Consider Palliative Care And Hospice As Part Of The Process
Palliative care addresses the overall well-being of people with chronic illnesses like progressive brain disorders and dementia. Palliative care and end-of-life hospice care are not the same thing.
- Palliative care. Palliative care providers can help you work through important decisions about which treatments and procedures will bring the biggest benefits. They can also provide medications to relieve pain, anxiety, emotional distress, and other symptoms that arise in late stage dementia. They may be able to help you access the services of social workers, nutritionists, and therapists to meet a wide range of needs.
- Hospice care. Hospice services can ease the transition to end-of-life care, supplying equipment and treatments that bring greater comfort and make it easier to care for a person in this stage.
Can People Recover From Dementia
Unfortunately, theres no cure for dementia or Alzheimers disease, though many studies are underway. In the meantime, its essential to understand howto help a loved one who has been diagnosed with dementia.
So, can a person die from dementia? Unfortunately, yes.
However, this doesnt mean that those struggling are without hope or help. Educating yourself about thecomplications of dementia andcauses of death in Alzheimers patients is a significant first step toward helping your loved one live as full a life as possible.
How Does A Person Die From Dementia
Can dementia kill? Alzheimers 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:
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We Know That Roughly A Third Of People With Dementia Will Reach The More Advanced Stages And Die In Those Advanced Stages
Its a difficult process because its very, very unpredictable. And theres little research in this area, compared to the research that we have on the early stages of dementia. I think its important that we acknowledge theres uncertainty, and as professionals, one of the major things that we can do is say, Well, we dont actually know how this is going to pan out, but we will work through it with you and make sure the person is comfortable at all stages.
Coping With End Of Life Experience A Difficult Proposition
The protracted period from diagnosis to death from Alzheimers disease has been called the long goodbye, and for good reason.
Other individuals afflicted with terminal diseases, whether its cancer that has metastasized beyond the reach of treatment, or heart disease that has fatally weakened cardiac muscle, retain the basic elements of their personalities until they draw their final breaths. But with Alzheimers disease, as it slowly progresses, the components of an individuals personality are worn away along with their cognitive skills and memory. Usually, near the end, they no longer even speak. Their body declines, but the pace of their cognitive decline is speedier. Usually, by the time someone with Alzheimers disease dies, the traits, tendencies and abilities the person possessed have long since departed.
Friends and family of the individual with Alzheimers disease become strangers, and, in a sense, the individual with Alzheimers disease becomes a stranger to family and friends.
That fact often changes the grieving process for those left behind. When death does come, it often seems like the person they knew and loved has, for all intents and purposes, been gone for a while.
After some reflection, she realized, in her words, that I had lost her a decade before.
She continued, You feel a gradual loss. My mother was such a bright, active woman. She was so well-read, you could talk to her about anything. When she actually died, I felt strangely empty of grief.
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Signs Of The Dying Process
As someones condition gets worse and they are within a few days or hours of dying, further changes are common. The person may:
- deteriorate more quickly than before
- lose consciousness
- develop an irregular breathing pattern
- have a chesty or rattly sound to their breathing
- have cold hands and feet.
These changes are part of the dying process when the person is often unaware of what is happening.
Signs And Symptoms Of Alzheimer’s Disease
Memory problems are typically one of the first signs of cognitive impairment related to Alzheimers. Some people with memory problems have a condition called mild cognitive impairment . With MCI, people have more memory problems than normal for their age, but their symptoms do not interfere with their everyday lives. Movement difficulties and problems with the sense of smell have also been linked to MCI. Older people with MCI are at greater risk for developing Alzheimers, but not all of them do so. Some may even revert to normal cognition.
The first symptoms of Alzheimers vary from person to person. For many, decline in nonmemory aspects of cognition, such as word-finding, vision/spatial issues, and impaired reasoning or judgment may signal the very early stages of the disease. Researchers are studying biomarkers to detect early changes in the brains of people with MCI and in cognitively normal people who may be at greater risk for Alzheimers. More research is needed before these techniques can be used broadly and routinely to diagnose Alzheimers in a health care providers office.
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How Do You Die From Alzheimer’s
Alzheimer’s disease affects around 4.5 million people in the United States. It most often occurs in people over 60 years old, but rarely it may occur in younger people. It starts as a low level of forgetfulness and proceeds to loss of ability to communicate or care for yourself. You may ask the question, How do you die from Alzheimer’s? The answer comes with the stages of Alzheimer’s disease and how it progresses. Certain things occur in the body that can affect your physical functions. This article will explain these things and tips for helping care for a loved one living with the disease.
What You Can Do For Your Loved One
As an individual with dementia declines, you can help them by providing a loving and supportive presence. Sit with them. Hold their hand. Play music they enjoy.
One of the greatest gifts you can give your loved one is helping to get their affairs in order. Ensure that financial and healthcare powers of attorney are put in place, so you can make decisions when your loved one is no longer able. Look into funeral arrangements before you need them, so you dont need to make important decisions in a time of crisis.
Talk to your loved ones physician about the possibility of palliative care support in the home and hospice care when your loved one is ready.
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What Are The Warning Signs Of Alzheimers Disease
Symptoms usually develop gradually and worsen over the years. Symptom progression varies from person to person and mostly manifests as forgetfulness in the initial stages.
One or more of the following symptoms may be present in someone with Alzheimer’s disease:
- Memory loss that disrupts daily life such as getting lost in a familiar place or repeating questions
- Inability to recognize familiar faces
- Trouble handling money and paying bills
- Difficulty completing basic tasks at home, work, or leisure
Being Patient: You Write That When Your Mom Was Administered Morphine You Didnt Realize That Was The End Can You Tell Us About That
Jasja De Smedt Kotterman: Right, and I dont know why it didnt click with me. I somehow thought that with morphine, you would still be conscious, but not in pain. Actually, its a question I would love to ask Liz as well, because I had heard of people being on morphine to help them with pain, but that they were still able to talk a little bit, so what really surprised me was that she just never regained consciousness after that.
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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.
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.
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Being Patient: Dr Sampson Should You Have That Discussion Right After A Diagnosis
Dr. Liz Sampson: Yes, if you can do it in a sensitive way. The problem is that lots of people who have dementiaand perhaps its a blessingdont have insight into that because the part of the brain that gives us insight and self-awareness is affected quite early on in dementia. Sometimes, you can try and introduce the topic, but it can be very difficult for people who are in the early stages of dementia to visualize a future self and what they might want.
You can keep it very general and say, Was that a good idea? What happened to that person? What would you like? Discussing the subject with your siblings or other family members could be helpful, but dont put too much pressure on the person with dementia because its conceptually difficult to think, What would my future self want? But a very gentle discussion at an opportune moment could be helpful.
This interview has been edited for length and clarity.
Whats The Best Way To Care For Someone Whos In Late Stages Of Dementia
The ideal time to plan for late stage care is when the person with dementia can still participate in the decision-making process. However, even if the person with dementia and caregivers communicated clearly while the disease was in early stages, things can change. Symptoms can progress more or less quickly and resources may dwindle.
Here are a few things to keep in mind if you are caring for someone in late stage dementia:
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Being Patient: Dr Sampson What Happens To The Brain When Someone Is Dying From Alzheimers
Dr. Liz Sampson: Its a really complex issue, and I think one of the problems is that often, we dont perceive that dementia and Alzheimers can be a life-limiting illness. Because of that, its not discussed in the same way as when someone is diagnosed with cancer or another terminal illness. I think everyones different, and its an individual journey for people. Theres an added layer of complexity because lots of people with dementia or Alzheimers disease who are elderly might not even live to the advanced stages of dementia. Many people will die from other causes, such as heart failure, stroke, accidents and all of the other things that were at risk of dying from when we get older. We know that roughly a third of people with dementia will reach the more advanced stages and die in those advanced stages.
Common Types Of Dementia
Most people who have dementia experience problems with cognitive skills, depression, indifference, and a lack of interest in doing things.
People with Lewy body dementia and Alzheimer’s disease may have similar early symptoms. Memory loss is common in both conditions, for example. Lewy body dementia also commonly causes fluctuations in arousal, hallucinations, sleep problems, and difficulty walking.
In contrast, people in the early stages of frontotemporal dementia usually don’t have memory problems. Instead, they might have obvious changes in personality and behavior.
Vascular dementia, which occurs as a result of having many strokes throughout the brain, can cause problems understanding concepts, emotional and personality changes, and memory problems. This type of dementia may accompany other types, making the decline more severe.
And chronic traumatic encephalopathy , which occurs after repeated head trauma, often begins to cause symptoms years after the traumatic brain injuries, with a significant progression of mood changes, personality changes, and a decline in memory and cognitive skills.
With Lewy body dementia, frontotemporal dementia, vascular dementia, and CTE, the memory problems may respond to cues/reminders, while in Alzheimer’s there is often a forgetting of recent events altogether.
In the final stage of all types of dementia, a person goes through a major decline in everyday functioning.
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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.
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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Do Brain Cells Die As We Age
With normal aging, we dont find that neurons die in massive numbers. While with Alzheimers disease, the neurons or brain cells die in large numbers in certain areas of the brain.
This is the end product of the process of Alzheimers disease. Alzheimers causes neuron death. And this neuron death manifests as memory, thinking, and behavior changes.
But your brain is so resilient that it is able to adapt for many decades to this cell death.
Neuroscientists believe that when the very first signs of memory, thinking or behavior changes appear in an Alzheimers patient, their neuron loss is approximately 70% in certain areas of the brain.
This 70% loss represents a massive number of dead neurons in brain regions that are earliest affected by Alzheimers disease.
It is a truly remarkable process. Your brain is fighting and largely maintaining cognitive skills until you reach some sort of critical point. It is at this juncture, where a very large percentage of neurons are missing from the brain regions critical for memory formation, that Alzheimers becomes evident.
It is one of the most impressive things, that our brain is able to fight this process, and do a pretty good job of fighting for so long.
What causes this cell death? Alzheimers affects two proteins, beta-amyloid and tau. It causes tangle and plaque formation, brain inflammation, lost connections, and neuronal death.