Late Stages Of Alzheimers Disease Symptoms
The needs of the person with Alzheimers become much more demanding as the disease progresses. In the late stages of Alzheimers, the person with the disease loses the ability to respond appropriately and is unable to converse with others. They will also develop an inability to control movements like sitting, standing and walking.
Here are some other common symptoms of the disease that can occur:
- Catches colds and infections easily
- Day/night reversal of sleep pattern
- Difficulty communicating
- Difficulty using the toilet independently
- Eventually requires help with activities of daily living, 24 hours per day
- Eventually unable to walk
- Hoarding, rummaging
- Inability to sit and eventually to swallow
- Incontinence
- Loss of awareness of surroundings
- Needs help walking
- Needs progressively more help with personal care
- Personality changes such as aggression, anxiety, hostility,;irritability or uncooperativeness
- Repetitive questioning
- Sundowners
- Verbally aggressive or demanding behavior
- Wandering
Understanding What Keeps Dementia Sufferers Awake At Night
April 12, 2001 — Sleep disturbance is a very common and very problematic symptom of dementia. New research indicates that causes of this sleep disturbance may differ in different kinds of dementia. Hopefully, understanding these causes will lead to better treatments.
Dementia is a term used to refer to a loss of thinking abilities. Although there are many causes of dementia, it is most often associated with aging. The most common cause of dementia associated with aging is Alzheimer’s disease, which affects approximately one in 10 people over age 65 and nearly half of those over age 85.
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As dementia progresses, sleep problems along with other difficult dementia symptoms tend to get worse. This may be a good time to evaluate whether you need additional support to help ensure your loved ones health and safety and your own. Learning what to expect at each stage of dementia can help you;plan for adequate care.
Heres what you should know when caring for someone with dementia and sleep problems:
- Dont use physical restraints.;Many people believe its best to restrain their loved ones in bed at night to prevent wandering. This may do more harm than good. Instead, if you have a bed with guard rails, raise the rails. This may help to deter them from climbing out of bed and wandering.
- Dont do it alone.;Consider taking shifts with another family member or looking into;respite care. Respite care, or short-term care, gives you a chance to take a break while providing a safe environment for your loved one.
- Reduce stimulation.;To allow for a calming, soothing environment, avoid loud noises or a lot of activity during the evening and night.
- Prioritize your health and rest.;Taking care of a loved one with dementia and sleep problems may take a toll on your own mental health. Consider getting help from family members or exploring other care options, such as;memory care, which provides 24-hour specialized care for people with memory loss.
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Is Alzheimers Actually A Sleeping Disorder
The relationship between Alzheimers and sleep is an area of intense, ongoing research. An article in Psychology Today: Is Alzheimers disease actually a sleeping disorder? refers to findings by researchers at UC Berkeley suggesting that poor quality sleep may be the missing link that connects amyloid buildup in the mid-frontal lobe of the brain to memory loss in Alzheimers patients. This area of the brain is largely responsible, not for memories, but for the generation of non-REM and slow-wave sleep. And less non-REM sleep causes memory impairments. So, it could be Alzheimers impact on sleep quality that affects memory, rather than the disease itself.
Common Struggles Of Late
Alzheimers care at any stage can be difficult, but as the condition worsens, the disease transitions from merely mental to far more physical. Peoples minds can no longer tell them how to do some of the most simple tasks, leaving their bodies immobile and weak. And thats when care has to transition too; caregivers have to learn to handle the physical difficulties the Alzheimers patient faces along with the mental ones.
For those who care for someone with late-stage dementia or another disease, weve compiled a list of common problems and what you can do to help keep the Alzheimers sufferer comfortable during their last days of life. We hope these tips will not only make things easier for the person you care for but also for you.
Here are some things to watch out for:
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Tips For Managing Sleep Problems In Alzheimer’s
Alzheimers disease often affects a persons sleeping habits. It may be hard to get the person to go to bed and stay there. Someone with Alzheimers may sleep a lot or not enough, and may wake up many times during the night.
Here are some tips that may help caregivers manage sleep problems in people with Alzheimers disease:
If You Have Questions About Alzheimer’s Check Out Webmd’s Alzheimer’s Disease Board
“We and many others have observed that patients with dementias … all have sleep disturbance,” researcher David G. Harper, PhD, tells WebMD. “It’s one of the leading reasons for institutionalization of people with dementia,” as the patient is up all night, keeping the caregiver awake. Harper, the author of the study that appears in this month’s Archives of General Psychiatry, is a research fellow in psychology in the department of geriatric psychiatry at McLean Hospital in Belmont, Mass., and Harvard University.
“Separating the dementia is really important for understanding the mechanisms of the disturbed in Alzheimer’s disease,” expert Edward O’Malley, PhD, tells WebMD. “This can really get at what the nature of that disruption is and hopefully offer treatments.”
Because sleep disturbance is the single greatest reason why caregivers feel obligated to institutionalize their loved ones with dementia, O’Malley says that this research, “can go a long way toward maintaining home care of Alzheimer’s patients.” O’Malley is director of the Sleep Disorders Center at Norwalk Hospital in Connecticut.
In healthy people, changes in body temperature occur throughout the day and night, they are controlled by the body clock in the brain, and they mimic activity cycles. In general, body temperature is lowest when activity levels are lowest, such as in the middle of the night, and body temperature is at its highest during periods of highest activity, such as in the middle of the day.
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What To Do If Alzheimers Patients Sleep A Lot
This idea of patients sleeping a lot and not performing any activity or physiologic need like eating, drinking, and speaking may alarm both caregivers and relatives. It is understandable to panic or be concerned, especially if you have known these people to have been active most of their lives.
If the patient sleeps a lot but is easily woken if they need to eat or drink their medications, there is no need to get concerned as of the moment, this is just a normal symptom of their disease and we could expect this to get worse over time. Just try and allow him to follow an everyday routine so he can grow accustomed to what he needs to do at a certain time. You can also a good tip to turn off all the lights at night so the patients brain gets triggered to sleep.
If the patient chooses to sleep all through the day and this could pose harm to his condition since he would rather snooze than eat or drink, then you must ask his doctor about what steps to take so he does not compromise his health because of his diseases symptom.
What Should I Do If A Person With Dementia Is Sleeping A Lot
If the person is in the later stages;of dementia;and they have gradually started sleeping more and more, it is likely to be due to the dementia progressing.;;
However, if the excessive;sleeping has started more suddenly, or the person doesnt seem well in other ways, it may have another cause.;;
If this is the case you should speak to the GP, to rule out any infections or conditions that could be having an impact.
It may also be worth asking for a medication review with the GP or speaking to a pharmacist as medication can cause a range of side effects.;
If the person is sleeping a lot but it isnt having a negative impact on;them;it is often best to just go with it;and make sure they are comfortable.;
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Why Dementia Patients Dont Sleep
Sleep is a common source of stress for dementia patients caregivers and family members. Understanding the factors that cause the person with dementia to have sleep problems can help you manage this problem and make care easier for both you and your loved one.
Sleep changes come with aging.; Healthy adults also experience changes in sleep patterns as they age. These sleep changes are considered a normal part of aging, as aging is associated with changes in the circadian rhythm .
However, in people with dementia, these changes are more common. The brain deterioration caused by dementia affects the brains ability to sleep and causes problems with circadian rhythm.
Research shows that sundown syndrome causes as many as 20 percent of patients with Alzheimers to experience increased anxiety, confusion, and agitation as the evening approaches. Many persons with dementia also experience restlessness and changes in their sleep during the night.
The disruption in your loved ones sleep-wake cycle may lead to other behavioral and emotional issues.
In patients with Lewy-body dementia and Parkinsons, there is a sleep disorder known as REM sleep behavior disorder, which can cause violent movements during sleep.
Some other factors that cause dementia patients insomnia include mental and physical exhaustion at the end of the day, confusion and fear triggered by reduced lighting and increased shadows, and disorientation because of the inability to separate dreams from reality.
Do Alzheimer’s Patients Sleep A Lot
Alzheimer’s disease is a degenerative disease of the brain. It is characterized by thinning of the brain surface and loss of brain cells, which gradually ceases a persons ability to speak, express, or make decisions.
Alzheimers disease is the most common cause of dementia . People with Alzheimer’s disease first develop memory loss. Sleeping excessively is a common feature of later-stage dementia. The reason for the excess sleepiness may be one of the following:
- As the;disease;progresses, the brain damage becomes more extensive, and the patient wants to just lie down.
- The muscle weakness brought on my brain cell death and reduced movements may make the person inactive.
- The side effects of the various medications Alzheimers patients take may cause sleepiness.
- The depression may often accompany the diagnosis of Alzheimers, and this may manifest as increased sleeping.
- The general lethargy is seen in patients with Alzheimers due to reduced food intake.
As the disease progresses, memory loss worsens and problems with thinking, decision making, reasoning, language, or perception develop. Alzheimer’s is a disease with no cure, but there are ways to stop or slow its progression with medications and other therapies. These can treat symptoms and improve the quality of life.
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Sleep Medications And Alzheimers
If your loved oneâs doctor prescribes medicine to help them rest, theyâll probably start at the lowest dose possible and stop the drugs as soon as sleep patterns improve.Â;
Medications include:
- Tricyclic antidepressants such as nortriptyline and trazodone
- Sleeping pills such as zaleplon and zolpidem
Doctors also sometimes prescribe drugs called antipsychotics such as risperidone . They can be helpful, but they also might increase the risk of death in some people with dementia. Youâll want to talk carefully with your loved oneâs doctor about this medicine before they take it.
Just as Alzheimerâs sleep problems can change over the years, so do the ways you can handle it. Always talk to your doctor about which options are best.
Review Any Medication Being Taken
The side-effects of some dementia drugs may not promote a restful sleep, so chat to your parents doctor about the optimum time of day to take them.;Dont be tempted to give sleeping pills to someone with dementia, as hypnotics or sedatives can exacerbate confusion.
Weve detailed the medications used in the;treatment of dementia to help you understand the different types and those that might affect sleep.
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Common Causes Of Sleep Changes And Problems In People With Dementia
Its hard to manage a problem if you dont understand why it might be happening. There are several factors that can cause older adults with dementia to have sleep problems. These include:
- Sleep changes with aging. Healthy aging adults do experience changes with their sleep as they age. Sleep becomes lighter and more fragmented, with less time spent in deep REM sleep. One study also estimated that total sleep time decreases by 28 minutes per decade, starting in mid-life. Although these changes are considered a normal part of aging, lighter sleep means its easier for aging adults to be woken up or disturbed by any other sleep-related disorders or problems, such as arthritis pain at night. Aging is also associated with a shift in the circadian rhythm, so that many older adults find themselves sleepy earlier at night and hence wake up earlier in the morning. For more, see here: How Sleep Affects Health, & Changes With Aging
- Many sleep-related disorders become more frequent with aging. Common sleep-related disorders include sleep apnea and related conditions , which may affect 40-50% of seniors, as well as restless leg syndrome, which is thought to be clinically significant in 2.5% of people.
Hence, its not surprising that sleep problems are so common in people with dementia! Now lets talk about what can be done to improve things.
Does Quality Of Sleep Matter For People With Dementia
The quality of a person’s sleep;gradually deteriorates as they get older. They tend to get less deep or slow-wave sleep, which helps to keep the brain healthy and refreshed.;
Even though a person;with dementia may end up sleeping more than a typical person of their age even as much as 1415 hours a day; it is unlikely to all be good quality sleep.;
Sleeping a lot can also be influenced by peoples sleeping patterns before they had dementia, as some people need more sleep than others.;
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How Does Dementia Change Sleep Patterns
Circadian rhythm is a collection of physical and psychological processes; that guide our sleep-wake cycle by responding to indicators in our environment. People with dementia experience fundamental changes in their circadian rhythm that work against getting quality sleep on a regular schedule.
The suprachiasmatic nucleus is the part of the brain that serves as our internal clock and responds to cues, such as light, to indicate when we should be alert and when we should feel sleepy. Individuals who have Alzheimers diseasethe most common type of dementiaoften have damaged cells in the SCN and decreased cellular activity in this part of the brain. The result of this dysfunction is that patients are often unable to follow a 24-hour sleep-wake cycle and instead sleep excessively during the day and sleep much less at night.
Additionally, dementia is associated with changes in sleep structure. When we sleep, our bodies cycle through a series of sleep stages, from light sleep , to deep sleep , and then dream sleep . Slow-wave sleep and REM sleep are critical parts of how sleep works to restore the body and mind. People with dementia spend less time; in slow-wave sleep and REM sleep and more time in the earlier stages of sleep. This reduction of deep sleep and REM sleep can worsen as dementia progresses.
Paranoia In Alzheimer’s Patients
“Paranoia is a misperception in their mind of an actual event occurring,” Rubinstein explains. Alzheimer’s caregivers shouldn’t argue, she suggests. Instead, look for a seed of truth. For example, if today’s accusation is that you stole a favorite item, and you actually do have a history of borrowing things, consider that there is some validity to your loved one’s feelings. “They need reassurance that everything is okay,” Rubinstein says. Instead of getting defensive when facing this Alzheimer’s symptom, apologize for “losing” the item and promise to replace it soon.
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Stages Of Alzheimers Disease
Not all people who experience memory loss or cognitive dysfunction already has dementia or Alzheimers. some people may be developing mild cognitive impairment or MCI. We normally associate memory lapses with age, right? Well, in MCI, patients develop memory problems earlier than expected, but these lapses do not interrupt with their normal activities. Some may also experience problems with movement and smell, but these issues do not necessarily account them to have Alzheimers. however, those with MCI may be at a higher risk of developing Alzheimers disease.
MildAlzheimers disease. This stage may be the most noted stage where patients with Alzheimers get diagnosed. They manifest symptoms that are easily correlated to dementia, so Alzheimers is easily considered. These may include confusion about certain memorable events, increased incidence of wandering or getting lost within a familiar location, difficulty in performing daily tasks and activities like budgeting and running errands, and even having behavioral or personality disorders.
ModerateAlzheimers disease. At this stage, the early symptoms get worse. As the disease progresses, the patient now has additional difficulty in his sensory function, he now develops hallucinations and language impediments. He forgets or has difficulty recognizing close relatives and friends. They also may have difficulty in caring for themselves like dressing up, eating on their own, and going to the toilet.