Standard Vs Alzheimers/dementia Advance Directive
Unlike the standard advance healthcare directive, which specifies what medical actions should be undertaken if you are too ill or incapacitated to make decisions, an Alzheimers / dementia directive covers decisions involving day-to-day choices such as where you would like to be treated, who the preferred caregiver is, and whos authorized to be your healthcare agent.
The Alzheimers directive is more about the challenges of living with Alzheimers, such as where are you going to live, how your care is going to be paid for, what to do with your pets, when to stop driving, what happens when you can no longer have intimate relations with your spouse or partner, not medical issues.
Robb Miller, Former Executive Director, End of Life Washington
Like all directives, this one cannot account for every care decision that may arise. We suggest writing a personal statement, describing your history, values , and any other information that will help others understand or at least have a sense of who the directives author is. This allows caregivers to make informed decisions based on more complete information and allows them to fill in the gaps in unanticipated situations.
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:
Signs And Symptoms Of Alzheimer’s Disease
Alzheimer’s disease is a progressive condition, which means the symptoms develop gradually over many years and eventually become more severe. It affects multiple brain functions.
The first sign of Alzheimer’s disease is usually minor memory problems.
For example, this could be forgetting about recent conversations or events, and forgetting the names of places and objects.
As the condition develops, memory problems become more severe and further symptoms can develop, such as:
- confusion, disorientation and getting lost in familiar places
- difficulty planning or making decisions
- problems with speech and language
- problems moving around without assistance or performing self-care tasks
- personality changes, such as becoming aggressive, demanding and suspicious of others
- hallucinations and delusions
- low mood or anxiety
Read more about the symptoms of Alzheimer’s disease.
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How Do You Die From Alzheimer’s Disease
Reader Question 2704 votes
Alzheimers disease is a progressive brain disorder that causes dementia, destroying memory, cognitive skills, the ability to care for oneself, speak and walk, said Ruth Drew, director of family and information services at the Alzheimers Association.And since the brain affects everything, Alzheimers ultimately affects everything, she said, including the ability to swallow, cough and breathe.
Once patients reach the advanced stages of Alzheimers, they may stop eating and become weak and susceptible to infections, said Dr. Jason Karlawish, a professor of medicine at the University of Pennsylvania. Unable to swallow or cough, they are at high risk of choking, aspirating food particles or water into the lungs and developing pneumonia, which is often the immediate cause of death, he said.
You see a general decline in the contribution the brain makes, not just in thinking, but in maintaining the bodys homeostasis, Dr. Karlawish said. Using a feeding tube to nourish patients and hospitalizing them for infections does not significantly extend life at the advanced stages of the disease and is discouraged because it can prolong suffering with no hope of recovery, he said.
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Be Aware Of Their Eating And Drinking
The person may have lost their appetite or have difficulties swallowing safely. In the last days, the person may stop eating or drinking. This can be very distressing to watch, but it is normal for people approaching the end of life.
You should offer the person food and drink for as long as it is safe and they show an interest. Its important to keep the persons mouth comfortable provide sips of fluids and keep lips moist and clean.
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Trends In Dementia Caregiving
There is some indication that families are now better at managing the care they provide to relatives with dementia than in the past. From 1999 to 2015, dementia caregivers were significantly less likely to report physical difficulties and financial difficulties related to care provision. In addition, use of respite care by dementia caregivers increased substantially . However, as noted earlier, more work is needed to ensure that interventions for dementia caregivers are available and accessible to those who need them. A 2016 study of the Older Americans Act’s National Family Caregiver Support Program found that over half of Area Agencies on Aging did not offer evidence-based family caregiver interventions.
Recognising When Someone Is Reaching The End Of Their Life
Read about some of the signs that a person with dementia is nearing their death, and how you can support yourself as a carer, friend or relative.
It is important to know when a person with dementia is nearing the end of their life because it can help in giving them the right care. However it can be difficult to know when this time is.
This uncertainty can have a big impact on how the persons family feel, and may also affect how they feel themselves.
There are symptoms in the later stages of dementia that can suggest the person is reaching the final stage of their illness. These include:
- speech limited to single words or phrases that may not make sense,
- needing help with most everyday activities,
- eating less and having difficulties swallowing,
- bowel and bladder incontinence,
- being unable to walk or stand, problems sitting up and controlling the head, and becoming bed-bound.
It is likely that a person with dementia is nearing the end of their life if they have these symptoms, along with other problems such as frailty, infections that keep coming back, and pressure ulcers .
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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.
Stage : Mild Dementia
At this stage, individuals may start to become socially withdrawn and show changes in personality and mood. Denial of symptoms as a defense mechanism is commonly seen in stage 4. Behaviors to look for include:
- Difficulty remembering things about one’s personal history
- Difficulty recognizing faces and people
In stage 4 dementia, individuals have no trouble recognizing familiar faces or traveling to familiar locations. However, patients in this stage will often avoid challenging situations in order to hide symptoms or prevent stress or anxiety.
Lack Of Proper Nutrition
This is what happens during the later dementia stages.
Persons with the illness will struggle to eat well, hydrate, and stay healthy.
Many may not be in a position to prepare or eat food without assistance. This may cause them to go off food which can make them dangerously lose weight.
Some individuals will also lose muscle control towards the end of the disease where they cannot chew properly or even swallow food.
When the individual is not getting adequate nourishment, they become weaker and are more susceptible to the risk of infections, fractures, and falls which may lead to their demise.
There are also chances that a person with dementia may end up inhaling fluids or foods. It mostly happens because they lose the skill to coordinate breathing and swallowing because of the damage that happens in the brain which controls these activities.
When this happens, it can lead to life-threatening chest infections and choking.
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.
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Avoidable Use Of Health Care And Long
6.5.1 Preventable hospitalizations
Preventable hospitalizations are one common measure of health care quality. Preventable hospitalizations are hospitalizations for conditions that could have been avoided with better access to, or quality of, preventive and primary care. Unplanned hospital readmissions within 30 days are another type of hospitalization that potentially could have been avoided with appropriate post-discharge care. In 2013, 21% of hospitalizations for fee-for-service Medicare enrollees with Alzheimer’s or other dementias were either for unplanned readmissions within 30 days or for an ambulatory care sensitive condition . The total cost to Medicare of these potentially preventable hospitalizations was $4.7 billion . Of people with dementia who had at least one hospitalization, 18% were readmitted within 30 days. Of those who were readmitted within 30 days, 27% were readmitted two or more times. Ten percent of Medicare enrollees had at least one hospitalization for an ambulatory care-sensitive condition, and 14% of total hospitalizations for Medicare enrollees with Alzheimer’s or other dementias were for ambulatory care sensitive conditions.
How Alzheimer’s Disease Is Treated
There’s currently no cure for Alzheimer’s disease, but medicines are available that can help relieve some of the symptoms.
Various other types of support are also available to help people with Alzheimer’s live as independently as possible, such as making changes to your home environment so it’s easier to move around and remember daily tasks.
Psychological treatments such as cognitive stimulation therapy may also be offered to help support your memory, problem solving skills and language ability.
Read more about treating Alzheimer’s disease.
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How Do Dementia Patients Die
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.
What Are The Symptoms Of The Final Stages Of Alzheimers
Late Stages of Alzheimers Disease SymptomsCatches colds and infections easily.Day/night reversal of sleep pattern.Difficulty communicating.Difficulty sleeping.Difficulty swallowing.Difficulty using the toilet independently.Eventually requires help with activities of daily living, 24 hours per day.More itemsJul 6, 2018
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Can You Die From Dementia
Dementia is usually considered a disorder affecting memory and is associated with aging. In the initial stages, this could be true. Loss of memory is one of the earliest signs of the disease.
However, according to experts, dementia is a fatal brain failure that needs to be taken seriously like other terminal diseases that kill a patient slowly. It is not just an ailment that is associated with the elderly.
Even though the distinction is not really known in the medical field and to the general public, it is something that needs to be considered when one has to be treated at the very end stage of the condition.
It is believed that the fact that people are misinformed and misguided about dementia, the end stage treatment is usually made very aggressive.
The disease progresses quite slowly and the fact that it affects so many people means that it should be taken seriously. Dementia is a collection or a consequence of different diseases like Alzheimers disease, vascular dementia, and Parkinsons disease. In later stages, you can tell the type of dementia that is affecting a certain patient.
The patient can have eating problems, pneumonia, fever, pain, and difficulty breathing, which are all caused by the failure of the brain. In the end, dementia involves so many other parts of the body.
It is important to appreciate that the brain is the engine of our bodies. It controls everything, including metabolism, gastrointestinal tract, the lungs, and even the heart.
Specific Information In This Report
Alzheimer’s Disease Facts and Figures
- Brain changes that occur with Alzheimer’s disease.
- Risk factors for Alzheimer’s dementia.
- Number of Americans with Alzheimer’s dementia nationally and for each state.
- Lifetime risk for developing Alzheimer’s dementia.
- Proportion of women and men with Alzheimer’s and other dementias.
- Number of deaths due to Alzheimer’s disease nationally and for each state, and death rates by age.
- Number of family caregivers, hours of care provided, and economic value of unpaid care nationally and for each state.
- The impact of caregiving on caregivers.
- National cost of care for individuals with Alzheimer’s or other dementias, including costs paid by Medicare and Medicaid and costs paid out of pocket.
- Medicare payments for people with dementia compared with people without dementia.
- Number of geriatricians needed by state in 2050.
The Appendices detail sources and methods used to derive statistics in this report.
When possible, specific information about Alzheimer’s disease is provided in other cases, the reference may be a more general one of âAlzheimer’s or other dementias.â
How Alzheimer’s Causes Death
In late-stage Alzheimer’s disease, people become extremely confused and disoriented. The behavior of someone with late stage Alzheimer’s may become more agitated and restless, while other persons experience withdrawal and apathy. Sometimes, people with later stage dementia cry and call out. Eventually, they lose the ability to communicate, and they may not respond at all.
Additionally, people in the late stages are unable to care for themselves, becoming bedbound and completely dependent on others for their activities of daily living. Their ability to be continent of bowel and bladder declines.
Their appetite decreases as well, and eventually, they lose the ability to swallow, leading to poor nutrition and a high risk of aspiration. Aspiration, where a person’s food goes “down the wrong tube” when they swallow it, greatly increases the risk of pneumonia developing because they’re not able to fully cough and clear the food out of their esophagus and then it settles into their lungs.
Under these difficult conditions, it’s not hard to imagine how vulnerable people with late-stage dementia become, sometimes succumbing to infections, pressure sores, and pneumonia. One study found that half of all people with dementia admitted to a hospital for pneumonia or a hip fracture died within six months of leaving the hospital.
Other factors that impact the death rate in Alzheimer’s disease include advanced age, increased falls, and delirium.