Brenda’s Story
September 6 2024 | Last Updated: Sept 6 2024
Brighter Days in 6 months
Smoking, Falls, Depression, Hearing Problems
Brenda was 82 years old when she went to see a geriatrician. She came to the appointment with her daughter, hoping to get well enough to leave Long-Term Care, where she was living now.
She had moved in after a series of falls that led to a few head injuries and broken bones, which both prevented her from living on her own any longer.
Her story is shared to explain the importance of fall prevention and other dementia prevention targets.
What led to Brenda’s need for long-term care?
Brenda had been living on her own until about 6 years ago. She had high blood pressure, diabetes, and smoked about 10 cigarettes a day. These factors gradually led to narrowed arteries in her heart and brain (called “cardiovascular disease”).
She had her first stroke at 76 years old, which made it hard to manage things like cooking and remembering to take her medications.
She moved in with her daughter and during the next 6 years she spent most of her time inside, other than going out to the balcony to smoke several times a day.
She became weaker from the lack of exercise, and she started to fall. Her daughter got her a walker, but Brenda didn’t like using it because it made her feel old.
Eventually she had a series of bad falls. The first landed her in hospital for over 2 months, and her daughter said her memory was never quite the same after that.
The next big fall caused a broken hip, and another 2 month stay in hospital. It was after this fall that Brenda was told she would have to move to Long Term Care.
Now in Long Term Care, her memory had gotten worse.
Her memory testing was 15/30 on the MoCA (low).
What Were the Causes?
Brenda had many causes for her memory problems, including:
Heart-health risk factors (smoking, high blood pressure, lack of exercise, and diabetes) which had led to a lack of blood flow in the brain (strokes).
Head injury from falls
Hearing impairment
Low mood from her loss of independence
What Did They Do?
Unfortunately by the time Brenda saw a geriatrician, her memory problems were in moderate stages, which was too late to reverse the changes with today’s medical knowledge.
However, her geriatrician made special note of what Brenda was already doing to protect her mind, including:
Sleeping well
Eating a balanced diet
Quitting smoking since her last hospitalization
It was important that she continue to do these things.
They also settled on a plan that might help to slow-down her memory changes and at the very least improve her quality of life.
1) Hearing Problems
Brenda liked the idea of being able to keep herself occupied by watching TV, but she had a hard time hearing what was on.
Her daughter agreed to take her to an audiologist (the hearing specialists) to get fitted for hearing aids.
2) Fall Prevention
Brenda hated using her walker, but since using it regularly after her last hospital stay, she had not had any more falls.
Her geriatrician explained that she should use the walker at all times to prevent more falls, which could otherwise make her memory even worse.
It was suggested that she decorate the walker so that it expressed her unique personality.
3) Depression Treatment
Brenda’s mood was understandably low after losing her sense of independence and feeling isolated in her new home.
Her geriatrician suggested her daughter take her out several times a week to the local park, and she started on a medication called Citalopram to help get her through the worst of her feelings right now.
How is Brenda now?
Brenda rolled into her next appointment with a blue walker and hot pink tassels around the handles.
She hadn’t had any more falls, and her memory testing was now 17/30 - a two point improvement.
The improvement was unexpected but likely a result of enough time passing since her last concussion, the use of hearing aids, and her improved mood.
While visiting at the local park twice a week she had made a new friend with a man who walked his dog there every day. Friendship - and pets - are a great way to lift someone’s mood.
What does Brenda’s story tell us?
Brenda’s story is a reminder of how our daily habits can gradually build up into a cascade of events that are difficult to reverse once they are too far along.
By using a walker and exercising some of Brenda’s later falls could have likely been avoided.
However, Brenda’s story also shows us that it is never too late to make changes for our health and quality of life.
Brenda is much happier today, feels that her life has meaning, and continues to share new moments with her friends and family.
Disclaimer: The stories shared on this website are composites of several clinical cases, designed to protect individuals' privacy. They are intended for educational and informational purposes only and should not be construed as medical advice or a reflection of any specific person. Any resemblance to actual persons, living or deceased, is purely coincidental.