Cognitive issuses

[Flpopsi]

My wife has bulbar onset an can't speak and has swallowing problems. She lost use of her right hand (her writing hand) about 6 months ago. She had been able to walk slowly until recently when she started falling on a regular basis. Her falls have resulted in broken wrist, compression fractures in her spine, cuts and bruises on arms and several large bumps on her head. She has a walker, rollator, cane and safety rails in key areas. The major problem is she won't listen to my advise and lost the ability to reason logically. Tonight she had two falls about 30 minutes apart, one banged her elbow and the other put a big bump on her head. She tries to do things that she is not capable of doing anymore. The neuro has said that she has cognitive problems where it's hard to follow logical sequences and decisions. How can I stop her from walking which results in for many falls

 

[4tloml]

So very sorry you and your wife are facing this. Does she have a wheelchair? With that much falling, doctor should get one ordered ASAP. Meanwhile, the ALS Association and MDA (Muscular Dystrophy Association) often have "loaner" chairs until her custom chair arrives.

When cognition becomes so compromised, I think the stage where they simply can't get onto their feet without help becomes easier--definitely safer. My husband's cognition has been similarly impacted and so I have to stay within earshot all of the time. He spends most of his time in a lift chair, so when I hear it moving, I need to get to him because he will try to stand and walk. (Luckily, our house is small enough that I can hear, otherwise, I'd be using a baby monitor.) When he's in the wheelchair, I keep him buckled and his hands aren't able to unbuckle himself. I now have a bar on the bed and I listen for movement. He can't really turn well or get himself up, so hearing him attempt to gets me running.

If your wife is still using a walker, a gait belt can be helpful. The doctor should be setting you up with an Occupational Therapist (OT) and Physical Therapist (PT), who could provide specific tips and information relative to your environment and instructions on how to use assistive devices (like the gait belt).

The bottom line is that she can't be left alone and needs constant supervision. It is a difficult stage when our PALS simply don't understand the risks they are taking. We want them to be in control of their choices, but making a choice involves assessing risk/reward. When cognitive decline steals their ability to assess, I learned the hard way that caregiving sometimes entails making certain choices for them.