As there is a wide variety of different kinds of dementia, there are also an extensive number of possible symptoms that a person may live with.
For some, it may be challenges with their memory, for others it may be difficulties with speech and swallowing. Another common symptom that many people with dementia experience is challenges with mobility.
Physiotherapy can help people with dementia in a number of ways. They can provide assistance and support by tailoring unique routines. This can include;
- Movement exercises to keep muscles strong and flexible and make certain motions and activities easier
- Balance training to help reduce risk of falls and may encourage them to stand on their own or use a walker.
- Gait re-education with or without walkers
- Provide advice on mobility aids or equipment that a person may need to promote mobility and function
One study looked at the benefits of physiotherapy for people with advanced dementia. In a small scale study, it looked at 16 patients of a long-term care hospital ward who all had advanced dementia.
What it found was that mobility skills increased in six of these when physiotherapy – this consisted of body awareness, music and movement and functional mobility training – was introduced for the first time.
These improvements were seen within one to six weeks of treatment, and it was found therapy has the “optimal response” when done from five to nine weeks.
Unfortunately many aged care residents, hospital patients and older people with moderate to advanced dementia, find that they are denied physiotherapy for a number of reasons.
One common reason reported is that a person is not suitable because “they cannot remember the instruction or the advice given to them” or that they cannot follow the instructions given to them.
And while people with dementia may find physiotherapy challenging, the therapy can be altered and moulded to their capabilities. This may come back the health professional’s understanding of dementia and the potential benefits of keeping people as mobile as possible.
For example, instead of making them do stretches that require them to stand, do exercises that they can manage while they are sitting down, or that they can do from their beds.
Ideally, these exercises will be assisted by a physiotherapist or a carers, which lowers the risk of them falling or doing the exercise wrong.
Just because a client can be “challenging” does not give a justified reason as to why they should not access or be assisted with a particular therapy.
It’s important to encourage older people to do what they can within their limitations, and not set them up to fail with exercises that are too hard, or worse yet, give up on them entirely.
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