Wow....I have seen such things before in people with progressive neuro disease.....it is hard to pin it on progression per say, because it seems unlikely that there would be an immediate and drastic decline overnight....question: was there any physical trauma (i.e. fracture or anything that required medication or surgical intervention)? It could be the medication. Also, my belief is that sometimes trauma causes a stress to the system that then "causes" a more rapid decline....it has been hypothesized that numerous neurodegenerative diseases respond to stress. David A. Lehman, PhD, PT Associate Professor Tennessee State University Department of Physical Therapy 3500 John A. Merritt Blvd. Nashville, TN 37209 615-963-5946 [EMAIL PROTECTED]
-----Original Message----- From: Ron Carson [mailto:[EMAIL PROTECTED] Sent: Wednesday, December 17, 2003 8:01 AM To: [EMAIL PROTECTED] Subject: [OTnow] Help with Client Hello: I am working with a client who was diagnosed with Alzheimer's Disease approximately 7 years ago. She has shown a steady decline in occupational independence during the years but she has shown a significant decline in the past month. The family is 100% dedicated to keeping their mother at home. The family reports, that about three weeks ago, the client was walking in/out of the home with SBA. While outside, the client fell, apparently when striking at a caregiver. Since her fall, she has shown tremendous decline in her ability to walk, stand and transfer. Prior to the fall, the client would stand in the bathroom while the family cared for hygiene. To day, the client required max assist (X2) to stand. The possibility of a hip injury/fracture remains, but all orthopedic x-rays were negative. The questions I have are: 1. What are the likely causes of the client's recent decline: a. Normal progression of the disease b. Fear of falling/standing secondary to recent fall 2. Based on the above, or any other plausible explanations, what treatment approaches will best facilitate this client to be able to increase her participation in toileting and transfers. Thanks, Ron P.S. I am seeing the client today and Friday and plan to make a decision about which direction to take our remaining therapy. Should we continue working on remediation of underlying issues or begin adaptive strategies to decrease the family's burden and promote the client's safety _______________________________________________ To unsubscribe, visit: http://otnow.com/mailman/listinfo/otlist_otnow.com The OTnow Mail Archive: www.mail-archive.com/[EMAIL PROTECTED] =============================================== _______________________________________________ To unsubscribe, visit: http://otnow.com/mailman/listinfo/otlist_otnow.com The OTnow Mail Archive: www.mail-archive.com/[EMAIL PROTECTED] ==============================================
