Guest guest Posted April 30, 2010 Report Share Posted April 30, 2010 The walker discussed below is this one: http://www.spinlife.com/critpath/match.cfm?categoryID=251 (saving for the Links section) > > (I'm updating Geri Hall's post so that I can keep saving them in the > links w/out having her expired contact info on the post) > > > Could someone tell me some thing? I'm having trouble tonight > >getting this letter out. > > Ronnie has fell before? And the Dr.seemed to help.But now he > >isfalling again? Is this the way it works? Falling and keep falling? > > He is having trouble holding his kidneys and some bowel trouble > >too? He is even wetting the bed? But if I ask him if he is having > >trouble he says know I knew I did it? Now do you think he is in > >denial? Or is it just me?Having trouble hearing me too.If he hears > >something and I don't he says I'm not going crazy I heard it. Help me > >understand if you can? Thank you a head of time. I know one of you > >can help.Arletha > > Geri Hall's response: > > " Arletha > People with LBD fall for several reasons: > > 1. The Parkinsonain shuffle causes them to pitch forward and lose > control. Also it causes them to catch their feet on rugs, throw rugs, > etc. Other than a cholinergic (aricept, etc), Physical and > Occupational therapies there isn't much that can be done about this. > This also causes falls going upstairs. > > 2. Decreased psychomotor speed. Once the patient starts to fall their > neurological responses are too slow to allow them to compensate. Also > they are bradykinetic due to the motor disorder. Again, the > cholinerics are usually the best alternative. > > 3. Decrease motor planning - The patient knows what he wants to do but > can't make the muscles move in the appropriate sequence to get this > done AND the more the patient thinks about the activity, the worse the > problem. So the best thing to do is distract if you see > them " frozen, " and offer your hand as if to shake it, giving a slight > slight pull towards you. > > 4. Orthostasis - Usually due to medications (but can be due to > immobility and/or a PD-Plus disease such as MSA). This means the > blood pressure falls when the patient stands up. We compensate by > using support hose, changing medications, exercises, abdmoinal > binders (a girdle for women), and getting people up verrrrrryyyyy > sloooooowwwwwllly. > > 5. Tripping, slipping due to decreased visual perception. When people > experience changes in visual perception there are some things that are > classic even early on. Decreased depth perception (this is one reason > why the people on TV seem more real), decreased verticality (the > world is on a slant), decreased facial and object recognition, and > decreased dynamic horizontal visual acuity (you don't see things > moving across the visual field). There are others too, but that is > enough for now. You approach that problem two ways: decrease or > eliminate TV when the patient is around; making sure the environment > is simple (no throw rugs, minimal chatchkes and knick knacks, few > pictures of people around etc -- NO CLUTTER!!!!) > > When people start to fall we often try one of the wheeled walkers that > looks like a shopping cart. It has to have a retractable brake so the > patient doesn't have to coordinate hand brakes. It should have a seat > and a basket. A person with LBD as a rule should not be given a cane > as it is too easily used as a weapon. Moreover, if the therapist > wants to try your LO on a standard walker first, refuse. It sets the > patient up for failure and then Medicare won't pay for the more > expensive (about $400) walker. Go for the expensive one first. > > Last, falling is normal in the progression of the disease. We try to > keep the person as mobile as possible but...all falls can't be > prevented. It is CRITICAL that a physical therapist show you and your > LO how to get up without injuring yourself and the proper way to > assist walking to minimize injury. " > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 30, 2010 Report Share Posted April 30, 2010 Wow...I didn't know that they have walkers with weight activated brakes. So many of those rollator walkers require almost super-human stength to stop or slow them going down hill. Is it possible to post another link in that folder for 'Weight Activated Brake ' also...in addition to the one that says 'Falling'. I just had a difficult time finding it and wanted to go back and look at it, but didn't realize that it was just listed as falling (as it should because of the message included.) If I should ever need that, I probably would have not opened the 'Falling' file as most of the other items in that main folder have the item listed. Just a thought...not a requirement. > > > > (I'm updating Geri Hall's post so that I can keep saving them in the > > links w/out having her expired contact info on the post) > > > > > Could someone tell me some thing? I'm having trouble tonight > > >getting this letter out. > > > Ronnie has fell before? And the Dr.seemed to help.But now he > > >isfalling again? Is this the way it works? Falling and keep falling? > > > He is having trouble holding his kidneys and some bowel trouble > > >too? He is even wetting the bed? But if I ask him if he is having > > >trouble he says know I knew I did it? Now do you think he is in > > >denial? Or is it just me?Having trouble hearing me too.If he hears > > >something and I don't he says I'm not going crazy I heard it. Help me > > >understand if you can? Thank you a head of time. I know one of you > > >can help.Arletha > > > > Geri Hall's response: > > > > " Arletha > > People with LBD fall for several reasons: > > > > 1. The Parkinsonain shuffle causes them to pitch forward and lose > > control. Also it causes them to catch their feet on rugs, throw rugs, > > etc. Other than a cholinergic (aricept, etc), Physical and > > Occupational therapies there isn't much that can be done about this. > > This also causes falls going upstairs. > > > > 2. Decreased psychomotor speed. Once the patient starts to fall their > > neurological responses are too slow to allow them to compensate. Also > > they are bradykinetic due to the motor disorder. Again, the > > cholinerics are usually the best alternative. > > > > 3. Decrease motor planning - The patient knows what he wants to do but > > can't make the muscles move in the appropriate sequence to get this > > done AND the more the patient thinks about the activity, the worse the > > problem. So the best thing to do is distract if you see > > them " frozen, " and offer your hand as if to shake it, giving a slight > > slight pull towards you. > > > > 4. Orthostasis - Usually due to medications (but can be due to > > immobility and/or a PD-Plus disease such as MSA). This means the > > blood pressure falls when the patient stands up. We compensate by > > using support hose, changing medications, exercises, abdmoinal > > binders (a girdle for women), and getting people up verrrrrryyyyy > > sloooooowwwwwllly. > > > > 5. Tripping, slipping due to decreased visual perception. When people > > experience changes in visual perception there are some things that are > > classic even early on. Decreased depth perception (this is one reason > > why the people on TV seem more real), decreased verticality (the > > world is on a slant), decreased facial and object recognition, and > > decreased dynamic horizontal visual acuity (you don't see things > > moving across the visual field). There are others too, but that is > > enough for now. You approach that problem two ways: decrease or > > eliminate TV when the patient is around; making sure the environment > > is simple (no throw rugs, minimal chatchkes and knick knacks, few > > pictures of people around etc -- NO CLUTTER!!!!) > > > > When people start to fall we often try one of the wheeled walkers that > > looks like a shopping cart. It has to have a retractable brake so the > > patient doesn't have to coordinate hand brakes. It should have a seat > > and a basket. A person with LBD as a rule should not be given a cane > > as it is too easily used as a weapon. Moreover, if the therapist > > wants to try your LO on a standard walker first, refuse. It sets the > > patient up for failure and then Medicare won't pay for the more > > expensive (about $400) walker. Go for the expensive one first. > > > > Last, falling is normal in the progression of the disease. We try to > > keep the person as mobile as possible but...all falls can't be > > prevented. It is CRITICAL that a physical therapist show you and your > > LO how to get up without injuring yourself and the proper way to > > assist walking to minimize injury. " > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 30, 2010 Report Share Posted April 30, 2010 Done - in 2 sections in the Links section... > > > > > > (I'm updating Geri Hall's post so that I can keep saving them in the > > > links w/out having her expired contact info on the post) > > > > > > > Could someone tell me some thing? I'm having trouble tonight > > > >getting this letter out. > > > > Ronnie has fell before? And the Dr.seemed to help.But now he > > > >isfalling again? Is this the way it works? Falling and keep falling? > > > > He is having trouble holding his kidneys and some bowel trouble > > > >too? He is even wetting the bed? But if I ask him if he is having > > > >trouble he says know I knew I did it? Now do you think he is in > > > >denial? Or is it just me?Having trouble hearing me too.If he hears > > > >something and I don't he says I'm not going crazy I heard it. Help me > > > >understand if you can? Thank you a head of time. I know one of you > > > >can help.Arletha > > > > > > Geri Hall's response: > > > > > > " Arletha > > > People with LBD fall for several reasons: > > > > > > 1. The Parkinsonain shuffle causes them to pitch forward and lose > > > control. Also it causes them to catch their feet on rugs, throw rugs, > > > etc. Other than a cholinergic (aricept, etc), Physical and > > > Occupational therapies there isn't much that can be done about this. > > > This also causes falls going upstairs. > > > > > > 2. Decreased psychomotor speed. Once the patient starts to fall their > > > neurological responses are too slow to allow them to compensate. Also > > > they are bradykinetic due to the motor disorder. Again, the > > > cholinerics are usually the best alternative. > > > > > > 3. Decrease motor planning - The patient knows what he wants to do but > > > can't make the muscles move in the appropriate sequence to get this > > > done AND the more the patient thinks about the activity, the worse the > > > problem. So the best thing to do is distract if you see > > > them " frozen, " and offer your hand as if to shake it, giving a slight > > > slight pull towards you. > > > > > > 4. Orthostasis - Usually due to medications (but can be due to > > > immobility and/or a PD-Plus disease such as MSA). This means the > > > blood pressure falls when the patient stands up. We compensate by > > > using support hose, changing medications, exercises, abdmoinal > > > binders (a girdle for women), and getting people up verrrrrryyyyy > > > sloooooowwwwwllly. > > > > > > 5. Tripping, slipping due to decreased visual perception. When people > > > experience changes in visual perception there are some things that are > > > classic even early on. Decreased depth perception (this is one reason > > > why the people on TV seem more real), decreased verticality (the > > > world is on a slant), decreased facial and object recognition, and > > > decreased dynamic horizontal visual acuity (you don't see things > > > moving across the visual field). There are others too, but that is > > > enough for now. You approach that problem two ways: decrease or > > > eliminate TV when the patient is around; making sure the environment > > > is simple (no throw rugs, minimal chatchkes and knick knacks, few > > > pictures of people around etc -- NO CLUTTER!!!!) > > > > > > When people start to fall we often try one of the wheeled walkers that > > > looks like a shopping cart. It has to have a retractable brake so the > > > patient doesn't have to coordinate hand brakes. It should have a seat > > > and a basket. A person with LBD as a rule should not be given a cane > > > as it is too easily used as a weapon. Moreover, if the therapist > > > wants to try your LO on a standard walker first, refuse. It sets the > > > patient up for failure and then Medicare won't pay for the more > > > expensive (about $400) walker. Go for the expensive one first. > > > > > > Last, falling is normal in the progression of the disease. We try to > > > keep the person as mobile as possible but...all falls can't be > > > prevented. It is CRITICAL that a physical therapist show you and your > > > LO how to get up without injuring yourself and the proper way to > > > assist walking to minimize injury. " > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 30, 2010 Report Share Posted April 30, 2010 Thanks.... > > > > > > > > (I'm updating Geri Hall's post so that I can keep saving them in the > > > > links w/out having her expired contact info on the post) > > > > > > > > > Could someone tell me some thing? I'm having trouble tonight > > > > >getting this letter out. > > > > > Ronnie has fell before? And the Dr.seemed to help.But now he > > > > >isfalling again? Is this the way it works? Falling and keep falling? > > > > > He is having trouble holding his kidneys and some bowel trouble > > > > >too? He is even wetting the bed? But if I ask him if he is having > > > > >trouble he says know I knew I did it? Now do you think he is in > > > > >denial? Or is it just me?Having trouble hearing me too.If he hears > > > > >something and I don't he says I'm not going crazy I heard it. Help me > > > > >understand if you can? Thank you a head of time. I know one of you > > > > >can help.Arletha > > > > > > > > Geri Hall's response: > > > > > > > > " Arletha > > > > People with LBD fall for several reasons: > > > > > > > > 1. The Parkinsonain shuffle causes them to pitch forward and lose > > > > control. Also it causes them to catch their feet on rugs, throw rugs, > > > > etc. Other than a cholinergic (aricept, etc), Physical and > > > > Occupational therapies there isn't much that can be done about this. > > > > This also causes falls going upstairs. > > > > > > > > 2. Decreased psychomotor speed. Once the patient starts to fall their > > > > neurological responses are too slow to allow them to compensate. Also > > > > they are bradykinetic due to the motor disorder. Again, the > > > > cholinerics are usually the best alternative. > > > > > > > > 3. Decrease motor planning - The patient knows what he wants to do but > > > > can't make the muscles move in the appropriate sequence to get this > > > > done AND the more the patient thinks about the activity, the worse the > > > > problem. So the best thing to do is distract if you see > > > > them " frozen, " and offer your hand as if to shake it, giving a slight > > > > slight pull towards you. > > > > > > > > 4. Orthostasis - Usually due to medications (but can be due to > > > > immobility and/or a PD-Plus disease such as MSA). This means the > > > > blood pressure falls when the patient stands up. We compensate by > > > > using support hose, changing medications, exercises, abdmoinal > > > > binders (a girdle for women), and getting people up verrrrrryyyyy > > > > sloooooowwwwwllly. > > > > > > > > 5. Tripping, slipping due to decreased visual perception. When people > > > > experience changes in visual perception there are some things that are > > > > classic even early on. Decreased depth perception (this is one reason > > > > why the people on TV seem more real), decreased verticality (the > > > > world is on a slant), decreased facial and object recognition, and > > > > decreased dynamic horizontal visual acuity (you don't see things > > > > moving across the visual field). There are others too, but that is > > > > enough for now. You approach that problem two ways: decrease or > > > > eliminate TV when the patient is around; making sure the environment > > > > is simple (no throw rugs, minimal chatchkes and knick knacks, few > > > > pictures of people around etc -- NO CLUTTER!!!!) > > > > > > > > When people start to fall we often try one of the wheeled walkers that > > > > looks like a shopping cart. It has to have a retractable brake so the > > > > patient doesn't have to coordinate hand brakes. It should have a seat > > > > and a basket. A person with LBD as a rule should not be given a cane > > > > as it is too easily used as a weapon. Moreover, if the therapist > > > > wants to try your LO on a standard walker first, refuse. It sets the > > > > patient up for failure and then Medicare won't pay for the more > > > > expensive (about $400) walker. Go for the expensive one first. > > > > > > > > Last, falling is normal in the progression of the disease. We try to > > > > keep the person as mobile as possible but...all falls can't be > > > > prevented. It is CRITICAL that a physical therapist show you and your > > > > LO how to get up without injuring yourself and the proper way to > > > > assist walking to minimize injury. " > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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