How can an Alzheimer's person go thorugh physical therapy?

Southernhope asked...

My 83-year-old mother-in-law, suffering from dementia, has now broken her hip and surgery is scheduled for Friday. I've read all of the posts about recovering from hip surgery but what i haven't seen (and can't figure out) is how in the heck does a person who can't remember or understand much, then go through physical therapy? There were days (before this accident) where she literally could not remember how to walk.

it's all sad...and knowing that this surgery seems to be unavoidable, I'm really at a loss as to how to help.

Expert Answer

Joanne Koenig Coste is a nationally recognized expert on Alzheimer's care and an outspoken advocate for patient and family care. She is the author of Learning to Speak Alzheimer's. Also, she currently is in private practice as an Alzheimer's family therapist. Ms. Koenig Coste also serves as President of Alzheimer Consulting Associates, implementing state-of-the-art Alzheimer care throughout the United States.

Your concern about your mom-in-law's impending surgery is both admirable and warranted. The most difficult problem, related to surgery in elderly dementia patients, is the after-effect of anesthesia. To that caveat, I must add that often the person, who is cognitively impaired, becomes extremely agitated when they find themselves in strange surroundings with people caring for them who are not familiar, the sounds are foreign, the odors are unrecognizable, the environment itself is scary, and the list goes on. Be prepared that this possible behavior is not truly offensive but is, in fact, defensive - she will be defending herself against a world she simply does not understand. Lots of extra love and support works wonders! Now, with that said, let me assure you that physical therapy (PT) can be a very positive service for the post-operative dementia patient. Not so very long ago, Pt was not offered to the recovering AD person because they did not meet the criteria of being 'able to follow instructions' or to recall directions for exercises suggested by the PT. Fortunately, times have changed and Physical Therapy has become an important facet in the best recovery whether or not the person can follow or retain instructions. It is the appropriate movements performed by the therapist that are beneficial to future use of the injured joint. Frequently, the PT will demonstrate gentle range-of-motion exercises to members of the family or others who will be with the patient following surgery.
People with a dementing illness who are in the final stage of Alzheimer's or a related disease, and are now in need of total care, still benefit from physical therapy to control pain and maintain whatever movement remains. I suggest you read the related topic "Physical Therapy for a Broken Hip" for further information on the reasons to include post-operative PT. This was a great question and I know many readers are wondering the same thing. Thanks!