Support And Family Preferences
Memory care is not the only option for those with memory impairments. Many families choose to have a dedicated caregiver come to a private home. Caregivers can be relatives or professionals, but the length of time they support an individual can greatly affect that persons time in memory care. Some caregivers work in a private home for years before the individual transitions to a memory care community, reducing the time the person spends in the community. Other caregivers are a temporary support resource to help with the move.
Individuals with memory impairments and their families choose how long they stay in a private residence, with or without support, and when they want to move to a memory care community.
Hospice Care For Advanced Dementia: When Is It Time
Hospice has long been known for the ability to provide comfort and dignity throughout the dying process. Sadly, too few people are aware that a person does not have to be dying from cancer or experiencing excruciating pain in order to take advantage of end-of-life care. Hospice care is effective for patients suffering from a wide variety of chronic conditions, including heart failure, chronic obstructive pulmonary disease , amyotrophic lateral sclerosis , stroke, renal failure, liver failure and even dementia.
Unlike other serious illnesses, Alzheimers disease and related dementias are extremely difficult to categorize into the neat stages of progression that are typically used to determine whether hospice care is appropriate. Life expectancy is difficult, if not impossible, to pinpoint for patients affected by AD or other forms of cognitive impairment, such as vascular dementia, Lewy Body dementia and frontotemporal dementia. Furthermore, patients in the later stages of these conditions are usually unable to communicate pain, discomfort, wants and needs. This means that family caregivers and even their loved ones physicians can have a tough time deciding when to call in hospice.
Maintain A Support System And Practice Self
Nurses providing dementia and Alzheimer’s care often work for the same patients over long periods of time, becoming personally attached to them and their families. As their patients progress through the disease, nurses may experience a range of emotions—anxiety, sadness, guilt, anger, and depression.
Nurses need to manage their self-care by recognizing and managing these feelings. If left untreated, stress can lead to physical problems such as headaches and high blood pressure, or emotional and behavioral changes such as irritability and inability to sleep. If these kinds of symptoms emerge, nurses should consult with their doctor or a mental health specialist. Nurses can be proactive in managing their stress by routinely engaging in relaxation techniques and arranging with the patient’s family to provide temporary respite care when time off is needed.
Many caretakers manage their stress by connecting with other caretakers and joining professional organizations. The Alzheimer’s Association offers networking opportunities and caregiving resources. ALZConnected, an online community that provides access to resources, programs, and community services, also provides support and encouragement to caregivers.
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Forgetting to take prescription medication, or taking too much of it, can lead to serious side effects. Reminders, alerts, and pill separators may be effective for seniors with early-stage dementia, but those with significant cognitive decline need more intervention. Medication management is an important feature of memory care.
8. Is your loved one getting proper nutrition?
Seniors with dementia may require special diet plans to combat existing health conditions. Adults aging in place may forget to eat, or they may overeat after forgetting theyve recently had a meal, leading to significant weight changes.
9. Have you started to feel caregiver burnout?
Balancing your loved ones needs with your own is vital. Its normal for dementia caregivers to feel frustrated or overwhelmed sometimes. But if left untreated, those feelings can lead to caregiver burnout and negative consequences for the caregiver and their loved one. Teepa Snow, a noted dementia care specialist, recommends asking yourself the next four questions to determine if burnout is a problem.
10. What are two things that are going OK, and one thing you wish were different?
If your immediate answer is that nothing is going well, or you have to really think about it, its time to seek help when caring for someone with dementia.
11. What are some things you still like about your loved one?
13. Are you and your family safe?
The Role Of Nurses In Providing Care To Patients With Dementia Or Alzheimers
The population pool of older people has steadily increased across the world. The elderly not only have longer life expectancy than ever before, but many live with chronic conditions that require healthcare services provided by geriatric specialists. Consequently, the demand for Alzheimer’s and dementia nursing care continues to grow. Nurses with gerontological specialties and training in these conditions play a crucial role in helping these patients maintain their quality of life and remain independent as long as possible.
Because there is currently no cure for dementia, patients rely on the care management provided by nurses in both clinical and home-based settings. Nurses provide direct care to patients, helping to relieve the burden placed on family members and other caregivers. An important component of Alzheimer’s and dementia nursing care involves education and communication about treatments, progression of symptoms, interventions, and coordination of services with other specialists.
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Offers Caregivers Great Peace Of Mind
It can be very stressful to leave a person who has late-stage dementia alone at home.
You might even stay with them all day and night and still not offer the proper care they require.
Relatives and friends get to enjoy great peace of mind when their loved one is in a good nursing home. It also creates opportunities for spending quality time together when they visit the ill person in the home.
When the person with dementia is at a premium nursing home, it also implies that relatives and friends can go back to their normal routines seeing that the ill person is in the right environment.
Relief from some of the caregiving responsibilities is always welcome from the caregivers.
The 7 Stages Of Dementia
Alzheimers disease and other common forms of dementia including vascular dementia, dementia with Lewy bodies, and frontotemporal dementia are progressive conditions, with symptoms worsening over time as the disease progresses. Learn more about the stages of dementia and what to expect from your loved one as dementia progresses.
Although the two terms are often used interchangeably, Alzheimers disease and dementia are two different terms. Dementia is an umbrella term used to describe several conditions and it includes Alzheimers, as well as other conditions with shared symptoms. More than mere forgetfulness, an individual must have trouble with at least two of the following cognitive areas to be diagnosed with dementia:
- Memory
- Reasoning and judgment
- Visual perception
The assessment tools used to determine which stage of dementia a person is experiencing are meant to be a guide and a rough outline of what caregivers can expect and when they can expect it. Some symptoms may occur later than others, others may appear in a different order than the scale predicts, and some may not appear at all. Some symptoms may appear and then vanish, while others will continue to worsen over time. Because every person is different and dementia manifests itself uniquely, the speed at which dementia progresses varies widely. On average, a person with Alzheimers disease lives 4 to 8 years after a diagnosis, but some have been seen to live as long as 20 years.
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Can Dementia Get Worse Suddenly
According to the National Institutes of Health, dementia, Alzheimers, and other memory loss diseases are progressive conditions that worsen significantly over time. However, the speed at which the condition progresses is based on unique circumstances between people.
The memory loss in some dementia patients in good health without any underlying diseases tends to deteriorate slower. However, the condition could lead to significant brain damage, causing the disease to suddenly and rapidly decline.
Dementia deterioration is usually a gradual, slow process that takes months or years to advance to its next stage. The condition will progress quickly in rare cases, making significant deteriorating changes in just weeks or months.
Life Expectancy And Dementia With Lewy Bodies
Dementia with Lewy bodies accounts for around 7% of cases of dementia. Lewy bodies are tiny protein deposits that affect thought, memory and movement and are linked to both dementia and Parkinsons disease.
Hallucinations, sleep disturbance, and movement problems can be an early feature in dementia with Lewy bodies, so that diagnosis may be made at an earlier stage. Some research suggests that survival can be significantly shorter with this challenging condition, however, the Alzheimer’s Society says:
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What Are The Signs And Symptoms Of End
In its most advanced age, the individual with Alzheimers is likely unable to move about without assistance or unable to speak to be understood. According to the National Institute on Aging, the most advanced stage of dementia requires assistance with all activities of daily living, including self-care, grooming, and eating.
In some cases, the individual can no longer eat due to difficulty swallowing or cannot recognize anyone, including family members and caregivers. These dementia patients may need special care, medication management, medical care, bathing, dressing assistance, and other care options that retirement communities can provide.
Signs Its Time For Memory Care
While many seniors with early stage dementia can live independently or with the help of family caregivers, those with greater cognitive decline may need help from specially trained dementia care professionals in memory care communities. But because dementia symptoms can vary day to day or moment to moment, its not easy to pinpoint when its time for memory care. When talking about memory care, or some form of a different living arrangement, Ill center the talk around ability to perform activities of daily living and safety, says Dr. Philip Branshaw, an internal medicine specialist in Batavia, Illinois.
Learn signs of Alzheimers or another type of dementia doctors look for, and some simple tools they use to measure cognitive decline. Then, answer 13 questions about your loved one and their caregiving situation to see if its time for a memory care facility.
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Challenges Of Caring For Seniors With Dementia In Long
Within long-term care homes, 69% of residents had dementia in 20152016. The proportion of those having any form of cognitive impairment was 87%.
The population in long-term care has changed rapidly over the past 5 years to be the population with moderate to severe dementia. What we know now is that if you are in long-term care, you have cognitive impairment, said Cooper.
It can be quite challenging to provide care for residents with dementia in long-term care homes. In addition to severe cognitive impairment , 50% had responsive behaviours, 31% had signs of depression and 82% required extensive assistance or were dependent for activities of daily living.
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.
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Figure 1 Dementia Prevalence Rates Vary Widely Across Different Groups
Prevalence of Probable Dementia Among the U.S. Population Ages 70 and Older, 2015
Note: Excludes persons in nursing homes. Vicki A. Freedman et al., Short-Term Changes in the Prevalence of Probable Dementia: An Analysis of the 20112015 National Health and Aging Trends Study,Journals of Gerontology, Series B 73 : S48-S56.
Dementia prevalence increases with age. About 5% of adults ages 70 to 79 had probable dementia in 2015, compared with 16% of adults ages 80 to 89 and 31% of adults ages 90 and older. As the U.S. population grows older, the number of people with dementia is projected to increase sharply.10
Women are slightly more likely to have dementia than men. Among adults ages 70 and older, 10.1% of women and 9.6% of men had probable dementia.
Non-Hispanic whites have lower rates of dementia than other racial/ethnic groups. The rates of probable dementia among Hispanic and other racial/ethnic minorities ages 70 and older was double the rate among non-Hispanic white older adults . Recent declines in dementia prevalence have been concentrated among non-Hispanic white and non-Hispanic black groups, whereas dementia prevalence has been persistently higher among the Hispanic/Latino population.11
What Affects Life Expectancy In Dementia
The life expectancy of someone living with dementia depends on many factors. The type of dementia, the severity of dementia at the time of diagnosis, and the individual’s age, sex, and their general health and wellbeing can all impact on the time they can live with the disease. The key things that affect life expectancy include:
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Type Of Memory Impairment
Dementia is typically the most common type of memory impairment in memory care communities, but dementia has multiple types, including Alzheimers disease, vascular dementia and Creutzfeldt-Jakob disease , among others.
Each type of dementia has its own progression rate. For example, CJD usually progresses rapidly. Many individuals with CJD have less than a year between diagnosis and death, reducing the time they stay in memory care communities. A person with Alzheimers, on the other hand, could remain in memory care for years. Its not uncommon for someone with Alzheimers to live a full life in a supportive community for five or 10 years, or even more.
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.
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How Far Has The Disease Progressed
Alzheimers disease has three stages – patients at each stage require different levels of care. A person diagnosed with Alzheimers usually lives another four to eight years after diagnosis but could live as long as 20. Early stage Alzheimers patients can live relatively normal lives, although they may notice memory lapses, have difficulty organizing themselves and may struggle in particular work or social settings. Patients at this stage can usually manage to stay in their own homes, and may still have the legal capacity to make decisions about their future care preferences.
The next stage, moderate Alzheimers, can last for several years. Patients during this stage will have obvious symptoms, such as confusion, severe memory lapses, getting lost, and behavioral or personality changes, like delusions, suspicion, moodiness, changes in sleep patterns, and in some cases loss of bladder or bowel control.
Late stage Alzheimers sufferers become unable to function and eventually lose control of movement. They need 24-hour care and supervision. They are unable to communicate, even to share that they are in pain, and are more vulnerable to infections, especially pneumonia.
Can Dementia Patients Live In An Assisted Living Facility
According to reports by long-term care ombudsmen in America, assisted living facility evictions are in the top ten of all grievances they receive each year. In many cases, family members have little to do about an eviction taking a mother, father, or grandparent out of an assisted living center.
Most states regulate and govern how assisted living centers handle their evictions with flexible laws that tend the side with residential care businesses and memory care facilities over the resident. However, there are remedies for patients with Alzheimers disease who have suffered at the facility staff or caregivers hands.
Have you suffered injuries through medical negligence or been asked to leave an assisted living community because of your health? The personal injury attorneys at Rosenfeld Injury Lawyers, LLC, can help. Call at 424-5757.
Some Assisted Living Facilities May Not Be Suitable for Dementia Patients
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