Physiotherapy Role in the Management of Dementia:
- Falls Assessment- Physiotherapists have specific training in falls assessment and treatment. Patients with dementia are at a higher risk of falling. A multi-factorial falls assessment can be an integral component in the management and treatment of a dementia patient who is falling. In a multi-factorial falls assessment, a number of core components are addressed. These include: balance assessment, muscle power assessment, low contrast visual acuity test, sensation testing, timed up and go test, blood pressure in supine and in standing and gait analysis.
- Gait Assessment- Patients with dementia have specific gait impairments. Many present with antropulsion, retropulsion, chasing centre of gravity and decresed balance on turning. These gait impairments put the patient with dementia at a high risk of falling. In the early stages, the Physiotherapist can assess the patient for a mobility aid. The aim is to keep the patient mobile for as long as possible within limits of safety. Physiotherapists are skilled in gait analysis and can identify any gait impairments that a patient with dementia can present with.
- Cardio-Vascular Training- Evidence shows that CV training is important in the management of a patient with dementia. CV training improves lower limb ambulatory strength and therefore leads to an improved gait pattern. It also has other beneficial factors such as maintaining adequate weight, improved circulation and decreases the symptoms of arthritis, which often can present as a co-morbidity.
- Carer Education and Support- Carer’s are often involved in joint goal setting with the patient on initial assessment. Goals can be both short term and long term and usually relate to improving mobility, thus improving the patient’s activity and participation in life events. Carers are often trained on how to safely transfer patients from bed to chair, educated on home exercise programmes and how to assist the patient with dementia in the use of a mobility aid.
- Hollistic Approach to Care- Linking in with other disciplines ensures optimal patient care. This might include the GP, Occupational Therapist, Public Health Nurse, Counsellor and Voluntary Organisations.
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