Corticobasal Degeneration Home Care in Delhi | CBD Care

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Clinical Case Study

Corticobasal Degeneration Home Care in Delhi

A clinical documentation of neurological support, mobility assistance, and fall prevention for a geriatric patient with Corticobasal Degeneration.

Patient Age: 68 years

Gender: Male

Location: Vasant Kunj, Delhi

Primary Condition: Corticobasal Degeneration (CBD)

Duration of Care: 3 Months

Final Outcome: Maintained safe mobility, reduced fall risk

Patient Background

Mr. Suresh Mehta is a 68 year old retired government officer living in Vasant Kunj, Delhi, with his wife and son. Before his diagnosis, he maintained an active lifestyle, enjoying morning walks and managing his household finances independently. Over the course of a year, his family noticed unusual changes. He began dropping objects from his right hand and developed a stiff, unsteady gait.

His medical history was largely unremarkable except for mild hypertension. The gradual onset of unilateral motor symptoms initially suggested a possible stroke, but progressive neurological evaluation confirmed a neurodegenerative cause. As his symptoms worsened, his wife took on the role of primary caregiver. However, his increasing stiffness and balance issues made it physically demanding and unsafe for her to assist him alone.

The family realized that managing a progressive movement disorder required professional support to prevent falls and maintain his quality of life.

Clinical Diagnosis

Mr. Mehta was diagnosed with Corticobasal Degeneration. CBD is a rare, progressive neurological disorder characterized by the loss of nerve cells in specific areas of the brain, particularly the cerebral cortex and the basal ganglia. This causes severe difficulties with movement, coordination, and cognitive function.

Documented Clinical Findings

Progressive muscle stiffness, particularly on the right side
Difficulty controlling the right hand, often described as an alien limb
Impaired balance and frequent near falls
Reduced coordination and slowed movements
Dependence on family for dressing and personal hygiene

Clinical Notes

The diagnosis was primarily clinical, supported by an MRI brain report showing asymmetric parietal lobe atrophy. Specific laboratory blood values were not documented in the provided home care records, as the condition is not diagnosed through blood tests. The neurologist confirmed the diagnosis based on the characteristic motor and cognitive profile.

Hospital Treatment

Mr. Mehta was hospitalized for 8 days after a sudden worsening of his mobility led to a near fall at home. The hospital stay was primarily for acute observation, neurological evaluation, and physical therapy assessment. The medical team ruled out acute stroke or secondary infections.

During his stay, he was prescribed medications to manage muscle rigidity. A physiotherapist evaluated his gait and transfer capabilities. Since CBD is progressive and there is no disease modifying treatment, the medical team focused on symptom management. He was discharged with a recommendation for continuous home care and structured rehabilitation.

Discharge Risk Profile

High fall risk during transfers and walking
Risk of joint contractures due to severe muscle stiffness
Caregiver burnout risk for the elderly wife

Why Home Healthcare Was Needed

Progressive neurological conditions like CBD require long term management. The hospital environment was necessary for acute assessment, but prolonged stay was not indicated. However, Mr. Mehta was no longer safe navigating his home independently. His wife lacked the physical strength to assist him safely from a seated to a standing position or catch him if he lost balance.

Professional Home Nursing was required to manage his medication schedule and monitor for side effects. More importantly, a trained caregiver was needed to assist with daily activities and safe transfers.

Structured Physiotherapy was critical to maintain joint mobility, prevent contractures, and teach the family safe transfer techniques. Home healthcare provided a safe bridge between hospital discharge and long term chronic care at his residence in Delhi.

Home Care Plan by AtHomeCare

The home care plan was designed to maximize safety, maintain existing mobility, and support the family. While the disease is progressive, structured care significantly improves the patient quality of life and prevents secondary complications.

Patient Care & Transfers

A trained caregiver provided Patient Care, assisting with bathing, dressing, and personal hygiene. The caregiver used proper body mechanics to assist Mr. Mehta from bed to wheelchair, preventing falls and protecting the wife from back strain.

Neurological Physiotherapy

A specialized physiotherapist visited regularly. The program focused on passive stretching to reduce rigidity, balance training, and gait exercises. This helped slow down the physical decline and maintained joint integrity.

Fall Prevention

The Patient Care Taker ensured the environment was free of loose rugs and obstacles. The patient was never left to walk unassisted. Grab bars were recommended for the washroom.

Medication Management

The nurse ensured medications for rigidity and blood pressure were administered on time. The patient was monitored for dizziness or orthostatic hypotension, a common side effect that increases fall risk.

Equipment Setup

To ensure safe mobility at home, the family utilized Medical Equipment including a hospital bed with side rails and a specialized wheelchair. While his condition was stable enough not to require ICU At Home Delhi services, the hospital grade equipment ensured his safety and comfort in a residential setting.

Recovery Timeline

Since Corticobasal Degeneration is a progressive disease, the timeline reflects stabilization, safety maintenance, and caregiver empowerment rather than a cure.

Day 1

Clinical Status: High fall risk, severe stiffness in the right limbs, anxious about walking.

Intervention: Caregiver established a safe transfer routine. Nurse reviewed medication schedule. Fall hazards removed from the bedroom.

Day 3

Clinical Status: Patient adjusted to the hospital bed. Stiffness slightly reduced with medication.

Intervention: Physiotherapist began passive stretching of the right arm and leg to prevent contractures.

Week 1

Clinical Status: Improved confidence during supervised sitting and standing.

Intervention: Balance training initiated. Caregiver educated the wife on using a transfer belt for safe mobility.

Week 2

Clinical Status: Patient tolerated sitting in a wheelchair for meals.

Intervention: Active assisted exercises introduced. Patient reported feeling less trapped and more engaged in family life.

Week 4

Clinical Status: Plateau in motor recovery, but safety improved significantly. No falls recorded.

Intervention: Doctor home visit conducted to review medication efficacy. Care plan adjusted to focus on maintenance therapy.

Month 2

Clinical Status: Gradual progression of stiffness, but functional safety maintained.

Intervention: Family fully trained in transfer techniques. Nursing visits reduced to weekly checkups.

Month 3

Clinical Status: Disease progression continues, but patient remains comfortable and safe at home.

Intervention: Ongoing caregiver support. Focus shifted to comfort care, emotional support, and preventing pressure ulcers.

Clinical Evidence

The following table documents the functional safety and care metrics observed during the home care period. Quantitative neurological scores were not available in the home care records, so functional milestones and safety metrics are used as the primary evidence.

Functional Parameter	Baseline (Discharge)	Week 4	Month 3
Transfer Safety	Requires max assistance	Requires min assistance	Requires moderate assistance
Fall Incidents	Frequent near falls	Zero incidents	Zero incidents
Sitting Tolerance	15 minutes	45 minutes	30 minutes (fatigue dependent)
Joint Contracture Risk	High (right arm)	Reduced	Managed with daily stretching
Caregiver Confidence	Low, high stress	Moderate, trained	High, independent

Medical Authority

Dr. Ekta Fageriya, MBBS

Specialization: Geriatric Medicine

RMC Registration No.: 44780

Clinical Experience: 7 Years

Treating Doctor Details

Treating Doctor:

Qualification:

Hospital:

Medical Registration:

Clinical Comments:

Future Recommendations:

Supporting Clinical Documents

The care plan was executed based on the following verified clinical records:

Hospital Discharge Summary confirming Corticobasal Degeneration
MRI Brain Report showing asymmetric parietal atrophy
Neurologist prescription for rigidity management
Home Nursing Progress Notes documenting functional status and fall prevention

Note: Confidential patient identifiers and specific laboratory values have been omitted to protect privacy.

Recovery Outcome

While corticobasal degeneration is progressive, structured home care helped Mr. Mehta maintain safer mobility and participate more comfortably in daily routines. The primary success of this intervention was the complete elimination of fall incidents at home over a three month period.

His joint stiffness was managed effectively through daily physiotherapy, preventing contractures that could have caused pain. His medical stability was maintained, and his wife became highly confident in assisting with transfers and daily activities without fear of injury.

The remaining challenge is the inevitable cognitive and motor decline associated with CBD. Long term care will require ongoing physiotherapy, continuous caregiver support, and regular neurological follow up to adapt the care plan as symptoms progress.

Key Clinical Learnings

Safety Over Cure

In progressive neurodegenerative diseases, success is measured by safety and comfort, not cure. Preventing falls and contractures is a significant clinical victory.

Caregiver Training is Essential

Family members often lack the physical strength and technique for safe transfers. Training the wife on body mechanics and transfer belts was crucial for sustainable home care.

Environmental Modification

Medical equipment like hospital beds and grab bars transform a standard home into a safe clinical environment, preserving the patient dignity and safety.

Maintenance Physiotherapy

Even when a patient cannot improve, physiotherapy is vital to slow down physical decline, maintain joint range of motion, and manage pain associated with rigidity.

Frequently Asked Questions

Can corticobasal degeneration patients receive home care in Delhi?

Yes. Patients with CBD can receive professional home care in Delhi, including physiotherapy, fall prevention assistance, and support with daily activities to maintain safety and comfort.

Why is fall prevention important for corticobasal degeneration?

CBD causes progressive balance issues and muscle stiffness. Fall prevention is critical to avoid fractures and head injuries, which can severely complicate the disease progression and reduce mobility.

Does home care cure corticobasal degeneration?

No. CBD is a progressive neurodegenerative disease. Home care focuses on managing symptoms, maintaining mobility for as long as possible, and ensuring patient safety and quality of life.

What is an alien limb phenomenon in CBD?

It is a symptom where a limb, usually the hand, moves involuntarily or feels as if it has a mind of its own. This is common in corticobasal degeneration and makes daily tasks difficult.

How does physiotherapy help a CBD patient at home?

Physiotherapy helps by stretching stiff muscles to prevent contractures, improving sitting balance, and teaching the patient safe ways to transfer from bed to wheelchair.

Can a family member manage CBD care alone?

Managing CBD alone is physically and emotionally demanding. Professional caregivers are trained in safe transfer techniques, which protects both the patient from falls and the family from physical strain.

What are the warning signs that require hospital attention in CBD?

Sudden worsening of stiffness, signs of a fall like head injury or fracture, difficulty swallowing, or sudden breathing issues require immediate medical attention.

Is a hospital bed necessary for CBD home care?

While not always mandatory, a hospital bed with side rails is highly recommended. It helps with safe positioning, prevents rolling out of bed, and makes caregiving easier for the family.

How long can a patient with CBD be cared for at home?

With the right medical equipment and professional home care support, a patient can be cared for at home throughout the disease progression, avoiding prolonged hospital stays.

Does AtHomeCare provide CBD rehabilitation in all areas of Delhi?

AtHomeCare provides CBD rehabilitation services across Delhi NCR, including areas like Vasant Kunj, South Delhi, and Dwarka, ensuring patients have access to clinical care at home.

Contact Information

Corporate Office

Unit No. 703, 7th Floor, ILD Trade Centre
D1 Block, Malibu Town, Sector 47
Gurgaon, Haryana 122018

9910823218

care@athomecare.in

Medical Disclaimer

Every patient is unique. Treatment decisions must always be made by qualified healthcare professionals. Emergency symptoms require immediate hospital care. Home healthcare complements, but does not replace, emergency medical services.