Whats The Life Expectancy For Someone With Dementia
Each person will have an individual experience of dementia. The speed and pattern of progression of the disease can differ-but the condition is progressive and will get worse over time. Sadly, dementia will limit the life expectancy of the person affected the condition has now overtaken heart disease as the leading cause of death in England and Wales.
Eating And Drinking At The End Of Life
People with dementia can develop problems with eating, drinking and their ability to swallow at any stage of their illness, although it is most common to see this at the more advanced stages. In this section you’ll be able to explore why this happens and how you can help.
When a person with advanced dementia takes in only a very limited amount of food and fluids or can no longer swallow safely, it can be an extremely difficult and emotional time for family and care staff as they try to work out how to best respond and care for the person with dementia. It is important to try and maintain eating and drinking, even in very small amounts, for comfort and enjoyment. Speech and language therapists can help and advise about swallowing changes at this time.
What happens when Pete can no longer swallow? Will he just starve to death? I dont want him suffering.
A woman speaking about her husband who has dementia.
How Dementia Complicates Hospice Eligibility
Estimating how long a person has to live is nearly impossible. It simply cannot be done with absolute accuracy in most cases, but a general idea is required in order to establish a persons eligibility for receiving hospice care. To qualify for most programs, an individual must have a terminal health condition and a life expectancy of six months or less. However, not all life-threatening diseases progress predictably. Any dementia caregiver can attest to the fact that a loved ones condition can improve or worsen on a daily basis. Fortunately, physicians and hospice staff who are knowledgeable about dementia, especially in the later stages, can help families determine when it is time to seek out comfort care.
Dementia can complicate the eligibility process for hospice but taking a persons personality prior to their diagnosis into consideration can help, explains Meredith Fields Lawler, LCSW, Director of Outreach Programs at the Crossroads Hospice Charitable Foundation based in Tulsa, Oklahoma.
Fields Lawler recalls a patient many years ago who had Lewy Body dementia and whose daughter was experiencing an immense amount of stress over the worsening of his symptoms. He would often lose track of time, and it had become hard to hold his attention. The daughter and I sat together and through tears she told me about what her dad was like while she was growing up.
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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
- Incontinence
- 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.
Final Signs And What To Do
If it has been established that the person is now dying and they become restless, this is often referred to as terminal restlessness. It is important to recognise restlessness and report it to a doctor or nurse immediately. Restlessness could be due to pain or high temperature and needs to be relieved.
If you notice the person is restless and you think they are uncomfortable, you could try helping them move into a more comfortable position. If this does not help, seek advice as they may need pain relief. Likewise, if you notice the person is hot to touch then they may need to be cooled down by a fan or cool flannel on their forehead and given rectal paracetamol by the nurse. They may also need medication to relieve the restlessness if the above does not help.
As death approaches the persons breathing pattern can change. This is caused by the person going into unconsciousness. It is often called Cheyne-Stoke breathing. The person may have periods where they have regular breathing, then stop breathing for a few seconds. Breathing usually gets faster and there can be long gaps in between. The person who is dying is unaware of this but family members may find this quite distressing. It is important that you or another senior member of staff explain to the relatives that this is what is to be expected and that the person is unaware. It is natural.
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Outlook For Vascular Dementia
Vascular dementia will usually get worse over time. This can happen in sudden steps, with periods in between where the symptoms do not change much, but it’s difficult to predict when this will happen.
Home-based help will usually be needed, and some people will eventually need care in a nursing home.
Although treatment can help, vascular dementia can significantly shorten life expectancy.
But this is highly variable, and many people live for several years with the condition, or die from some other cause.
If you or a loved one has been diagnosed with dementia, remember that you’re not alone. The NHS and social services, as well as voluntary organisations, can provide advice and support for you and your family.
What Are The Symptoms
Each person is unique and will experience dementia in their own way. The different types of dementia tend to affect people differently, especially in the early stages.
A person with dementia will often have cognitive symptoms . They will often have problems with some of the following:
- Day-to-day memory difficulty recalling events that happened recently.
- Repetition repeating the same question or conversation frequently in a short space of time.
- Concentrating, planning or organising difficulties making decisions, solving problems or carrying out a sequence of tasks .
- Language difficulties following a conversation or finding the right word for something.
- Visuospatial skills – problems judging distances and seeing objects in three dimensions.
- Orientation – losing track of the day or date, or becoming confused about where they are.
Some people have other symptoms including movement problems, hallucinations or behaviour changes.
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The Start Of The Dying Process
As someones condition worsens and they get to within a few days or hours of dying, further changes are common. The person will often:
- deteriorate more quickly than before
- lose consciousness
- develop an irregular breathing pattern
- have cold hands and feet.
These changes are part of the dying process. Healthcare professionals can explain these changes so you understand what is happening. The person is often unaware of what is happening, and they should not be in pain or distress.
Medication can be used to treat the persons symptoms. If the person cant swallow, there are other ways of providing this, such as medication patches on the skin, small injections or syringe drivers . Speak to a GP or another health professional about this.
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Towards The End Of Life
It can be very difficult for family and carers to prepare for the end, but by thinking about it and making some plans, it may be a little easier. When someone reaches the final stages of life one of the main concerns is to ensure that they are comfortable and as pain free as possible. If you are concerned that the person with dementia may be in some pain or discomfort, discuss this with the doctor and nursing staff.
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Difficulty Determining Time Or Place
Losing track of dates and misunderstanding the passage of time as it occurs are also two common symptoms. Planning for future events can become difficult since they arent immediately occurring.
As symptoms progress, people with AD can become increasingly forgetful about where they are, how they got there, or why theyre there.
How Does Dementia Reduce Life Expectancy
Dementia reduces life expectancy in two ways.
First, some of the diseases that are closely linked to Alzheimers disease and vascular dementia, such as diabetes and cardiovascular disease can mean a lower life expectancy. For example, vascular dementia is closely linked to heart disease and stroke. A person with vascular dementia is at risk of dying at any stage of dementia, from one of these.
The other way that dementia reduces life expectancy is through the effects of severe disease.
These all make them much more likely to develop other medical problems that can lead to death, such as infections or cardiovascular problems .
This is why the later stage of dementia is often the shortest.
A person with dementia can also die at any stage from another condition not closely related to their dementia. Cancer and lung disease are common examples.
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What Are The 7 Stages Of Dementia
Dementia does not affect every person in the same way. It presents itself differently in each individual and progresses at different rates. Some people will stay in a state of mild decline for an extended period, while others may develop multiple symptoms quickly. Understanding the seven stages of dementia can make these transitions a little easier for your loved one and you as their caregiver.
Physical Difficulties In The Later Stages Of Dementia
The physical changes of late-stage dementia are partly why the person is likely to need much more support with daily living. At this stage they may:
- walk more slowly, with a shuffle and less steadily eventually they may spend more time in a chair or in bed
- be at increased risk of falls
- need a lot of help with eating and so lose weight
- have difficulty swallowing
- be incontinent losing control of their bladder and bowels.
The persons reduced mobility, in particular, raises their chances of blood clots and infections. These can be very serious or even fatal so it is vital that the person is supported to be as mobile as they can.
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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.
Environment Modification & Medical Intervention
Changing the environment is another effective way to reduce or even abort an episode of delusion or hallucination. If a person imagines they see people in the window, you can open or close the curtains to modify the environment. Maintaining a well-lit space is another way to reduce fear by eliminating shadows. Some seniors may have trouble identifying themselves during an episode and will claim that a stranger is looking at them through the mirror. Covering the mirror or moving them away from it will help reduce the intensity of their episode. Many seniors who suffer from dementia will feel that people are stealing from them. In actuality, most often items have simply been lost, misplaced, or put away in a new location. Keeping duplicates of commonly lost items on hand can also help arrest an episode.
Most holistic and interactive interventions work well for seniors suffering from dementia, but there are times when medications may be the only option. A medical professional can evaluate the senior to ascertain if medication to reduce delusions and hallucinations is the best option. Seniors who suffer from separate mental illnesses like schizophrenia may be suffering from delusions and hallucinations due to that condition and not dementia.
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Getting Prepared For A Death
Care staff need to know the persons wishes for their death: where they would prefer to be when they die, who should be present, how pain might be treated, and so on. A persons spiritual and cultural needs are important throughout their life, but may take on a particular significance at the end of their life. We can only support a person nearing death properly if we know this information and have recorded it accurately so they have the best possible, and personalised, end-of-life care
Ensuring that a person is as physically comfortable as possible when they are dying also takes preparation. Is a hospital-style bed available, for example, if it is needed? Is a suitable mattress to hand? How can dignity best be maintained if all personal care is provided at a persons bedside? Does the persons room need to be altered in any way, for example fitting new lighting?
Relatives also need to be prepared. For family, having a good relationship with care staff may be a critical part of the lead-in to this dying phase. You also need to know family members wishes at this time. For example, do they want to be present for the death if possible?
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.
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Treatments For Vascular Dementia
There’s currently no cure for vascular dementia and there’s no way to reverse any loss of brain cells that happened before the condition was diagnosed.
But treatment can sometimes help slow down vascular dementia.
Treatment aims to tackle the underlying cause, which may reduce the speed at which brain cells are lost.
This will often involve:
- taking medicines, such as those used to treat high blood pressure, lower cholesterol or prevent blood clots
Other treatments, including physiotherapy, occupational therapy, dementia activities and psychological therapies, can help reduce the impact of any existing problems.
How Many Stages Of Dementia Are There
There are several different types of Dementia, with Alzheimers disease being the most common. Though when it comes to the different stages of Dementia, we can typically categorise the trajectory of the disease as mild, moderate or severe.
Although this three stage model is useful for providing an overview of early, middle and final stages of Dementia, most people prefer a seven stage model that breaks cognitive decline down into seven specific categories. The progression of Dementia will be different for everyone, but knowing where a loved one falls on this scale can help to identify signs and symptoms, whilst also determining the most appropriate care plan. So, what are the 7 stages of Dementia?
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Stage : Very Mild Cognitive Decline
Stage 2 can vary between typical age-related memory problems that most seniors face, such as forgetting specific dates or slower recall of a name or word. Or this stage could include some of the beginning signs of dementia that are often not obvious to doctors and loved ones. Some of the side effects that correspond with stage 2 include:
- Forgetting everyday phrases or names
- Forgetting the location of important objects
Aggressive Behaviour In Dementia
In the later stages of dementia, some people with dementia will develop what’s known as behavioural and psychological symptoms of dementia .
The symptoms of BPSD can include:
- increased agitation
- aggression
- delusions
- hallucinations
These types of behaviours are very distressing for the carer and for the person with dementia.
It’s very important to ask your doctor to rule out or treat any underlying causes, such as:
- uncontrolled pain
- infection, such as a urinary tract infection
- side effects of medicines
If the person you’re caring for behaves in an aggressive way, try to stay calm and avoid confrontation. You may have to leave the room for a while.
If none of the coping strategies works, an antipsychotic medicine can be prescribed as a short-term treatment. This should be prescribed by a consultant psychiatrist.
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