Surprising Symptom of Dementia: Paratonia

Caregiver helping elderly woman with dementia put on a cardigan while she resists due to muscle stiffness, highlighting paratonia, a common dementia symptom.
Have you ever tried moving your loved one with dementia, only to find them stiff or resistant, as if they’re fighting back? This surprising symptom, known as paratonia, affects up to 90% of individuals with dementia as the disease progresses. In this article, we break down the two types of paratonia—oppositional and facilitory—and offer practical tips on how to manage this muscle stiffness.

Paratonia: The Surprising Dementia Symptom You Need to Know About

Dementia can be a truly challenging journey for both the individual affected and their caregivers. While most people are aware of common symptoms like memory loss and confusion, there’s one surprising symptom that might catch you off guard. Have you ever tried to help your loved one with dementia move, only to find them stiff and resistant, almost as if they’re fighting against you? Well, that might be a symptom of something called paratonia.

What Is Paratonia?

Paratonia is a type of muscle stiffness or rigidity that tends to develop as dementia progresses. It’s characterized by involuntary resistance to passive movement. In simpler terms, it feels like your loved one is fighting against you when you try to move them, but they aren’t consciously doing this. They may actually want to cooperate, but their muscles are saying otherwise.

This condition is more common than you might think. In the early stages of dementia, it affects about 10% of people, but as the disease progresses into the later stages, it can impact up to 90% of individuals. So even if you haven’t seen this in your loved one yet, it’s worth knowing about because there’s a high chance it could develop over time.

Two Types of Paratonia: Oppositional and Facilitory

Paratonia isn’t a one-size-fits-all kind of condition. There are actually two types: oppositional paratonia and facilitory paratonia. Let’s break these down.

Oppositional Paratonia

Oppositional paratonia is when it seems like the person is actively resisting your attempts to move them. Picture this: You’re trying to help your loved one raise their arm or reposition them in a chair, but instead of the arm moving fluidly, it feels stiff and rigid. It’s like the arm is fighting you every step of the way.

To give you a visual example, imagine a doctor trying to move a patient’s hand. The doctor is gently guiding the hand downward, but it’s like the hand has a mind of its own, resisting the downward motion. One arm might drop easily, but the other stays stiff, almost like it’s pushing back. You can click here to watch an example of oppositional paratonia around the 60″ mark.

That’s oppositional paratonia in action. It looks like resistance, but it’s not a conscious decision on the part of the person with dementia. Their muscles are simply reacting that way due to the condition.

Facilitory Paratonia

Now, facilitory paratonia is the opposite. This is when the person seems to go along with your movements a little too much. Have you ever noticed that when you stop moving a loved one’s limb, they continue the motion on their own, almost as if they’re overly eager to help? That’s facilitory paratonia.

Here’s an example: Imagine the same doctor shaking the patient’s hand. When the doctor lets go, instead of the hand coming to rest, it continues to shake slightly, as if it’s trying to keep the movement going. This is facilitory paratonia—an exaggerated cooperation with the movement. Click here to see an example of facilitory partonia.

Where You Might Notice Paratonia

You may not see paratonia in every interaction, but there are some common situations where it tends to appear. If your loved one with dementia has paratonia, you’ll likely notice it during activities that require moving their limbs. For instance:

  • Dressing: Lifting arms to put on a shirt or guiding legs into pants can become more difficult.

  • Bathing: Helping them step into the shower or sit down in a bathtub may trigger that muscle stiffness.

  • Repositioning: Moving them from a chair to a bed or adjusting their position on the couch could bring out that involuntary resistance.

These everyday tasks, which are already challenging in dementia care, can become even harder when paratonia is involved.

What Can You Do About Paratonia?

Here’s the thing—while there is no cure for paratonia, there are definitely ways to manage it and make caregiving a bit easier. The most important thing to keep in mind is the speed of your movements. If you notice that your loved one is showing signs of paratonia, slow down. The slower you go, the more likely it is that they’ll be able to go along with what you’re trying to do.

But if you move quickly? That’s when you’re more likely to encounter rigidity and resistance. Quick movements tend to exacerbate the muscle stiffness, making things harder for both you and your loved one.

Communication Is Key

Another thing that can help is letting your loved one know what’s happening before you actually start moving them. Sounds simple, right? But it makes a world of difference. If you tell them what you’re going to do, it gives their body a moment to prepare, even if their muscles are still reacting involuntarily.
For example, if you’re about to help them stand up, you might say, “Okay, I’m going to lift your arm now.” Giving them a heads-up can sometimes reduce the shock of movement and make them more comfortable, even if they can’t fully cooperate due to the paratonia.

Consult a Physical or Occupational Therapist

If you’re finding it particularly difficult to manage paratonia, I highly recommend getting in touch with a physical therapist or occupational therapist. These professionals are trained to work with conditions like paratonia, and they can offer specific strategies tailored to your loved one’s unique needs.

For example, they might suggest certain exercises or ways of moving that can help reduce the impact of the muscle stiffness. They can also teach you techniques that make caregiving tasks like dressing, bathing, and repositioning a bit easier, even when paratonia is at play.

The Impact of Paratonia on Daily Care

There’s no sugarcoating it—paratonia can make daily care a lot harder. When your loved one’s body is stiff or resistant to movement, simple tasks like getting them dressed or helping them move can feel overwhelming. It can also increase the risk of falls. If their muscles are resisting your efforts to help, it can throw off their balance, making them more likely to stumble or fall.

That’s why it’s so important to let your loved one’s healthcare provider know if you notice signs of paratonia. While there’s no direct cure, keeping their doctor informed ensures that they can recommend the best management strategies for your situation.

Managing Paratonia with Patience and Care

Caring for someone with dementia is already a challenge, and adding paratonia to the mix can feel like another layer of difficulty. But with a little patience, some adjustments to your caregiving routine, and the right support from professionals, it’s absolutely possible to manage.
Slower movements, clear communication, and consulting with physical or occupational therapists are key steps you can take to make life a little easier for both you and your loved one.

Managing Paratonia with Patience and Care

Caring for someone with dementia is already a challenge, and adding paratonia to the mix can feel like another layer of difficulty. But with a little patience, some adjustments to your caregiving routine, and the right support from professionals, it’s absolutely possible to manage.
Slower movements, clear communication, and consulting with physical or occupational therapists are key steps you can take to make life a little easier for both you and your loved one.

Final Thoughts

Paratonia is just one of the many surprising symptoms that come with dementia, but understanding it can significantly improve your caregiving journey. Have you noticed signs of paratonia in your loved one? Share your experiences in the comments below—I’d love to hear from you.

And if you’re looking for a community of caregivers who truly understand what you’re going through, I invite you to check out the Care Collective. It’s a place where caregivers come together for support, expert Q&A sessions, and access to a treasure trove of resources. You don’t have to go through this alone.

Watch On YouTube

Want to watch the in-depth video that inspired this post?

Click the video below to watch. ↓

Like what you’re reading?

Get helpful dementia care tips, support, and real-life solutions in your inbox every Thursday—for free.

Sign up for my Dementia Dose Newsletter with your email below 👇

Share the Post:

Related Posts

Leave a Comment

Discover more from Dementia Careblazers

Subscribe now to keep reading and get access to the full archive.

Continue reading

Skip to content