Advice in assisting dementia sufferer

[Mosaic]

An elderly rellie of some 90 years is suffering with vascular dementia - generally happy in self but increasingly immobile. There is no medical reason other than age and the progress of the dementia for mobility difficulties.

Recently when being assisted from car to home or wherever, doorways seem to be posing a big difficulty. The rellie kind of sticks across the threshold and won't / can't move backwards or forwards, and becomes panicky if attempts are made to take elbow, support and lead etc.
I've found the only solution to be to coax the rellie back out and then back in taking tinier steps.
I wondered if anyone has come across this, has any advice to offer or any insights? I understand that perception is affected as the disease progresses but it seems strange that this just happens going into doorways.

[Fitzer]

This seems to be not uncommon in these kinds of degenerative problems, my mother had cortico-basal degeneration and had exactly the same problem, your solution seemed to be the only one we could find I'm afraid. We never found any reason but then the mind is an odd thing, good luck with your caring.

[Mosaic]

Thanks for that Fitz

[woofgang]

suggestions from my days as an occupational therapist, now retired.

Focus on something other than the walking, so instead of saying, lets go out to the car, talk about where you are going in the car, if the destination is the bathroom or loo, talk about nice talc, fluffy towels...anything really related to where you are going. Similarly keep reli's attention up and ahead..point out a picture on the wall, for instance.

If its possible (and it may not be) mark a wide line along the floor in a contrasting colour that flows through the doorway or other sticking point.

Next one sounds silly but it works...sing something that she can walk to the rhythm of, get her to join in if she can.

If she does "get stuck" try getting her to mark time on the spot then say "One Two Three, GO" or get her to do a LITTLE rock forward with each count.
If you are going to do either of the last two, then you need to get her "ready" by saying something like "okay xxx we need to get you unstuck, let march on the spot....ready one two, one two"....when she is marching then "are you ready? one two three go" Use a similar "script" if you are going to try the rocking technique. Think of the way a child rocks as she (he) gets ready to jump into a turning skipping rope. Rocking is a bit riskier, I would try the marching on the spot one first.

if any of these "tricks" are going to work, they will work better with practice, so if you have any success at all, then persevere.

[Eve]

Have you tried asking her gently what is wrong when she stops or do you concentrate more on trying to persuade her to get through the door?

If she gives you an answer it might help in finding a solution.

If she takes tinier steps the second time, maybe approaching with tinier steps initially could be worth a try?

[Mosaic]

Thanks for your splendid suggestions folks.
Dear old thing is totally deaf and pulls out the hearing aids, but also due to the disease is generally not engaging with talk much, mainly yes / no - so you see Jenna there are limits on trying to conceptualise and talk about what the problem might be.
The distraction technique sounds a good idea Woofgang, especially as the dear old thing's main goal is to get back to the comfy chair on all occasions, so I think a 'nice walk to the comfy chair' will be a tag they can relate to.

The walking comes and goes - very unbalanced especially to one side, but also related to the simple fact that the comfy chair is the favourite place and anything else is not really wanted.

Thanks again.

[Huderon]

Silly thought ... if the other side of the doorway is a patterned surface, the rellie might see the darker parts of the pattern as "holes" they could step into and fall. For home you could try putting a light, plain coloured rug just inside the door.

Some time ago, probably on Woman's Hour, there was an interview with a doctor who specialised in dementia. She was talking about the things she was doing to prepare for the possibility that she would suffer from it, and one of them was replacing patterned floor surfaces at home with plain, light coloured ones. I couldn't find a link to that interview on a quick search, and don't have time to plough through the WH archive right now, but I will have a proper look this evening and post a link if I can find it.

[Mosaic]

Thanks Huderon - I recall that radio 4 article as well, and I think you have a point. The doorways concerned are prone to shadows at certain times of day and so may be confusing. Thanks.