Eating And Weight Loss In The Later Stages Of Dementia
Eating and drinking becomes more difficult as dementia progresses. People in the later stages of dementia may experience loss of appetite among other symptoms.
The later stages of dementia
Many people with dementia lose weight in the later stages. Weight loss can affect the immune system and make it harder for the person to fight infections and other illnesses. It can also increase the risk of falling and make it harder for the person to remain independent.
People in the later stages of dementia may also develop difficulties with swallowing and chewing. People with swallowing problems are at risk of choking and of food or saliva going down the windpipe, causing an infection. Swallowing difficulties can be common in the later stages as the persons muscles and reflexes no longer work properly. They can be distressing for the person and those supporting them.
If the person is having difficulties its important to speak to the GP they may refer the person to a speech and language therapist or nutritional specialist.
The person should be supported to eat and drink for as long as they show an interest and can do so safely . There are ways to help make this easier for the person. For example:
Often behaviour is a means of communication and can be a result of the person feeling a certain way .
Can Dementia Get Worse Suddenly
Dementia is a progressive condition, meaning that it gets worse over time. The speed of deterioration differs between individuals. Age, general health and the underlying disease causing brain damage will all affect the pattern of progression. However, for some people the decline can be sudden and rapid.
How Can You Help Someone With Chewing Or Swallowing Difficulties
Avoid giving your loved one certain foods they find difficult to chew or swallow. It is important to ensure that their oral hygiene is good because pain in their mouth can make chewing difficult.
Soft, moist food is easier to manage, especially if your loved one tires easily. If your relative wears dentures, ensure that they fit correctly and are comfortable. If not, their dentist should be able to help.
Referring a person who has problems with swallowing to a speech and language therapist may help. If your elderly relative holds food in their mouth, chews continuously or leaves hard to chew food on the plate, ask their doctor for a referral.
If your elderly relative is drowsy or does not sit up properly, they may have difficulty in swallowing safely. It is important, particularly in the later stages of dementia care, to ensure that the person is sitting upright, and is comfortable and alert before offering them anything to eat or drink. If they are in bed, they need to be well supported and positioned correctly.
A physiotherapist will be able to advise you on how best to position your loved one for eating and drinking, and an occupational therapist may be able to suggest suitable aids to help them eat and drink. Their GP will refer them to a physiotherapist or occupational therapist if appropriate.
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What Are The Signs Of End
It is important for caregivers to know when an individual with dementia is close to the end of their life, because it helps ensure they receive the right amount of care at the right time. It can be difficult to know exactly when this time is due to the variable nature of dementias progression, but understanding common end-of-life symptoms of seniors with dementia can help. Below is a timeline of signs of dying in elderly people with dementia:
Final Six Months
- A diagnosis of another condition such as cancer, congestive heart failure or COPD
- An increase in hospital visits or admissions
Final Two-to-Three Months
- Speech limited to six words or less per day
- Difficulty in swallowing or choking on liquids or food
- Unable to walk or sit upright without assistance
- Hands, feet, arms and legs may be increasingly cold to the touch
- Inability to swallow
- Terminal agitation or restlessness
- An increasing amount of time asleep or drifting into unconsciousness
- Changes in breathing, including shallow breaths or periods without breathing for several seconds or up to a minute
Patients with dementia are eligible to receive hospice care if they have a diagnosis of six months or less to live if the disease progresses in a typical fashion. Once a patient begins experiencing any of the above symptoms, it is time to speak with a hospice professional about how they can help provide added care and support.
Loss Of Mental Ability
Memory problems are usually the most obvious symptom in people with dementia. Forgetfulness is common. As a rule, the most recent events are the first forgotten. For example, a person with early stages of dementia might go to the shops and then cannot remember what they wanted. It is also common to misplace objects.
Early memories stay longest. Events of the past are often remembered well until the dementia is severe. Many people with dementia can talk about their childhood and early life. As dementia progresses, sometimes memory loss for recent events is severe and the person may appear to be living in the past. They may think of themself as young and not recognise their true age.
Someone with dementia may not know common facts when questioned . They may have difficulty remembering names or finding words. They may appear to be asking questions all the time.
Language problems can also develop. For example, someone with dementia may have difficulty understanding what is said to them or understanding written information. Problems with attention and concentration can also occur. It is common for someone with dementia not to be able to settle to anything and this can make them appear restless.
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Signs Of Death In Elderly With Dementia: End Stage
Dementia is a term used to describe the persistent or chronic decline in ones mental processes and this include personality changes, impaired reasoning, and memory loss. The most common form is Alzheimers disease and it accounts for over 70 percent of all the dementia cases.
It is one of the greatest causes of death in the United States with over five million people living with the disease in the country alone. One of the age groups affected by dementia is the seniors. If you are a caregiver, it is important to know the signs of death in elderly with dementia.
Most progressive dementias and Alzheimers disease do not have any cure. The diseases get worse with the passage of time, but the timeline can be very different from one person to the next.
Caring for persons with the diseases can be stressful and very challenging, especially when their personality begins to change and their cognitive function starts to decline. It is possible that the individual will not even recognize the people who are closest and dearest to them.
As the disease progresses, the person needs more and more support from the caregiver and the family. If the person is elderly, the caregiver needs to know about all the signs that the patient may be dying.
You may need to put the patient on hospice so as that he or she can get the appropriate care during such moments. This offers the family and the patient spiritual, physical, and emotional care.
Weight Loss Tied To Early Alzheimer’s
Accelerated Weight Loss Precedes Symptoms
Older people in the study who were followed for an average of six years lost twice as much weight in the year before the first signs of dementiadementia appeared as people who did not develop Alzheimer’s-related dementias — 1.2 pounds compared with a weight loss of 0.6 pounds per year.
The acceleration in weight loss was too small to help physicians identify Alzheimer’s earlier in individual patients, the study’s researchers tell WebMD. But the finding may help researchers better understand the disease.
The new research appears in the September issue of the Archives of Neurology.
“We are getting glimpses into what is happening with the brain in the pre-symptomatic stage before dementia occurs,” says David K. Johnson, PhD.
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Theories Of Body Weight Loss In Dementia
Numerous explanations have been put forth to explain associations observed between malnutrition, BW loss, cognitive decline, and dementia . First, patients with dementia can experience BW loss from reduced energy intake owing to their decreased mental status, which causes them to simply forget or refuse to eat . This may result from impairments in episodic memory and attention that are associated with medial temporal lobe atrophy . Second, changes in behavior, such as repetitive actions and other behavioral disorders may both demand larger amounts of energy and reduce energy intake. Third, sensory changes such as deterioration of the olfactory bulb and/or diminished gustatory perception can contribute to weight loss as a result of cholinergic deficits . Fourth, dysphagia, or difficulties swallowing, may reduce energy intake . Fifth, hypermetabolism, defined as an elevated basal metabolic rate of > 10% , is suggested to cause BW loss. Studies in patients with AD show increased , but also reduced and no change in energy metabolism. However, hypermetabolism and BW loss were observed in a transgenic mouse model of AD using calorimetric cages . Still, it remains unclear whether hypermetabolism is a feature of all or a subset of AD cases.
The Seven Stages Of Dementia
One of the most difficult things to hear about dementia is that, in most cases, dementia is irreversible and incurable. However, with an early diagnosis and proper care, the progression of some forms of dementia can be managed and slowed down. The cognitive decline that accompanies dementia conditions does not happen all at once – the progression of dementia can be divided into seven distinct, identifiable stages.
Learning about the stages of dementia can help with identifying signs and symptoms early on, as well as assisting sufferers and caretakers in knowing what to expect in further stages. The earlier dementia is diagnosed, the sooner treatment can start.
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Body Weight Loss In Dementia
Unintentional BW loss is a prominent clinical feature in some individuals with dementia . For example, data indicate that 3040% of patients with dementia may experience clinically significant weight loss . Body weight loss in dementia may be characteristic of reduced nutritional status, which is partially explained by a reduced food intake . It has been shown that 1445% of community-dwelling patients with mild-to-moderate AD, and up to 68% of patients with severe AD, are at risk of malnutrition . Body weight loss is also observed in transgenic mouse models of dementia that recapitulate underlying neurodegenerative pathologies , albeit inconsistently , as this loss may also be explained by model-specific developmental problems or strain-specific genetic effects .
Unintentional BW loss is detrimental for the frail elderly because it is associated with higher rates of mortality , institutionalization , adverse health outcomes, decline in functional status, and overall poorer quality of life . In elderly with dementia, unintentional BW loss is associated with syndrome severity , higher rates of institutionalization , a higher incidence of behavioral problems , and ultimately mortality . In contrast, a BMI equal to or higher than overweight has been associated with reduced mortality in dementia . Thus, it appears that low or healthy adult BMI can lead to poorer health outcomes in patients with dementia, while a higher BMI may be protective.
Why Nutrition Is Important For People With Dementia
Good nutrition is vital for the health, independence and wellbeing of people with dementia. However, maintaining a healthy weight can be a challenge for many people with dementia. Difficulties eating and drinking are more noticeable as dementia progresses and unwanted weight loss is a common problem.
We all have likes and dislikes and eating habits that are particular to us as individuals.
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Do Dementia Patients Know They Are Confused
In the earlier stages, memory loss and confusion may be mild. The person with dementia may be aware of and frustrated by the changes taking place, such as difficulty recalling recent events, making decisions or processing what was said by others. In the later stages, memory loss becomes far more severe.
Signs Of Dying In The Elderly With Dementia
Dementia is a general term for a chronic or persistent decline in mental processes including memory loss, impaired reasoning, and personality changes. Alzheimers disease is the most common form of dementia, accounting for 60-80% of all cases of dementia. It is also the 6th leading cause of death in the United States, and over 5 million Americans are currently living with Alzheimers disease.
Alzheimers disease and most progressive dementias do not have a cure. While the disease inevitably worsens over time, that timeline can vary greatly from one patient to the next.
Caring for a loved one can be challenging and stressful, as the individuals personality changes and cognitive function declines. They may even stop recognizing their nearest and dearest friends and relatives. As dementia progresses, the individual will require more and more care. As a family caregiver, its important to be able to recognize the signs of dying in elderly with dementia. Hospice can help by offering care wherever the individual resides, providing physical, emotional and spiritual care to the patient and support their family.
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Major Weight Gain And Loss Worsens Dementia Risk In Elderly
29 May, 2019By Nursing Times News Desk
Older people who experience significant weight gain or weight loss could be raising their risk of developing dementia, suggests a study from South Korea.
Researchers noted there was existing evidence of a possible association between dementia and cardiometabolic risk factors, such as high blood pressure, cholesterol and blood glucose levels.
Both weight gain and weight loss may be significant risk factors associated with dementia
However, they said that the association between body mass index in late-life and dementia risk was previously unclear.
Therefore, the team of researchers from the Republic of Korea set out to investigate the association between BMI changes over a two-year period and dementia in an elderly population.
They examined 67,219 participants aged 6079 years who underwent BMI measurement in 2002-03 and 2004-05, as part of a national screening initiative.
At the start of the study period, characteristics were measured including BMI, socioeconomic status and cardiometabolic risk factors.
The difference between BMI at the start of the study period and at the next health screening was used to calculate the change in BMI.
After two years, the incidence of dementia was monitored for an average 5.3 years from 2008 to 2013.
During the 5.3 years of follow-up time, the numbers of men and women with dementia was 4,887 and 6,685, respectively.
Support For Healthy Eating
1. Choosing a plate that has a different color from the food so that the person with dementia can see it more clearly.
It also helps to offer flavourful food.
2. Feeding them or putting a drink in their hand if they have difficulties seeing it.
3. Giving the individual enough time to eat and drink.
4. Encouraging the person to participate in exercise during the day can help to increase appetite.
5. Try and give them foods that they enjoy, especially if you can provide a healthier option so that the suffering person can always look forward to mealtimes.
For instance, if a person prefers sweet food, you can always serve them a lot of fruit and a little forward so that at the end of the day, they still consume a balanced diet that is good for their health.
Note that smells and tastes from their favorite foods can stimulate the appetite.
Additionally, it is essential to serve tender food that is cut into small bites so that the person with dementia does not have a tough time chewing and swallowing the food.
6. Avoid distractions and overstimulation in the dining areas.
Turning off the TV or radio and making sure people do not make too much noise during meal times can help create the ideal eating environment.
8. At times, in dire cases, family members may consider going the artificial feeding route.
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How Does Dementia Progress
Typically, symptoms of dementia tend to develop slowly, often over several years. In the early stages of the disease, many people with mild dementia cope with just a small amount of support and care. As the disease progresses more care is usually needed.
In the later stages of dementia, speech may be lost and severe physical problems may develop, including problems with mobility, incontinence and general frailty. This can make people more susceptible to other health problems such as infections. Often, people with dementia die from another health problem such as a severe chest infection. So, the dementia isn’t the cause of their death but has contributed to it.
Some people can live for many years after dementia has been diagnosed. However, the condition does shorten lifespan. On average, once diagnosed with dementia, people are:
- In the mild early stage for one or two years.
- In the moderate stage, needing help looking after themselves for another two or three years.
- In a severe stage by four to five years after diagnosis, being completely dependent on carers and more or less completely inactive.
The average survival after diagnosis is 3-9 years, but people can survive for up to 20 years after being diagnosed with dementia.