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My husband has dementia and lives in a memory care facility. This week, the manager there told me that he has developed ankle inversion (his left ankle is turning outward), which I saw today when I out to visit. A nurse is coming next week to look more closely at his foot and ankle. He is in a wheelchair; he has great difficulty walking and only stands when assisted, to transfer to and from bed or toilet, etc.


He may have Parkinson's, though he has had no formal diagnosis. I have read a bit about dystonia but that seems to be a painful cramping condition. What baffles me is that he says his ankle and foot do not hurt, and they don’t appear to be cramped up. He does sometimes hold his hands in a claw-like position (in his dementia, he thinks he is holding something in his hand), but they do not hurt him either.


When he is being transferred, he tries to put some weight on the bent ankle and won’t (can’t?) place the sole of his foot flat. So, the concern is the ankle might sprain or snap.


I wonder if anyone has experience with a loved one with who is experiencing this ankle inversion as a function of dementia - is it a joint contracture that may increase as his disease progresses? Just looking for insights from this always helpful forum! Thank you.

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I hope this is not simply a nurse coming, but a nurse practioner?
I think you do need a diagnosis?
He may need to have a brace made for his foot.

I would try to BE THERE when the nurse visits. I cannot see how otherwise you will get your questions asked or answered.
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AHWilson Mar 24, 2024
Thanks for responding! To clarify: the NP who visits my husband’s memory care community initially wrote to me. The staff made her aware of his inversion during her visit, and at that time she put in an order for a visit from group which provides PT, OT, etc. They are a good bunch, and have provided care for my husband while he was still at home as well as since the move. They normally send a case manager, who I think is an NP, to review the situation before assigning therapists. So that’s why I said a nurse would be coming. We are at the beginning of this situation, and I definitely plan to be there for the initial visits and as many as possible going forward. Was mostly looking for thoughts from others who’ve seen something like this. I always find your comments helpful!
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One thing that was provided to my mom at the nursing home was passive range of motion physical therapy to prevent contractures, I'm concerned that no matter what the underlying cause staff being concerned that "the ankle might sprain or snap" don't seem to have a good handle on dealing with this condition, surely he could be fitted with a brace 🤔. Or perhaps this is really prepping you for a conversation about his decreasing ability to transfer and their willingness to care for someone with those needs.
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Funny this came up, just noticed it with my mom this week, helping her put her shoes on. I could be very wrong, but I think it's drop foot, from he degenerative spine, do to nerves.
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Anxietynacy Mar 23, 2024
Mom has a foot doctors appointment Monday, I was going to mention it to him
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Is it possible for a Physiotherapist to examine your Husband?

Footdrop? Could be dystonia as you mentioned? My LO has something like this.. it varies, sometimes appearing as tight cramping of the muscles (mostly without pain) but sometimes only mildly tight. I suspect the muscles have shortened through reduced use & less range of motion. Hand curls in & ankle turns out with great toe pulled up. This appeared after stroke. The Physio is a great help, providing massage & assisted stretches & exercises.
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