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.
Changes In Mood Emotions And Perceptions
Changes in mood remain in the later stages of dementia. Depression and apathy are particularly common.
Delusions and hallucinations are most common in the late stage of dementia. They are not always distressing but they can explain some changes in behaviour because the persons perception of reality is altered.
People with later stage dementia often respond more to senses than words. They may like listening to songs or enjoy textures. For example, they may like the feel of different types of material.
The Superpower Of Gist
Want to never have another ‘senior moment’?
In his non-fiction theater show, Lifes Most Dangerous Game, part of the ChangingAging Tour, Dr. Bill Thomas promises just that.
The audience participates in a game show-style rendition of the work of Daniel Kahneman. They follow a set of instructions to come up with the next number in a sequence. Research shows that younger people are able to do this faster than older people.
Dr. Thomas offers one explanation is that, the very beginning of wisdom is knowing a silly game when you see one and choosing not to play. Thomas reveals that Kahneman and his colleagues went farther. They showed that older people were better than younger people at understanding gist.
Recognise And Meet Spiritual And Cultural Needs
Care providers also need to be attentive to meeting a persons spiritual or cultural needs at the end of life. For one person, this may involve making sure they have contact with a religious leader in the last days or hours of their life, while another may want their favourite composers music to be played quietly but continuously throughout the period. This information should be recorded clearly, and should not come as a surprise to care staff who will know the person their life history, preferences and nature well. You should also discuss these aspects with the persons family or friends.
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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Life Expectancy And Treatment
About 10 15% of dementia cases are thought to be frontal lobe dementia, the disease affecting 1 in 5000 of the population. However in those under 65 it is believed to be 20 50% of cases. Onset of frontal lobe dementia is normally identified when the patient is between 45 and 65 years of age, although it has been seen in people aged 20 to 30 years of age. Only 10% of cases are identified in those 70 years and over.
The disease takes from three to ten years to progress, although there are instances of much shorter or longer times. The average life expectancy of a person diagnosed with frontal lobe dementia is eight years. Approximately 50% of deaths are as a result of pneumonia, following complications associated with inability of the person to move or care for themselves.
As with other forms of dementia there is no current cure for the disease, but there are a range of treatments that can help to manage and deal with the symptoms, and to help people to regain some of their lost functions.
These include drugs such as SSRI antidepressants to help control the symptoms like obsession, over-eating and depression. Antipsychotics may be given to address challenging and inappropriate behaviours. Psychological treatments such as cognitive stimulation and behavioural therapy can help maintain memory function address anxiety. Rehabilitative practices such as, occupational therapy, physiotherapy and speech therapy can help the brain to learn new ways to do things.
Stage : Very Severe Mental Decline/severe Dementia Quality Of Life: Very Severe Impact
Your loved one will not remember any of the past or recognize loved ones. He or she will have likely lost the ability to make healthcare decisions. You will need 24-hour care in the home for day-to-day activities. You may see your loved one:
- Lose the ability to speak, eat or swallow.
- Not be able to use the toilet or get dressed without help.
- Not be able to walk or sit without help.
- Loss of language skills throughout this stage
- Lose all bladder and bowel control.
- Loss of muscle control
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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.
How To Be Understood Without Words
This works in the reverse as well. When you want to be understood by someone living with dementia, be aware of your body language, contextual clues, tone, how you feel etc.
For example, if you want to talk about eating, do so in the kitchen or dining room to provide contextual clues. Use your body to express what you are talking about by motioning like you are eating. Finally, make sure your inner thoughts and feelings match what you are trying to say.
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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.
Provide Physical Comfort And Care
Assess the person to ensure they are not in discomfort or restless, and offer the kind of care described in the above section . Reduce any interventions to only what is necessary, for example change the persons position every few hours or when they need changing.
Give regular mouth care. This can be done hourly to prevent the persons mouth from becoming dry. Apply Vaseline to keep lips moist.
Give eye care, for example use a soft piece of wet clean gauze to prevent the persons eyes from looking sticky.
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Communicating In The Last Stage Of Dementia
The World Health Organization describes the last part of the dementia disease progress saying, the late stage of dementia is one of near-total dependence and inactivity. Memory disturbances are serious and the physical signs and symptoms become more obvious.
Communication sees drastic changes near the end of the dementia journey. We learn that words are not necessary for communication and have to develop other ways of connecting. Communication is possible through the entire journey with dementia.
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.
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How Can I Support Someone With Dementia Towards The End Of Life
Knowing the person will make it easier to provide person-centred care that is focused on what they need and want. It can help to know about their likes, dislikes and their wishes for how they want to be cared for. If the person isnt able to tell you about themselves, speak to their family, friends or other people who know them well.
Its a good idea to find out if the person has a copy of This is me , a document that records information about themselves. If you cant speak to the person, ask those close to them if they have a copy. They may have these details recorded in their care plan.
There are many ways to support someone with dementia at the end of life.
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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What Causes Alzheimer’s Disease To Progress So Quickly
The progression of Alzheimers disease varies widely between individuals, with most people living with the condition for between 3 and 11 years after the initial diagnosis. In some cases, people may survive for more than 20 years. When Alzheimers is detected early, there are possible treatments that can help to slow the progression of the disease and contribute to a longer life expectancy.
It is therefore crucial to plan for the future and follow the progression of the disease through each stage. Alzheimers disease first begins with physical changes in the brain. This can happen at a gradual pace before any noticeable symptoms appear. In fact, this pre-clinical Alzheimers disease stage can begin 10 to 15 years before any symptoms appear.
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.
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Care In The Later Stages Of Dementia
There are medicines used in the early stages of dementia that manage some of the behavioural symptoms. In the later stages some of these medicines can do more harm than good causing severe side effects that can increase confusion and frailty. It also becomes harder to diagnose and manage some of the normal illnesses that older people get such as Urinary Tract Infections . UTIs can exaggerate some symptoms of dementia and increase confusion sometimes know as delirium.
Pain is also something that can be present in the later stages of dementia, but can be harder to diagnose if the person isnt able to communicate it. For all of these reasons, its important to stay vigilant when looking after someone with dementia, and to talk to the GP if you are worried about anything.
There are dementia living aids and products that can help you to care for someone living with dementia. Something like a simple dementia clock or personal alarm can make the world of difference to your life and the live of the person you care for.
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.
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A Person With Dementia Doesnt Always Fit Into One Stage
Dementia affects each person in a unique way and changes different parts of the brain at different points in the disease progression.
Plus, different types of dementia tend to have different symptoms.
For example, someone with frontotemporal dementia may first show extreme behavior and personality changes. But someone with Alzheimers disease would first experience short-term memory loss and struggle with everyday tasks.
Researchers and doctors still dont know enough about how these diseases work to predict exactly what will happen.
Another common occurrence is for someone in the middle stages of dementia to suddenly have a clear moment, hour, or day and seem like theyre back to their pre-dementia abilities. They could be sharp for a little while and later, go back to having obvious cognitive impairment.
When this happens, some families may feel like their older adult is faking their symptoms or just isnt trying hard enough.
Its important to know that this isnt true, its truly the dementia thats causing their declining abilities as well as those strange moments of clarity theyre truly not doing it on purpose.