"In conversation with a physiotherapist"

talkingdementia

Jun 3

#DementiaAwareness Week 2022

Dementia Awareness Week 2022 (Monday 30 May to Friday 5 June) is an opportunity to support the 90,000 people living with dementia in Scotland and their families and carers. The theme for this year's Dementia Awareness Week is 'Prevent, Care, Cure'.

Hi! I'm Claire and I am here today to answer some of the questions Physiotherapists are frequently asked by people with dementia, their families, friends, carers, and the health professionals who work with them.

I will also share some resources, and some online communication hashtags as we would love you to get in touch with us and share your tips with us.

QUESTION: My family worry that I am going to get lost or hurt if I go out on my own – how can I reduce the risk of this?

ANSWER: This is often about managing risk, but the gains from remaining active can be powerful. Always have comfortable shoes and a warm coat handy to put on.

Having a goal based routine, e.g. going for the papers, getting milk, or going for a coffee, may remove some of the fear of others especially if you do this regularly and return. It also helps if your family know your familiar routes and routines.

Have a discussion with your family about what will happen if you do get lost. Keep a photo handy that they can share, and consider carrying your families' contact details with you. You can also sign up to the purple alert scheme. https://www.alzscot.org/purplealert

You can also consider and discuss wearing or carrying something that tracks where you are, so that if something does happen to you, you can be found. Mobile phones have inbuilt GPS technology, and you can get small keyrings or similar to clip on your bag, or put in your pocket.

QUESTION: I can't seem to sit still, and often walk until I am very tired, and at risk of falling. What can my family do to help me?

ANSWER: Walking can help to relieve stress and boredom and it is good exercise. But walking continuously, even when tired, could be a sign of an unmet need – i.e. there may be a purpose to your walking, but you and your family may not immediately know what this is. By understanding this, and looking for solutions, you may rest more easily when you need to. You may be walking to find someone or something, to reduce pain, because you are uncomfortable, because you are lost, bored or worried. This carer information leaflet from Alzheimer Scotland offers some more ideas to try.

QUESTION: I need a walking aid, but I often forget to use it – how can I remember to use this more easily?

ANSWER: Many people do not like to use walking aids as it makes them feel less able. Frames and sticks can also feel very impersonal, and people with visual impairment can find the grey ones hard to see, and identify as "my stick" or "my frame". Brightly coloured walking sticks that people choose themselves can work well, and there is evidence that red zimmers may be better for people with dementia. You can get a similar effect by "pimping your walking aid" to make it more memorable and something you want to use. Wrap it in bright coloured vinyl or tape, add some flowers, or attach a brightly coloured bag to carry your shopping in – we would love to hear and see your other ideas at #withPHYSIOyouCAN, and you can share more widely at #pimpmyzimmer

I recently heard from a person with dementia that they think of their walking aid like a dance partner – it's on their arm as they walk "onto the dancefloor", it takes them back to their chair at the end of the dance, and only once they are sitting do they let go. I wonder if this, or a similar narrative may work for you?

QUESTION: I am sitting more, and have found my motivation to move has reduced as my dementia has progressed – how can I be more active?

ANSWER: high levels of sitting time have been linked with frailty, falls and poor physical function, and older adults (OA) who break up their sitting time more frequently have better physical function (sardinha et al 2015) so if you do one wee thing – aim to break up your sitting time. A Simple way to do this is to stand up and sit down 5-10 times, and stretch when you stand.

Keeping motivated to move can be difficult. It is important to explore why you do not want to move: Is your mood low? Are you anxious about falling? Do you have physical changes or pain? Request a Physiotherapy assessment if you have any concerns.

Some Ideas to try include:

Try different activities – and have fun!
Plan exercise into your daily routine. Perhaps write out a schedule on a white board and calendar.
Exercise to your favourite music
Set a goal and track your progress e.g. how many sit to stands can you do, how long can you balance on one leg.
Buddy up and do activities with another person.
Try some balance exercises such as the super 6 or seated super 6 exercises on this page https://www.alzscot.org/ahpresources

Also on this page, is our recently launched document "Just Move"! We have a webinar on this running with Alzheimer Scotland and @AHDementia on Wednesday 29^th June at 3.30pm - come and join us to find out more, and share your ideas with us on twitter at #justmove

I hope these answers are helpful! If you have any concerns about your physical health or mobility, request a physiotherapy assessment via your local GP or mental health nurse/AHP. We CAN help you live well with dementia.

Contributor

Claire Craig is a Physiotherapy Team Lead & Mental Health Physiotherapist in NHS Ayrshire & Arran. She has completed the NES (National Education for Scotland) DSIL (Dementia Specialist Improvement Lead) training, and is an advocate for promoting movement with people with dementia, their carers and families. She loves to dance and will take every opportunity to share the benefits of dancing with everyone! Twitter: ClaireCraig_PT