DebbieG wrote:My 3/4 mom, age 85, is not doing well recently. She's had a couple of falls, and her cognition has declined. ... she needs something more. We're thinking that maybe the Amen Clinic could help - to see if a Spect scan would provide info that would enable Dad to target her treatment better, and see if there is something outside of functional medicine that could help her at least not get worse...Does anyone have experience with the Amen Clinic, especially with an elderly parent?
DebbieG, I'd give you and your parents a hug if I could, since all of you have been pulling together for several years to help your mom. I spent several years working with and learning from families with children who had traumatic brain injuries (TBI), and often they too felt like they should be doing something more, or seeing more results. I often encouraged them to remember every day just how much they had done, and the love that they gave their family through their efforts.
I think it's possible that you and maybe your dad are at a similar impasse--feeling like you should see more of a benefit from what you have done, and worried that you have not explored all the possible solutions. I used to have a rule at meetings I had on kids with TBI and other special needs: No one could bring up a "problem" until they had first described what was going well. For a child with frequent outbursts, it might be that the frequency, intensity or duration of outbursts was less now that the child's environment was more predictable. For a child with significant cognitive impairments, it might be that she was expressing herself through responses to music, and smiling with familiar people, and enjoying time spent with a family pet, and using assistive technology to ask for preferred foods. No one ever said "Nothing is going well" and often people said "It helps a lot to focus on when we can laugh together, or enjoy music, or relax on a drive or celebrate getting through a tough day."
It's presumptuous of me to offer more specific suggestions but--here I go! While getting PT myself, I have seen therapists working with individuals who appear to be at risk for falls and to be quite frail with patience and great skill in finding ways to increase their functional abilities. Your mother's DO should be able to write a prescription for a PT evaluation on "fall prevention and mobility". I would suggest that your father contact local PT agencies and ask specifically about whether they have therapists who work with people with cognitive impairments. (Most PTs are happy to tell you if they are not experienced with an issue.) Once a PT evaluation is done, they can contact Medicare or the Medicare insurance provider for approval and your mother would likely have little to no co-pay. You may also be able to have that PT give concrete suggestions on how to reduce the likelihood of falls--through grab bars, removing area rugs, providing a walker, or shoes that provide more stability.Here's the abstract from a January 2019 article that highlights the possible benefit of physical therapy focused on the vestibular system (the sense of where our bodies are in space as we move): Vestibular impairment, cognitive decline and Alzheimer's disease: balancing the evidence.
The vestibular (inner ear balance) system senses head movement and orientation in space. Vestibular sensory input plays a critical role in spatial cognitive abilities such as spatial memory and spatial navigation. Vestibular function declines with age, and recent studies have shown that age-related vestibular impairment is associated with poorer spatial cognitive skills in healthy older adults. Moreover, vestibular impairment is disproportionately prevalent among individuals with mild cognitive impairment and Alzheimer's disease, and specifically in cognitively-impaired individuals who have spatial deficits such as disorientation and difficulty driving. Indeed, emerging evidence suggests that age-related vestibular impairment contributes to a 'spatial' subtype of Alzheimer's disease, characterized by highly morbid symptoms such as wandering and falls. Given that vestibular impairment can be treated through simple, physical-therapy based exercises, identifying and treating vestibular deficits in older adults with and without cognitive impairment may offer substantial benefit in preventing, mitigating and forestalling cognitive decline.
As for the experience of forum members using the AMEN Clinics for elderly family members with AD, I did a search (using the magnifying glass icon on the upper right toolbar) and didn't find any examples of that. I watched my own mother show a gradual decline in spatial and memory skills, followed by what seemed like a steep acceleration of decline, especially in areas related to daily routines. She was also in her mid-80's and it was often very hard to see and accept that she was progressing on an uneven path with her personality and language still strong, but her confidence, her memory and her daily living skills receding. I found, however, that engaging her in conversations about the distant past with her large family was something we could both enjoy. Especially when her eyes twinkled while sharing some decades old family "scandal". Looking back 11 years after her death at age 86, I wish I had spent more time sharing her love of children and old musicals and less time worrying about the future. In the last 2 weeks of her life, she told me "I will cherish the wonderful life I've had." I think she was helping me to realize what was important--a wonderful last gift of parenting.
Warm wishes for your entire family in 2020, Debbie.