Medical Interventions In Late
If someone is in the later stages of dementia and becomes seriously ill, there may be discussion about whether to actively treat their illness. Ways of intervening may include resuscitation after a heart attack, antibiotic treatment for pneumonia, or giving food or liquids by mouth.
Giving or withholding treatment is a serious decision to make for someone else and is not an easy one to make. You need to consider:
Sometimes the decision can only be made by a guardian appointed by a tribunal or court. Each state and territory has different regulations but medical staff or Dementia Australia can advise you about appropriate contacts.
Things Not To Say To Someone With Dementia
Speaking to an elderly loved one with dementia can be difficult and emotionally draining. Alzheimers and dementia can lead to conversations that dont make sense, are inappropriate or uncomfortable, and may upset a family caregiver. However, over time, its important to adapt to the seniors behavior, and understand that their condition doesnt change who they are.
For senior caregivers, its important to always respond with patience. Here are some things to remember not to say to someone with dementia, and what you can say instead.
1. Youre wrong
For experienced caregivers, this one may seem evident. However, for someone who hasnt dealt with loss of cognitive function before, it can be hard to go along with something a loved one says that clearly isnt true. Theres no benefit to arguing, though, and its best to avoid upsetting a senior with dementia, who is already in a vulnerable emotional state due to confusion.
Instead, change the subject.
Its best to distract, not disagree. If an elderly loved one makes a wrong comment, dont try to fight them on it just change the subject and talk about something else ideally, something pleasant, to change their focus. There are plenty of things not to say to someone with dementia, but if theres one to remember, its anything that sounds like youre wrong.
2. Do you remember?
Instead, say: I remember
3. They passed away.
4. I told you
Instead, repeat what you said.
Deaths Where Dementia And Alzheimers Disease Was A Contributory Factor
The following analysis will focus on deaths where dementia and Alzheimer’s disease was not the underlying cause of death but was mentioned on the death certificate as a contributory factor.
This has been carried out in line with the leading causes of death groupings, based on a list developed by the World Health Organization . This categorises causes of death using the International Classification of Diseases, 10th edition into groups that are epidemiologically more meaningful than single ICD-10 codes, for the purpose of comparing the most common causes of death in the population.
As mentioned previously, the number of deaths registered due to dementia and Alzheimer’s disease in England and Wales in 2019 was 66,424. However, when we consider the number of deaths involving dementia and Alzheimer’s disease , this number increases to 93,568 deaths registered .
Of the deaths where dementia and Alzheimer’s disease was mentioned on the death certificate but not as the underlying cause, the most common underlying cause for males was cerebrovascular diseases and Parkinson’s disease , and the most common underlying cause for females was cerebrovascular disease . Table 2a and 2b show what other causes were most common as underlying causes of death where dementia and Alzheimer’s disease was mentioned on the death certificate.
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How Does A Person Die From Dementia
Can dementia kill? Alzheimer’s disease doesnt just make you forgetful. Its a serious, progressive condition which is, eventually, terminal. Alzheimers and other forms of dementia have now overtaken heart disease to become the leading cause of death in England and Wales.
The brain is responsible for more than thought, memory and understanding. It controls our bodily systems including breathing, circulation and digestion. Alzheimers kills cells in the brain. This damage initially leads to problems remembering things and communicating effectively. However, with time the brain damage affects the whole body, leading to death. This can be from a number of causes:
Flush Your Brain While You Sleep
Although it is not totally understood why inadequate sleep increases your dementia risk, one possible reason relates to the deposition of the Alzheimers protein, beta amyloid. Beta amyloid is the protein that clusters and clumps together to form Alzheimers plaques. No one is completely certain what its normal function is, although there is increasing evidence it is involved in the brains defense against invading microorganisms.
During the day, we all make some of this beta amyloid protein in the brain. When we sleep, however, brain cells and their connections actually shrink. This shrinking allows more space between the brain cells, so that beta amyloid and other substances that accumulate during the day can be flushed away.
So the theory is, if you dont get enough sleep, your brain wont have enough time to drain away beta amyloid and other substances. These substances then continue to accumulate, day after day, until they cause dementia.
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How Is Dementia Diagnosed
Dementiaas the syndromeis diagnosed by a clinical assessment of the person to see if he or she has a decline in cognitive ability and activities of daily living, sufficient to have a loss of independence. This is done through cognitive testing and interviews with the family. They might ask how the person manages with driving a car or getting dressed. Once you establish that a person has dementia or a lower-level cognitive disorder, then you try to determine the cause through a medical evaluation, and that includes physical and neurological examinations, as well as blood tests and brain imaging, which would be MRI or PET scans.
Those tests largely rule out other medical causes of dementia. However, for ruling in Alzheimers disease, we look at specialized biomarker studies, such as an amyloid PET scan or a lumbar puncture (to look for alterations in levels of such fluid proteins as amyloid and tau. Amyloid PET scans are not reimbursed by insurance and probably wont be until we have a specific and significant treatment to offer based on the results. Blood tests for Alzheimers disease are making great progress, though, and may be availableat least as screening testsin a few years.
Provide Support For Family And Friends
Keep any family or friends informed about what is happening in a gentle, sensitive and supportive way. This will help reassure them that the person is getting the care they need. You could consider signposting them to appropriate services, such as an Admiral Nurse or local Alzheimers Society. It can also help to give them an opportunity to talk about what is happening.
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Dementia As A Cause Of Death
23 Nov 2016
A statistical bulletin released by ONS last week reported that in 2015 Alzheimers Disease and other dementias were the leading cause of death in England and Wales. As the bulletin explained, more people die from cancer if all cancers are treated as a group, and the same goes for what is usually termed circulatory disease, which combines deaths from all forms of heart disease and stroke. In 2015, as in 2014, circulatory disease was the second main broad cause of death after cancer. The fact that there may appear to be little change at this level of analysis can however obscure the importance of changes that are happening at a lower level of analysis which treats e.g. different cancers as well as ischaemic heart disease and stroke as distinct causes of death. Hence the significance of the most recent bulletin: whereas in 2014 ischaemic heart disease was the most common cause of death at the more specific level of analysis, followed by dementias , in 2015 this ordering was reversed.
Figure 1: Age standardised death rates in women 2015
Figure 2: The directly age standardised mortality rate for deaths with any mention of dementia by subtypes, persons aged 20 and over, England, 2001-2014
About the Author:
Kenneth Howse is a Senior Research Fellow at the Oxford Institute of Population Ageing. He is also a key member of The Collen Programme on Fertility, Education and the Environment.
How To Test For Dementia
There is no single test that can determine a person is suffering from dementia. The doctor can diagnose different types of dementia such as Alzheimers based on their medical history.
This has to be done very carefully. In addition, the doctor may conduct laboratory tests, physical examinations, and changes in the way the patient thinks.
When all things are considered carefully, a doctor can be able to determine that a person is actually suffering from dementia with certainty. Determining the type of dementia can be hard, especially due to the fact that brain changes and symptoms that are associated with the different types of dementias sometimes overlap.
It is normal for the doctor to give a diagnosis of dementia without really specifying the type. In such a case, it is important for the patient to visit a specialist in this area like a psychologist or neurologist for a more specific diagnosis.
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How Should One Approach Care For A Dementia Patient
Thats a very broad question that really depends on the cause of the dementia, the stage of dementia, and the individual circumstances of the person and his or her family. Not everyone is the same. In Alzheimers disease, once a diagnosis is made, the early care is usually focused on starting medications to address symptoms, plus antidepressants for depression, if necessary. The early care is also focused on helping the family set expectations for the future so they can address any legal and financial planning concerns. Driving safety may also need to be formally evaluated.
As the disease progresses, the care may involve more assistance with activities of daily living, such as eating and dressing. Home care, which has the added benefit of alleviating burden on the spouse and other family members, can be helpful at this stage. We may consider other medications such as memantine , which may be appropriate in the moderate stages of disease, or other psychotropic medications for specific behaviors, such as agitation. In the later stages of the disease, all of the above continues, but the care may also be focused on considering alternative living arrangements, such as assisted living, a memory care unit, nursing home placement, or hospice care. But, with appropriate services in place, many people with Alzheimers disease are able to live at home to the very end.
Stages And Progression Of Lewy Body Dementia
Claudia Chaves, MD, is board-certified in cerebrovascular disease and neurology with a subspecialty certification in vascular neurology. She is an associate professor of neurology at Tufts Medical School and medical director of the Lahey Clinic Multiple Sclerosis Center in Lexington, Massachusetts.
If you or someone you know has recently been diagnosed with Lewy body dementia , you might be wondering what to expect as the disease progresses.
Like with Alzheimer’s disease, Lewy body dementia is marked by early, middle, and later stages. It’s what happens during these stages that makes the two different.
This article explains the stages and progression of Lewy body dementia as it proceeds through three stages.
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When Should I Ask For Support
Supporting people with dementia at the end of their life requires a team approach. Often, there will be many people involved in the persons care at the end of their life. Good communication and information sharing helps to ensure the person receives the care they need.
If youre unsure about anything or have any concerns seek advice from a colleague, manager or another health care professional.
There may be certain professionals who can advise on specific issues. These may include a GP, district nurses, social workers, other care staff and specialists.
Are There Any Treatments For Dementia
At this time there is no treatment for dementia. There is only medical care that can help manage symptoms and support people through their gradual decline.
The options for proper medical care with the diagnosis often include specialty caregivers, individual and family support groups, healthy diet and exercise, and frequent check-ins with your doctor.
Depending on which stage of dementia you or your loved one is in, the level of care required will vary. Someone in the earlier stages might need little to no care if symptoms are mild and not affecting daily life.
On the other hand, someone in the final stages of dementia will most certainly require 24/7 caregiving and constant supervision. If they dont have the proper care they need to avoid a risk factor such as choking or falling, it could lead to death.
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Dementia & Alzheimer’s Disease
Because dementia is an incurable disease, there is one pertinent question that many ask and that is how do dementia patients die?
Before answering this question it is important to note that in many countries Alzheimers disease and other kinds of dementia have been documented as the leading cause of death in the country, especially for the older generation.
According to Alzheimers Research UK, deaths due to dementia doubled from 40,253 in 2007 to 87, 199 in 2017 and the trend does not appear to change anytime soon.
In America, dementia is the 6th leading cause of death and currently, millions of people are living with the disease.
World Health Organization estimates that the number of dementia deaths across the globe will increase by more than 40% from 2015 to 2030.
Understanding Lewy Body Dementia
Lewy body dementia symptoms are so similar to those of other forms of dementia that LBD can be misdiagnosed. This might make more sense when you consider that there are many types of dementia.
It may help to think of dementia as one large “umbrella” that slowly robs people of their ability to think, talk, remember, and use their bodies. Many diseases crowd underneath this umbrella, including:
- Alzheimers disease
- Struggle with incontinence
With dementia with Lewy bodies, cognitive changes may appear earlier than, about the same time, or shortly after any physical changes surface.
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Youll Probably Need To Build A Support Network
Caring for someone in late stage dementia can be intense, demanding, and rewarding all in a single day. Youll be better equipped for the challenge if you can call on a varied group of support providers.
Nurses, doctors, home health aides, physical and occupational therapists, and hospice workers can help you take care of physical and medical needs. Mental health professionals, members of a faith community, and friends can help you meet emotional, social, and spiritual needs.
How Is Dementia Fatal And Why
An increasing leading cause of death among the elderly today is dementia. Dementia is a group of brain degenerative diseases that cause memory and thought impairment. There are different types of dementia that can affect people at various stages throughout old age.
Although there is no specific known cause of dementia, many times it results from the gradual deterioration of the brain which causes a severe impact on cognitive function over time. Its helpful to know what to expect if you care for someone with dementia.
If left unaddressed, the symptoms of dementia and the changes it causes can be overwhelming and sometimes frightening. Why exactly is dementia so fatal? How does dementia eventually kill you?
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What Do Elderly People Think About Life And Death
As we get older, death seems to be nearer than when we are younger. In as much as anyone can die regardless of age, for an older person, it seems like it is more likely to happen, especially when dealing with different health conditions that the body does not handle as it used to in the younger years.
For older persons, death does not always spell sorrow and terror, as is the case with younger people. Many of the older people are contented with what the short-term future has for them. You may think that people may get anxious as they become older, but this is not the case. Older people do not have much sadness and anxiety, especially related to death. They are actually more positive about life and death.
As we grow older, our perspective shifts. This is when you realize that things are not as they always seem. Most people fear death because they feel that they will lose the things that they have been working so hard to get over the years. However, for older people, this attachment to things acquired is not really pronounced. This is how some of the fear of death actually melts away.
When you look around you and you realize that there are things that are a part of you that will outlive you actually help in a major way. This could be the legacy we have in children or gardens planted. There are yet others who place value on their country, their religion, or families that live on even after they are gone.
Youll Need Support For Yourself Too
The National Institute on Aging points out that caregivers can experience confusion, depression, anxiety, fatigue, and grief at times. Its a good idea to plan regular times for others to take over caregiving responsibilities so you can take care of your own needs and experience some respite and relief.
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The Difference Between Alzheimers And Dementia
Although you may hear the terms dementia and Alzheimers disease used interchangeably, it’s important to know they are distinct concepts. Alzheimer’s is a specific health condition, although it is the most common cause of dementia.
Other causes of dementia include: