How should we tailor our treatment or approach a patient with the early and middle stages of dementia during gait training?
Answer
Remember GAIT tasks are often engrained into long term memory as procedural tasks therefore abilities may be preserved into later stages. Safety awareness can be a significant concern during follow through of tasks. Incorporate gait tasks into functional and desirable routines for the residents versus simply saying “Lets go for a walk” say “Lets take a walk down to activities”. Tie purpose to the task and make routine.
For residents with high level gait abilities in early stages of dementia provide verbal review of tasks prior to initiation. For example: “Mr. Jones we are going to walk to activities with your walker. Remember in order to stay safe do not let the walker get to far ahead of you and remember to watch out for other residents and wheelchairs in the hallways so we do not risk having a fall”.
For middle stages, provide verbal instuctions at only 2-steps max.
Renee Kinder, MS, CCC-SLP, RAC-CT
Renee currently serves as Director of Clinical Education for Encore Rehabilitation where she provides education for interdisciplinary team members related to clinical programming, Medicare regulations, documentation requirements, and evidenced based practice patterns. She maintains certification as a resident assessment coordinator (RAC-CT) from the American Association of Nurse Assessment Coordination (AANAC). She is an active member of the American Speech Language Hearing Association currently serving as Editor of Perspectives on Gerontology and acting as a member of ASHA’s Healthcare and Economics Committee. Additionally, she is a member of community faculty for the University of Kentucky College of Medicine, serves as an Ambassador for the Alzheimer’s Association of America, and acts as Vice President of Healthcare for the Kentucky Speech Language Hearing Association.
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