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 .;
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At this stage, individuals may start to become socially withdrawn and show changes in personality and mood.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.
Caregiving In The Late Stages
According to the Alzheimers Association, the later stages will be the most difficult, as your loved one is now very frail and relies on you for most of their daily care. At this late stage, encouraging your loved one to eat and sleep will grow increasingly difficult. During this time, they may lose the ability to walk steadily, so an occupational therapist may help them stay mobile without falling. Gather a team of experts to help you, like a speech therapist to help with communication and a nutritionist to recommend the best food and alternative food options, like blended meals, smoothies, and finger foods, that boost the immunity and are packed with nutrition. Incontinence, severe memory loss and disorientation, immune system problems, repetitive movements, and strange or unusual behavior must all be managed during this stage as well.
Watching a loved one live with dementia is never easy. With the proper tools, you can help them navigate their symptoms to live an enriching life. Staying on top of the latest research with Google alerts and attending seminars from expert speakers and medical professionals will keep you up-to-date on new treatments and care techniques. Most importantly, find a supportive community. There are many support groups for caregivers where you can share your successes, frustrations, fears, and joys with other caregivers. Remember, you are not alone!
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How Quickly Does Dementia Progress
The progression of dementia in your loved one is as individual as the person who has it. There is no specific roadmap or timeline to transition through the seven stages. But all types of dementia are progressive and damaging over time. Several factors can affect the rate of progression; these include:
Stages Of Alzheimers Disease
Alzheimers disease progresses slowly and can be categorized into three stages namely mild, moderate and severe. The mild stage is also referred to as the early stage, the middle stage is also referred to as the middle stage, and finally, the severe stage is also called the late stage.;
Alzheimers disease-associated changes in the brain startway before they exhibit any symptoms. This pre-diagnostic period can last up toyears. Another term used to label this condition is preclinical Alzheimersdisease. The stages of Alzheimers disease allow us to deduce how our abilitieschange with the progressive deterioration in brain health.
Following are the three main stages of Alzheimers disease.
- Mild Alzheimers disease
In this stage, a person can function independently and carryout routine activities with no difficulty. However, in this mild stage, it iscommon to encounter people experiencing memory lapses; the kind that compelsyou to forget familiar things. These signs are often picked up upon by friendsand family. Impaired concentration and hazy memory are a common finding in thisstage.
Additionally, one might also feel any of the following:
- Problems with finding the right word or name
- Trouble remembering names when introduced to newpeople
- Challenges performing tasks in social or worksettings.
- Forgetting something that one has just read
- Misplacing objects
- Increased trouble with planning or organizing
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How Dementia Causes Death
A person in the late stage of dementia is at risk for many medical complications, like a;urinary tract infection and pneumonia . They’re at an even higher risk of certain conditions because they’re unable to move.
Trouble swallowing, eating, and drinking leads to weight loss, dehydration, and malnutrition. This further increases their risk of infection.
In the end, most people with late-stage dementia die of a medical complication related to their underlying dementia.
For example, a person may die from an infection like aspiration pneumonia. This type of pneumonia usually happens because of swallowing problems.
A person may also die from a blood clot in the lung because they are bedbound and not mobile.
It’s important to know that late-stage dementia is a terminal illness.;This means that dementia itself can lead to death. Sometimes this is appropriately listed as the cause of death on a death certificate.
How Long Will A Person With Dementia Live For
Whatever type of dementia a person has, their life expectancy is on average lower. This is why dementia is called a life-limiting condition. This can be very upsetting to think about.
However, its important to remember that, no matter how a persons dementia changes over time, there are ways to live well with the condition.
Good support can make a huge difference to the persons quality of life at all stages of dementia.
How long a person lives with dementia varies greatly from person to person. It depends on many factors, such as the ones listed on The progression and stages of dementia page.
Other factors include:
- how far dementia had progressed when the person was diagnosed
- what other serious health conditions the person with dementia has such as diabetes, cancer, or heart problems ;
- how old the person was when their symptoms started older people are more likely than younger people to have other health conditions that may lower their life expectancy. A person in their 90s who is diagnosed with dementia is more likely to die from other health problems before they reach the later stages;than is a person diagnosed in their 70s.
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Stage : Age Associated Memory Impairment
This stage features occasional lapses of memory most frequently seen in:
- Forgetting where one has placed an object
- Forgetting names that were once very familiar
Oftentimes, this mild decline in memory is merely normal age-related cognitive decline, but it can also be one of the earliest signs of degenerative dementia. At this stage, signs are still virtually undetectable through clinical testing. Concern for early onset of dementia should arise with respect to other symptoms.
Small Vessel Disease And Vascular Cognitive Impairment
Vascular dementia can also be caused by small vessel disease. This is when the small blood vessels deep within your brain become narrow and clogged up. The damage stops blood from getting to parts of your brain. The damage can build up over time and may cause signs of vascular cognitive impairment. This can eventually lead to vascular dementia.
Many of the things that increase your risk of small vessel disease, such as high blood pressure and diabetes, also increase your risk of stroke.;
You can read more about how to reduce your risk of stroke and small vessel disease.
Knowing The Stages Of Dementia Helps You Plan
Even if the stages arent exact and symptoms can still be unpredictable, being able to plan ahead is essential.
The truth is that Alzheimers and dementia care is expensive and time-consuming. Being financially prepared for increasing care needs is a necessity.
On an emotional level, having an idea of what symptoms to expect helps you find ways to cope with challenging behaviors.;
It also gives you a chance to mentally prepare yourself for the inevitable changes in your older adult.
Caregiving In The Early Stages
Although most of your loved ones immediate medical needs can be managed on their own in the early stages, you may need to assist with tasks associated with memory or problem-solving. You may need to remind them of their doctors appointments and to set up the next appointment, along with taking their medications on time and getting refills as needed. You may need to assist them in managing their finances and keeping up with social and work obligations. At times, they may also need help remembering places, people, words, and names. In the early stages, you will want to encourage them to:
- Maintain their independence
- Establish a routine to delay the disease from worsening
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Caring For Someone With Vascular Dementia
There is no cure for . Controlling the underlying cause of the disease may help slow the decline in mental and physical abilities. Drugs for the treatment of Alzheimers disease may also work to treat symptoms and slow the progression of vascular dementia. But eventually, people with vascular dementia will lose their independence because symptoms will interfere with their ability to care for themselves.
At first, family members will likely be able to offer the necessary care for someone with vascular dementia. Simple reminders, structured routines, and simplified tasks can help them with daily functions. Providing cues and context can be helpful for recall. But caregivers often find behavioral and personality changes difficult to deal with because they can be distressing.
If youre caring for a loved one with vascular dementia, support is vital. There are several types of resources available to assist caregivers. Respite care and adult daycare programs are examples. Support groups can also help caregivers work through their feelings and find comfort from those in similar situations.
Life Expectancy And Vascular Dementia
Repeated small strokes can damage the brain and cause vascular dementia. Its the second most common cause of the disease. The pattern of disease progression is different from the gradual deterioration of Alzheimers disease. The symptoms may be steady for a while, then suddenly get worse followed by a further period of stability. This reflects times when blood clots interrupt the blood supply to the brain, causing damage.
Because people with vascular dementia is linked to strokes, people affected often have other illnesses and may have worse general health. Research suggests that the average life expectancy is around four years. However, sudden or severe deterioration can happen when there is a further stroke.
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Causes Of Vascular Dementia
Vascular dementia is caused by reduced blood flow to the brain, which damages and eventually kills brain cells.;
This can;happen as a result of:
- narrowing and blockage of;the small blood vessels inside the brain
- a single;stroke, where the blood supply to part of the brain is suddenly cut off
- lots of “mini strokes” that cause tiny but widespread damage to the brain
Tackling these might reduce your risk of vascular dementia in later life, although;it’s not yet clear exactly how much your risk of dementia can be reduced.
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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:
Who Is At Risk For Vascular Dementia
Some risk factors for vascular dementia can be managed; others, like age and gender, cannot. Among all factors, high blood pressure carries the greatest risk; vascular dementia almost never occurs without it.
Likewise, a high risk of stroke goes hand in hand with risk for vascular dementia. One-quarter to one-third of strokes are thought to result in some degree of dementia. People who smoke, consume excessive amounts of alcohol, have diabetes, or heart disease also have a higher rate of the condition.
Vascular dementia most commonly occurs in people between the ages of 60 and 75. Men seem to be more vulnerable than women, and the condition affects African-Americans more often than other races. People whose age, sex, or race puts them at increased risk of vascular dementia have that much more reason to manage risk factors within their control.
Dementia And Early Death
Across the globe, dementia rates are expected to double every 20 years for the foreseeable future, with an estimated 81 million cases by 2040.
It is clear from earlier studies that people with dementia have decreased survival compared with people without dementia. Even mild mental impairment linked to dementia is associated with an increase in death risk.
But the characteristics associated with mortality among patients with dementia have not been well understood.
There is general agreement that women with dementia tend to live slightly longer than men, but the impact of other characteristics, including education level, age at diagnosis, and marital status are less well known.
And many previous studies have been restricted to patients being treated for the disorder by a specialist or in a hospital setting, Brayne says.
“We wanted to see what is happening with the entire population, not just people who are treated for dementia,” she says.
Slightly over two-thirds of the people in the study who developed dementia were women, and the median age at dementia onset was 84 for women and 83 for men.
The median age at death was 90 for women and 87 for men. And average survival times varied from a high of 10.7 years for the youngest patients to a low of 3.8 years for the oldest .
As in other studies, dementia was associated with shorter survival, but the cognitive level among people with dementia did not appear to play a major role in death.
Facts About The Future
Studies into the main types of dementia have revealed the following about life expectancy
General life expectancy for someone with Alzheimers is around 8-12 years from diagnosis although this does depend on age and health. If you were relatively fit and healthy on the diagnosis you could live considerably longer than this. People who are diagnosed around the age of 65 tend to decline more slowly than those who are aged 80 or over. But with the right care and treatment, a fit and healthy 80 year old could still live into their nineties.
Did you know? A US study of 1,300 men and women with Alzheimers showed life expectancy to range from one year to 26 years from when their symptoms first appeared
Since vascular dementia is often linked to strokes people who are living with it can be in poorer general health than those with other types of dementia. Studies have shown their average life expectancy to be around four years after diagnosis, though their eventual decline is often linked to further strokes.
Dementia with Lewy bodies
After diagnosis, the average lifespan of someone with dementia with Lewy bodies was found in one study to be around 5-7 years after onset. However people have been known to live between two and 20 years with it, depending on their age, and other medical conditions they may have, such as Parkinsons disease which can be related to dementia with Lewy bodies.