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Suggest Treatment For Difficulty In Walking
Question: My father is 85 years old and has experienced a rapid decline. In August he could walk, now he can't stand on his own. He has had two falls. I have 24 hour home care on him now because he's not capable of a few of the basic ADLs. He and I both view the whole matter as "what happened?" I know he is on the decline, but he can barely use his leg muscles. What is such a rapid decline likely to be caused by?
Brief Answer:
Physiotherapy with nutritional improvement
Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Looking at the clinical symptoms and query, my opinion is as follows:
1. Such rapid decline, appears to be neurological deterioration.
2. The falls could be due to syncope/dizziness secondary to hypotension, loss of balance etc. Repeat falls could have affected him psychologically, further reducing his overall activity.
3. It could be due to nutritional, infection, endocrine cause, dehydration, toxin exposure, medication adverse effects, psychological or even stroke. Age related changes would not occur so fast, however it cannot be ruled out.
4. As he has deteriorated too much that he is unable to manage his basic activities, he will require good care and I assume he is getting it through 24 hour home care.
5. However, his mental status needs to be ascertained. Does he remember everything? Can he talk and understand you well? Any behavioural changes or delusions? --- If possible, a mini-mental examination will help.
6. Now,
a. Need to get a complete hemogram, along with thyroid profile, CT of brain will be necessary to identify any possible cause.
b. Physiotherapy to improve muscle strength
c. Family support and involvement in social activities
d. Improvement in nutrition particularly multi-vitamin supplements and moderate protein diet.
e. Medications to improve his neurological well being.
He should start moving with support to make him less bed ridden and to improve him psychologically.
Further opinion requires more details.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Physiotherapy with nutritional improvement
Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Looking at the clinical symptoms and query, my opinion is as follows:
1. Such rapid decline, appears to be neurological deterioration.
2. The falls could be due to syncope/dizziness secondary to hypotension, loss of balance etc. Repeat falls could have affected him psychologically, further reducing his overall activity.
3. It could be due to nutritional, infection, endocrine cause, dehydration, toxin exposure, medication adverse effects, psychological or even stroke. Age related changes would not occur so fast, however it cannot be ruled out.
4. As he has deteriorated too much that he is unable to manage his basic activities, he will require good care and I assume he is getting it through 24 hour home care.
5. However, his mental status needs to be ascertained. Does he remember everything? Can he talk and understand you well? Any behavioural changes or delusions? --- If possible, a mini-mental examination will help.
6. Now,
a. Need to get a complete hemogram, along with thyroid profile, CT of brain will be necessary to identify any possible cause.
b. Physiotherapy to improve muscle strength
c. Family support and involvement in social activities
d. Improvement in nutrition particularly multi-vitamin supplements and moderate protein diet.
e. Medications to improve his neurological well being.
He should start moving with support to make him less bed ridden and to improve him psychologically.
Further opinion requires more details.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
An excellent answer and I thank you.
Brief Answer:
You are welcome
Detailed Answer:
Hi,
You are welcome .
If you do not have any further queries, you can close the discussion and rate the answer.
Dr. Prakash HM
You are welcome
Detailed Answer:
Hi,
You are welcome .
If you do not have any further queries, you can close the discussion and rate the answer.
Dr. Prakash HM
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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