROTECTED]>
To: "Lehman, David" <[EMAIL PROTECTED]>
Sent: Tuesday, December 02, 2003 4:01 PM
Subject: Re[2]: [OTnow] Parkinson's disease / Alzheimer's


Hey D:

I think the memory problem is where I get confused. For example, I evaluated
a  woman yesterday with advance Alz. He son, the caregiver, reports a recent
and  significant  decline in his Mom's ability to ambulate, transfer, assist
with  toileting and bathtub transfers. (these are what I was referring to as
'functional symptoms')

Now,  the question becomes is this a memory disorder or a movement disorder?
And can't a memory disorder manifest itself as a movement disorder. In other
words,  can't  a  person  forget how to move? Finally, doesn't PD eventually
effect  one's  cognition, including memory? IF so, wouldn't PD them become a
memory disorder.

It  seems  that  while etiology of PD and Alz may differ, the results of the
diseases are similar.

Ron


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