In Joan's blog "Teenage Rebellion and My AD Husband" she gives links to Dr. Barry Reisberg's clinical stages of the disease. One of the links is an extremely detailed explanation of the stages and how long they can last. Under Stage 7, there was an interesting statement something like "superb care at the beginning of Stage 7, particularly 7B, can postpone the onset of loss of ambulation for a long period of time."
I started wondering--what is the definition of superb care? Then I thought about two of my friends' husbands who have AD, one who lives in an assisted living and the other in a nursing home. Of the former, the wife said "They have him in a wheelchair, but he can still walk." The other goes to visit her husband and gets him up to walk every day because she said the staff "leaves him in the chair". It is not surprising, with the ratio of staff to patients being what it is, that this is the situation. However, now I'm wondering if the loss ambulation could have been postponed, based on what the link stated, if a different kind of care was given.
I'm sure others with more experience will be along soon. I noticed that DH was having more difficulty walking before we placed him in July. He was much slower, taking 'smaller' steps, it seemed and taking more 'unsure' steps. However he is still walking and I take him out almost daily to walk around the grounds. He loves his bed though and chooses to lay down more than he sits in his recliner. When he was at home, his bed was in the back bedroom and not that handy. In trying to think it through, he was nearly as sedentary at home as he is at the assisted living with exception that he's laying down on that bed more. Its just hard to know for sure. Just seems logical that the more they can walk, the better..but with this disease who knowsss..
Thanks for drawing attention to Dr. Reisberg's clinical stages of AD. It places my husband with symptoms between 5 and 6E. I find it helpful in planning how to pace myself as a caretaker With a possible 3-4 years ahead of me, and with my 81st birthday coming up in Feb., I may have to drop back on my visiting hours with my 91-year-old husband: that's 3-4 hours a day, 5X weekly, and I'm tired. Lmohr's posting that she would visit maybe every other day sounds more reasonable. But then I keep thinking I may not have him much longer, and I should make the effort. As for the point you raise, it makes sense that the more you can keep a person functioning to the limit of their capabilities, the better, Having said that, I'm planning to take my husband by wheelchair, rather than use his walker, to the eye doctor this coming week. I think it will be easier on him, and he does walk a lot at the Care Facility (his room is a long distance from the dining room.)
I agree that there is no way of knowing how fast loss of ambulation will proceed. My husband was a pacer and would walk for hours. Unfortunately, he did not have the strength to walk for hours. After a while he would begin falling (this was while he was still at home). At first he would manage to pull himself up and try to keep going. Later, I simply had to leave him on the floor for a while until he had the strength to get himself up. At the nursing home, he had a very bad fall the first day he was there and they put him in a merry walker so that he could continue to walk but be safe. This lasted 4 months until he began upsetting the walker and it was no longer safe. He is now in a wheel chair. The staff did walk him a lot at first, but he has continued to weaken and his muscles are very stiff and his balance bad. I truly do not believe that continuing to let him walk would have kept him walking any longer. But, every case is different.
Mary75--this is the most detailed description of the stages that I've read, and the only one that includes possible timeframes. I was surprised to see how long Stage 7 can last, if the patient survives the entire time (six sub-stages lasting 1 to 1 1/2 years each). I agree that you need to conserve your strength and should consider fewer days and perhaps shortening the visit. 3-4 hours seems like a long time to me!