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Date: 31.10.2013
From: Jill williams

Subject: Fathers mobility

Hi,my father was diagnosed with RA 2 years ago at the age of 78.SInce this diagnosis which unfortunately coincided
with a diagnosis of atrial fibrillation,his mobility has decreased and now he can barely walk a few steps.
He has been on MTX for over a year and although it has helped with the inflammation ,since diagnosis he has barely moved.Prior to diagnosis he would walk miles a day.
He has had no physio or occ therapy,but has not asked for any.
I would be so great full for any advice,as I am at a loss as where to go from here.
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Date: 31.10.2013
From: Bsk

Subject: Re: Fathers mobility

He needs to go back to his rheumy and get his meds reviewed and also ask for a referral to both physic or OT. Hydrotherapy might help him. I think the physio or RA consultant can refer.
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Date: 31.10.2013
From: bsk

Subject: Re: Fathers mobility

p.s I'm also wondering if he is scared to walk because of his heart? That is something the GP could help with if that is the case. It def sounds as if he needs a bit of rehabilitation therapy.
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Date: 31.10.2013
From: Colin W

Subject: Re: Fathers mobility

Hi Jill , can you go to his appoinments when he see's the RA consultant , do you know what level MTX he takes & does he have any side effects from it , 25mg is the max they let us have but most of us take more DRAMD , you need ask for OT physio & even to try more drugs

the other thing is to monitor his blood results , with MTX we have monthly blood test & the nurse should be able to give you a booklet to monitor the results , CRP & ESR are the test for inflammation & will show how well the RA is controled
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Date: 31.10.2013
From: Chris

Subject: Re: Fathers mobility

Hi Jill, i feel for you and your father.

I'm hoping not to sound sexist here, but i think men can deal very poorly with loss and lose a lot of confidence. At his age it could be particularly hard to deal with, he might think that he will never be useful again. Sorry if i'm way off base here. But i know i have had thoughts like this.

If this is this case (even partly) i find it hard to suggest anything without knowing him. A sunny holiday might be extremely useful. Making him feel needed and not a burden, giving him renewed purpose.
Exercise is important for mood too, the above advice sounds good. Any group activity. Mindfullness. All could only help i think.

I wish you the best,
Chris
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Date: 31.10.2013
From: Jill Williams

Subject: Re: Fathers mobility

Hi,many thanks for all the replies,I will suggest to him re physio at his next appointment.I think that he has lost his confidence and is scared he will fall.
Another problem is independence and although I have suggested to go with him,the answer is always no.
He has regular blood tests performed at the hospital,so I presume that the results are always checked.A question to ask is his Hb too low varies between 11 and 11.5,he is always cold.
Any other advice would be so helpful.
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Date: 31.10.2013
From: Patricia

Subject: Re: Fathers mobility

Hi Jill - sorry to hear about your dad - it must be awful for him and you to see him like this.

I personally think Hb is a bit low at 11 or 11.5 although mine was at this level for quite a few months and nothing was done. However, it was discovered that my ferritin levels were also low (rheumatologist nurse asked for an anaemia screen) and then I was put on a good strength of iron supplements which have helped - I was getting a few palpitations which have gone now and was even more tired than the usual RA fatigue.

Very best wishes to you both....x
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Date: 01.11.2013
From: Jill Williams

Subject: Re: Fathers mobility

Many thanks,I will suggest he requests these bloods at his next appt.xx
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Date: 01.11.2013
From: bsk

Subject: Re: Fathers mobility

Many areas have a Falls Clinic. This might be a good place for a referral as they can deal with all the confidence issues and give them strategies for doing things.
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Date: 01.11.2013
From: Jill Williams

Subject: Re: Fathers mobility

Hi,thank you all for the above advice,sorry to ask so many questions but can the GP refer to the falls clinic,or the consultant?
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Date: 02.11.2013
From: Chris

Subject: Re: Fathers mobility

Hi Jill,
i think the 1st port of call is the GP for referrals. That is if your PCT (local NHS authority) has a falls clinic. On a quick scan of my PCT's website, i didn't find one here, although there must be some service...
But i did find a leaflet entitled 'How can I reduce the risk of falling in my home?'

http://www.bsuh.nhs.uk/patients-and-visitors/patient-information-leaflets/search-for-a-leaflet/?EntryId52=303332

Click on the link by 'document' to download it. It backs up a lot of the advice given here with some new bits too.

Best wishes,
Chris
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Date: 03.11.2013
From: helen

Subject: Re: Fathers mobility

Hello. Iv been reading thru the posts. Iv worked in care homes and did falls risk assessments. Many elderly preferred to furniture walk around their room as they felt safe holding onto walls backs off chairs etc. Rugs were a no go area small objects which wasn't used or needed in the room took away for safety. Make sure eyes are checked regularly&glasses are worn sensible shoes or slippers. Keep a close eye for urineary tract infections as causes falls and upsets the day to day living and plays havoc with their minds. Physio and Ot have a part in helping your dad feel safe in and outside with walking aids. Your dad needs to keep mobile as much as he can but he's a good age and I expect a little tired with age and having arthritis makes you feel tired at any age. If he lives alone maybe ask the ot for an alarm for around his neck just in case he does fall he could press it and call for help. He needs to have confidence in the physio Ot and district nurses they all play apart in keeping your dad safe and living independently in his own home.
It is a worry for you and I'm sure he doesn't want to be a burden to you but he's your dad and u want to help.
Good luck with all his appts
Helen.
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