Caring For Those With Dementia
Researcher Murna Downs, PhD, says most people don’t recognize that dementia is a disease people live with, and not just a death sentence.
Downs’ research focuses on quality-of-life issues among dementia patients.
“People with dementia live a long time, and we now know that there is a lot of awareness,” she says. “People assume that if someone doesn’t know where they are they have no other capacity for thinking and feeling. But people with dementia continue to think and to laugh and to feel the rain on their faces, and to try to make sense of their world.”
She adds that patients are often isolated because family members or other caregivers fail to recognize their need for interaction and stimulation.
“The therapeutic potential of human contact cannot be underestimated,” she says. “You would never put a small child in a chair and let them sit there all day with nothing to do. Children need stimulation and human contact and so do people with dementia.”
SOURCES: Xie, J. BMJ Online First, Jan. 11, 2008. Carol Brayne,professor, lecturer in epidemiology, department of public health and primarycare, Institute of Public Health, University of Cambridge, England. MurnaDowns, PhD, professor in dementia studies, Bradford Dementia Group, Universityof Bradford, England Ferri, C.P. Lancet, 2005 vol 366: pp2112-2117.
Weighing Hospitalization Against Hospice At The End Of Life
As a loved ones condition declines due to dementia, the likelihood of developing complications, such as aspiration pneumonia, pressure ulcers and urinary tract infections , increases greatly. Family members must decide whether to seek curative treatment at the hospital for conditions like these, which can be mentally and physically taxing on a person who is cognitively impaired. Sadly, even if secondary health issues resolve, it is probable that they will recur. The difficult question is, should families forgo treatment in the hospital and opt for comfort care? If so, when?
The answer lies in your loved ones personal end-of-life preferences. Hopefully this was a conversation that took place early on while they were still mentally competent and resulted in appropriate planning measures such as a living will, a do not resuscitate order, a voluntarily stopped eating and drinking , POLST form, or advance directive. If our loved ones wishes have been documented, then it is up to us as their caregivers to follow them.
Because late-stage dementia prevents patients from effectively clearing bacteria from the body and notifying others of their symptoms or pain, infections can easily take root and are often the cause of death. Urinary and fecal incontinence, difficulty swallowing and breathing, and overall reduced immune system function all contribute to illness.
If Youre Worried About Possible Dementia
Lets say youre like the man I spoke to recently, and youre worried that an older parent might have dementia. Youre planning to have a doctor assess your parent. Heres how you can help the process along:
- Obtain copies of your parents medical information, so you can bring them to the dementia evaluation visit. The most useful information to bring is laboratory results and any imaging of the brain, such as CAT scans or MRIs. See this post for a longer list of medical information that is very helpful to bring to a new doctor.
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How Much Time Can Treatment Add
Treatment will not prevent the progression of AD. It is also unclear if treatment can add time to a persons life. Ultimately, AD will progress and take its toll on the brain and body. As it progresses, symptoms and side effects will get worse.
However, a few medications may be able to slow the progression of AD at least for a short time. Treatment can also improve your quality of life and help treat symptoms. Talk with your doctor about your treatment options.
study identified several factors that affect a persons life expectancy. These include:
- Gender: A 2004 study found that men lived an average of 4.2 years after their initial diagnosis. Women were found to live an average of 5.7 years after their diagnosis.
- Severity of symptoms: People with significant motor impairment, such as a history of falls and a tendency to wander or walk away, had shorter life expectancies.
- Brain abnormalities: The study also detected a connection between brain and spinal cord abnormalities and the length of life.
- Other health problems: People with heart disease, a history of heart attack, or diabetes had shorter lifespans than patients without these complicating health factors.
Can A Person With Dementia Recover After A Hip Fracture
Although dementia makes it more challenging and decreases the likelihood of full recovery, people can regain their previous level of functioning. Dementia influences the recovery process, but research demonstrates that functioning level prior to hip fracture is a stronger predictor of successful rehabilitation than cognitive status.
In other words, if you were quite strong and mobile before breaking your hip, you are more likely to regain that strength and mobility, even if you have some memory loss or a diagnosis of dementia.
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Can Dementia Be Diagnosed During A Single Visit
So can dementia be diagnosed during a single visit? As you can see from above, it depends on how much information is easily available at that visit. It also depends on the symptoms and circumstances of the older adult being evaluated.
Memory clinics are more likely to provide a diagnosis during the visit, or shortly afterwards. Thats because they usually request a lot of relevant medical information ahead of time, send the patient for tests if needed, and interview the patient and informers extensively during the visit.
But in the primary care setting, and in my own geriatric consultations, I find that clinicians need more than one visit to diagnose dementia or probable dementia. Thats because we usually need to order tests, request past medical records for review, and gather more information from the people who know the senior being evaluated. Its a bit like a detectives investigation!
What Are The Average Life Expectancy Figures For The Most Common Types Of Dementia
The average life expectancy figures for the most common types of dementia are as follows:
- Alzheimers disease around eight to 10 years. Life expectancy is less if the person is diagnosed in their 80s or 90s. A few people with Alzheimers live for longer, sometimes for 15 or even 20 years.
- Vascular dementia around five years. This is lower than the average for Alzheimers mostly because someone with vascular dementia is more likely to die from a stroke or heart attack than from the dementia itself.
- Dementia with Lewy bodies about six years. This is slightly less than the average for Alzheimers disease. The physical symptoms of DLB increase a persons risk of falls and infections.
- Frontotemporal dementia about six to eight years. If a person has FTD mixed with motor neurone disease a movement disorder, their dementia tends to progress much quicker. Life expectancy for people who have both conditions is on average about two to three years after diagnosis.
To find out about the support available to someone at the end of their life, and to their carers, family and friends, see our End of life care information.
You can also call Alzheimers Society on 0333 150 3456 for personalised advice and support on living well with dementia, at any stage.
Dementia Connect support line
- Page last reviewed:
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Life Expectancy And Alzheimers Disease
Alzheimer’s disease is the most common cause of dementia. Abnormal proteins cause steadily increasing brain damage. This initially affects thought and memory and remember and progressively causes failure of all body systems.
Alzheimers is typically diagnosed at the mild dementia stage when memory and planning problems start to affect daily life. The life expectancy for an individual with Alzheimer’s is usually between 8-12 years from diagnosis however, someone fit and healthy on diagnosis could live considerably longer. In one American study, people lived from between one and twenty-six years after first spotting symptoms, so the variation is enormous.
Wide Range Of Life Expectancies
Jicha tells WebMD he decided to develop the formula after treating a patient who lived 22 years from the time of her Alzheimer’s diagnosis.
“We typically think of Alzheimer’s disease as being rapidly progressing, telling new patients they may have six to eight years, but that really, it is in God’s hands,” he says.
When Jicha and colleagues scrutinized the records of nearly 1,300 men and women who had been diagnosed with Alzheimer’s at their institution, they found patients lived anywhere from one to 26 years from when they first started losing their memory.
So the researchers used standard statistical methods to weed out which risk factors best predicted patients’ life expectancies.
“We looked at everything from age and education to family history and genetics to medical risk factors like high blood pressure and heart disease,” Jicha says.
Only three factors seemed to matter: age at first symptoms , sex , and level of impairment at diagnosis. Adding in any of the other risk factors didn’t change the bottom line, Jicha says.
Using the three factors, the researchers derived a simple formula to predict patients’ risks of dying. Then, based on these so-called risk scores, the patients were divided into four categories of life expectancy.
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Formula Predicts Alzheimer’s Longevity
That, says Gregory A. Jicha, MD, is the first question patients ask after receiving a diagnosis of Alzheimer’s disease.
Until now, the answer has largely been a guessing game. But Jicha and colleagues have developed a simple formula based on a patient’s sex, age, and cognitive skills at the time of diagnosis to more accurately predict life expectancy.
“Having a better of idea of how long they will live will allow patients and families to better plan for the future,” says Jicha, an assistant professor of neurology at the University of Kentucky in Lexington.
He presented his findings at the annual meeting of the American Academy of Neurology.
How Long Can Someone Survive With Very Little Food Or Water
My husband has later stage Alzheimer’s and has been declining over the past several weeks. I care for him at home by myself as all of our family live out of state. I also work full-time, but work from home 2 days/wk – so 3 days/wk, I’ve been taking him to an Alzheimer’s day care while I go into the office. But he’s become too weak and frail to do that any more – so I’ve hired in-home help. He won’t let the in-home help come near him and so doesn’t eat at all during the day while I’m at the office – and only eats/drinks a little when I come home. They try and put food and Ensure on his bed table, but he ignores it. Even when I’m with him during the day, he eats/drinks very little. He can’t/won’t get up up, so I’m cleaning/changing him in bed, which I don’t feel is adequate. I’m mentally, emotionally and physically exhausted. Tomorrow, I’m going to ask his neurologist to place an order for a hospice evaluation, but I was wondering how long he can continue with very little food or liquid – or not getting up at all?
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How To Get A Better Idea Of Life Expectancy For Your Individual Situation
Whilst every person is different, and every dementia journey is different, if you want more clarity about how long you, or your loved one might live, studies suggest that the main factors to consider are:
1. Age 2. General health when diagnosed .3. Which form of dementia they have .4. How much they can still do for themselves day to day. Experts call this functional ability, and it seems to matter more than cognitive ability. In other words, people who continue to try doing things for themselves, even if their dementia is quite advanced, tend to live longer than those who stop.
*Other factors, such as whether you are married, living at home or your level of education dont seem to have an impact.
Can Dementia Be Inappropriately Diagnosed In A Single Visit
Sadly, yes. Although its common for doctors to never diagnose dementia at all in people who have it, I have also come across several instances of busy doctors rattling off a dementia diagnosis, without adequately documenting how they reached this conclusion.
Now, often these doctors are right. Dementia becomes common as people age, so if a family complains of memory problems and paranoia in an 89 year old, chances are quite high that the older person has dementia.
But sometimes its not. Sometimes its slowly resolving delirium along with a brain-clouding medication. Sometimes its depression.
It is a major thing to diagnose someone with dementia. So although its not possible for an average doctor to evaluate with as much detail as the memory clinic does, its important to document consideration of the five essential features as listed above.
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The Dangers Of Hip Fractures In Dementia
Hip fractures are unfortunately common in older adults, and dementia increases this risk. Osteoporosis often develops as people age and so bones are less likely to remain intact in a fall. Falls are the cause of 95% of hip fractures, and 75% of those hip fractures occur in women.
Dementia At A Very Old Age
Salvatore 172 said:Hello guys, I just joined here.. I’m not sure if this is the right subforum for such a thread but I have a question as its really been messing with my head.Last week Wednesday my grandad was diagnosed with dimentia, as its early on and he’s in my home country and still in a and e the type of dementia is unknown to me, and probably will be for a few weeks . My question however is, as he is 86, going on 87 will the decline be a lot quicker? I would really like a straight answer with no ‘buttercoat’. I know that dementia affects everyone differently, but because of his age I have a feeling his decline will be very quick. I would also like to point out he is very healthy.. Thanks for reading
Age is just a number!!
Alzeimers diagnosis at 85yrs old.
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Do You Die From Dementia
The forgetfulness, confusion and communication problems of dementia are caused by increasing damage to cells in the brain. But the brain doesn’t just control memory and thought it is also the control centre for the body. Progressive brain cell death will eventually cause the digestive system, lungs, and heart to fail, meaning that dementia is a terminal condition. Studies suggest that, on average, someone will live around ten years following a dementia diagnosis. However, this can vary significantly between individuals, some people living for more than twenty years, so it’s important to try not to focus on the figures and to make the very most of the time left.
What Happens In The Later Stages Of Dementia
- Progressive loss of memoryThis can be a particularly disturbing time for family and carers as the person with dementia may fail to recognise close family members.
- Increased loss of physical abilitiesMost people with dementia gradually lose their ability to walk, wash, dress and feed themselves. Other illnesses such as stroke or arthritis may also affect them. Eventually the person will be confined to a bed or a chair.
- Increased difficulty communicatingA person with dementia will have increasing difficulty in understanding what is said or what is going on around them. They may gradually lose their speech, or repeat a few words or cry out from time to time. But continuing to communicate with them is very important. Remember, although many abilities are lost as dementia progresses, some – such as the sense of touch and ability to respond to emotions – remain.
- Problems eatingIt is common for people in the later stages of dementia to lose a considerable amount of weight. People may forget how to eat or drink, or may not recognise the food they are given. Some people become unable to swallow properly. Providing nutrition supplements may need to be considered. If a person has swallowing difficulties, or is not consuming food or drink over a significant period of time and their health is affected, nutrition supplements may be considered for consumption other than by mouth.
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Each Persons Journey Is Different
Each person has a unique health history. This health history is directly related to how AD will affect them. Its helpful, however, to know the statistics about average life expectancy, as well as how lifestyle and age can alter that length of time.
If you are a caretaker or were recently diagnosed with AD, you can find empowerment and courage in knowing how the condition tends to progress. This allows you to plan with your family and caretakers.
Offer Touch And Human Contact
Sit with the person, hold their hand and talk to them as if they can still hear you. Hearing can be the last sense that a person loses at death. This shows that you care and shows respect. If family are at their loved ones bedside, stay with the person when the relative has a break, and again hold the persons hand.
The care team would need to plan how you can provide this kind of one-to-one support.
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