Wednesday, October 22, 2014

Thursday, May 06, 2010 Karen, Community Member, asks

Q: Is it common for an Alzheimer patient to lean to one side while walking or standing?

My father was diagnosed with Alzheimers 3 years ago at the age of 67. He has progressed very fast. He is exhibiting moderate to late stages of the disease. We had to place him in a nursing home Alzheimers unit 4 weeks ago. He was beginning to become more angry and would hit and shove my mother and daughter. At the end of his 3rd week he has started to severly lean to his right side. He has parkinson's. He has severe arthritis to his Left shoulder. He had his Right shoulder replaced 2 yrs ago. He recieves pain medication for shoulder and this does not seem to lessen his leaning. Of coarse he will lean to the right side when sitting too.

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Answers (5)
Christine Kennard, Health Pro
5/ 8/10 3:24pm

Dear Karen


I am so sorry to hear about your father. Unfortunately aggression is a common cause of placement in a nursing home for people with Alzheimer's. Even though it is a difficult decision I am sure it is the best thing for all of you. It is very hard.


Leaning to the left side can be due to a number of different medical diseases and conditions. It is quite common in people with various neurological illnesses, one of which is Alzheimer's and/or Parkinson's disease. It is also seen in people who are very ill and weak, people who have severe arthritis and because of pain.


Presumably his doctor has examined him and has ordered the best treatment for your father.


I hope this is helpful. All my best wishes at this difficult time



Joseph, Community Member
5/ 7/10 1:02am

Hi Karen,  My mother has "unspecified dementia" (probably "vascular dementia" due to a stroke), and as the illness progressed, her walking became more difficult, she had many falls using her walker and developed the lean that you mentioned.  Her latest issues involve difficulty holding her head up and trouble swallowing food or pills.  Remarkably, she still has some degree of clarity in speaking although she is obviously confused.  Finding the right words to form a sentence has become a challenge for her, too.


I have witnessed the leaning issue in others with dementia and I consider it a common later symptom of the illness.  As far as I know, there is nothing that can be done to correct the problem.  My mother isn't even aware that she is leaning.  I'm sure that other answers will follow.  I hope this helps!  --  Joe  --

Dorian Martin, Health Guide
5/12/10 3:44pm

Hi, Karen,


My mom also increasingly leaned to one side as her Alzheimer's progressed. I also saw several other nursing home residents who had dementia who leaned over in their wheelchairs. I'm assuming that it was a combination of the disease affecting their balance and potential muscle weakness caused by inactivity.


Take care and stay in touch!



mattdegu, Community Member
7/ 7/13 4:23pm

It is also a recognised side-effect of long-term donepezil use (Aricept), the drug that's often used to lessen the effect of Alzheimer's. If it's really bad it might be worth stopping the drug. I give my mother a good many other things too (an Albion chelated magnesium suppliment, a good set of combined B's, garlic, a probiotic and ginger for better digestion and many more I think could be doing something but will never know for sure), so I am considering this route myself. Most of the things I get her (from the USA as it's cheaper) have shown double-blind trial results at least good as donepezil, which the verdict is still out on really, if not a little better. None of them cure it of course.


The drug-related leaning problem is called Pisa syndrome, and when it comes for Mum (so far it can come and go) it can be a real pain for us, as Mum is still really active, despite having the disease for well over 10 years now (since the 90's), and possibly as much as 20 years. She is relatively easy to manage though (though she wasn't at all for a period), and just wants to be out and about walking around all day, which I do with her. She doesn't make much sense any more, but her body's held up really well, and she is happy if the world around her is. Constant and interesting excercise (which needs 1 on 1 care) and the best nutrition humanly possible is the best way to tackle Alz I've found. The disease eats up everything and leaves their brains deficient in many areas, vitamins, minerals etc, which is why I suppliment so much.


As usual with diseases try and keep away from sugars, which tend to feed the disease. Best used as treats in the old-fashioned way. Cake isn't great for the elderly anyway. Sugar is taken via fruit anyway, and apples are particularly good: 1 a day at least. Caffein is the quickest hit to the brain, and should be daily, along with plenty of water - a good mineral water ideally if it's known as being bad where you are. Never, ever dehydrate. I go for at least 6-a-day plus supp's to make sure Mum is nutritionally at least okay. She needs patience at the table, as she often gets up and seems to lose interest, when in reality she'll eat it all and more besides! These days I let her start on chopped up dinner, and take just over if she doesn't make it to the end.


Basically, treat them as much like royalty as you possibly can.


Carol Bradley Bursack, Health Guide
7/ 8/13 8:03am

Thanks for your thoughtful answer Matt. You obviously work hard to figure out your mother's unique needs and help her maintain the best health possible.

Take care of yourself, too!


mattdegu, Community Member
7/ 8/13 2:00pm

Thanks, I do when I can, though I don't get always 5 a day myself I admit (it wasn't clear but by "6-a-day" I was talking about fruit and veg).


Every sufferer is unique to quite a large degree I think, but there are also things that can work for all of us. An example I think is to let sufferers dictate their routines wherever possible, rather than us automatically forcing them into ones that suits us. You can often see some quite 'Victorian' attitudes regarding that in the UK, where people often excuse the unpopularity with the sufferers by thinking "you've got to be cruel to be kind". That unhappiness often leads to the use of disease-accellerating sedatives and anti-psychotics that may otherwise not be needed at all. Generally the more freedom the sufferers have (or perceive they have), the happier and more manageable they are.


Of course there are always sufferers who are just plain difficult, and I think they especially need 1-1 care. That's not cheap of course, but is not necessarily more expensive than many care homes that use shared-care in sometimes quite disruptive environments. Ideally Alz patients really shouldn't be kept together too much, and in some cases at all. That makes it an expensive disease to manage of course, as typically in the medical/care world, people people with the same kind of problems tend to be kept together.


If you work out all the various options in the UK, mixing up NHS care (not very available with someone like Mum), the various forms of paid-for care, and family as much as you can (all to make sure the sufferer has always got 1-1 care) it can be a lot cheaper than paying for a care home per week.


In my case, the only person Mum would allow to manage her for the longest time was me, and I still don't feel comfortable leaving her too long (so I don't leave her at all unless my brother comes down for the day which he does from time to time), as when she wants to 'get outside' for example, she can kick up quite a bit of dust. The downside to Mum's longevity I suppose it how demanding on my time she is.



Carol Bradley Bursack, Health Guide
7/ 8/13 2:29pm

You are right on about the care they need. Ideally, we'd have more help available than what exists in the UK or the US. Meanwhile, we do our best to give loving care. Kindness and empathy can go a long way and you have a lot of that.



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By Karen, Community Member— Last Modified: 07/08/13, First Published: 05/06/10