Hello David; I agree with your observations that it is unlikely that the disease itself would lead to such immediate changes. I also believe that people with any type of disease( physical, mental or environmental) are more susceptible to stress and that stress can magnify their symptoms.
Regarding your physical trauma question... The family states that there was no bruising or any other signs of trauma. The ONLY medication she is on is something to stimulate her appetite. And, she has been on this meds, at the same dose, for an extended period of time Ron ======================================================= On Wednesday, December 17, 2003, @ 9:15 AM, you wrote: LD> Wow....I have seen such things before in people with progressive LD> neuro disease.....it is hard to pin it on progression per say, because LD> it seems unlikely that there would be an immediate and drastic decline LD> overnight....question: was there any physical trauma (i.e. fracture or LD> anything that required medication or surgical intervention)? It could LD> be the medication. Also, my belief is that sometimes trauma causes a LD> stress to the system that then "causes" a more rapid decline....it has LD> been hypothesized that numerous neurodegenerative diseases respond to LD> stress. LD> David A. Lehman, PhD, PT LD> Associate Professor LD> Tennessee State University LD> Department of Physical Therapy LD> 3500 John A. Merritt Blvd. LD> Nashville, TN 37209 LD> 615-963-5946 LD> [EMAIL PROTECTED] LD> -----Original Message----- LD> From: Ron Carson [mailto:[EMAIL PROTECTED] LD> Sent: Wednesday, December 17, 2003 8:01 AM LD> To: [EMAIL PROTECTED] LD> Subject: [OTnow] Help with Client LD> Hello: LD> I am working with a client who was diagnosed with Alzheimer's Disease LD> approximately 7 years ago. She has shown a steady decline in occupational LD> independence during the years but she has shown a significant decline in the LD> past month. LD> The family is 100% dedicated to keeping their mother at home. LD> The family reports, that about three weeks ago, the client was walking LD> in/out of the home with SBA. While outside, the client fell, apparently when LD> striking at a caregiver. Since her fall, she has shown tremendous decline in LD> her ability to walk, stand and transfer. Prior to the fall, the client would LD> stand in the bathroom while the family cared for hygiene. To day, the client LD> required max assist (X2) to stand. The possibility of a hip injury/fracture LD> remains, but all orthopedic x-rays were negative. LD> The questions I have are: LD> 1. What are the likely causes of the client's recent decline: LD> a. Normal progression of the disease LD> b. Fear of falling/standing secondary to recent fall LD> 2. Based on the above, or any other plausible explanations, what treatment LD> approaches will best facilitate this client to be able to increase her LD> participation in toileting and transfers. LD> Thanks, LD> Ron LD> P.S. I am seeing the client today and Friday and plan to make a decision LD> about which direction to take our remaining therapy. Should we continue LD> working on remediation of underlying issues or begin adaptive strategies to LD> decrease the family's burden and promote the client's safety LD> _______________________________________________ LD> To unsubscribe, visit: LD> http://otnow.com/mailman/listinfo/otlist_otnow.com LD> The OTnow Mail Archive: LD> www.mail-archive.com/[EMAIL PROTECTED] LD> =============================================== LD> _______________________________________________ LD> To unsubscribe, visit: LD> http://otnow.com/mailman/listinfo/otlist_otnow.com LD> The OTnow Mail Archive: LD> 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] ===============================================
