Stage : Moderate Decline
During this period, the problems in thinking and reasoning that you noticed in stage 3 get more obvious, and new issues appear. Your friend or family member might:
- Forget details about themselves
- Have trouble putting the right date and amount on a check
- Forget what month or season it is
- Have trouble cooking meals or even ordering from a menu
- Struggle to use the telephone
- Not understand what is said to them
- Struggle to do tasks with multiple steps like cleaning the house.
You can help with everyday chores and their safety. Make sure they aren’t driving anymore, and that no one tries to take advantage of them financially.
How To Improve A Loved One’s Quality Of Life After Diagnosis
While there is no cure for Alzheimer’s disease, there are activities and therapies designed to improve your loved ones quality of life. For example, the extent to which your loved one with Alzheimer’s disease can maintain their social relationships may play a large role.
At home, it’s important to try to maintain as much normalcy as possible. In particular, it can be helpful for your loved one to maintain their household responsibilities. In the later stages of the disease, your loved one’s needs are likely to change, and it’s critical for you as a caregiver to know how to care for yourself as well as your loved one.
How Might Dementia Affect People Towards The End Of Life
Dementia is progressive, which means it gets worse over time. In the last year of life, its likely to have a big impact on the persons abilities including memory, communication and everyday activities. The speed at which someone will get worse will depend on the type of dementia they have and who they are as an individual.;
The symptoms of later stage dementia include the following:
A person with later stage dementia often deteriorates slowly over many months. They gradually become more frail, and will need more help with everyday activities such as eating, dressing, washing and using the toilet. People may experience weight loss, as swallowing and chewing become more difficult.;
A person with later-stage dementia may also have symptoms that suggest they are close to death, but continue to live with these symptoms for many months. This can make it difficult for the person and their family to plan for the end of life. It also makes it difficult for those supporting them professionally.;
For more information on supporting someone with later stage dementia see Alzheimers Society factsheet, The later stages of dementia ;.
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Stage : Severe Decline
People with the sixth stage of Alzheimers need constant supervision and frequently require professional care. Symptoms include:
- Confusion or unawareness of environment and surroundings
- Inability to recognize faces except for the closest friends and relatives
- Inability to remember most details of personal history
- Loss of bladder and bowel control
- Major personality changes and potential behavior problems
- The need for assistance with activities of daily living such as toileting and bathing
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.
Tips For Managing Dementia End
Because individuals with advanced dementia will often have difficulty communicating, it is important that caregivers keep a close eye on their loved one for signs of pain or discomfort. These signs may include moaning or yelling, restlessness or an inability to sleep, grimacing, or sweating. This may also signal that its time to call hospice or a palliative care team to help with the pain management.
If an individual with end-stage dementia is having trouble sitting up without assistance, hospice can provide a hospital bed or other equipment to lift their head.
Perhaps the hardest thing for families is when a loved one with dementia is no longer able to eat or swallow. Because an individual with dementia is unable to understand the benefits of feeding tubes or IV drips, they will often be incredibly distressed and attempt to remove them, causing added pain and risk of infection. Instead, focusing on keeping the individual comfortable. Supporting them with mouth care to prevent their mouth from becoming dry will allow them to make their final transition in peace.
Using The Gds To Measure Dementia Progression
As the disease progresses, different signs and symptoms will become increasingly obvious. While there are several scales to measure the progression of dementia, the most common scale is the Global Deterioration Scale for Assessment of Primary Degenerative Dementia . The scale is also known as the Reisberg Scale. According to the GDS, there are seven different stages of Alzheimers disease correlating with four distinct categories: no Alzheimers, mild Alzheimers , moderate Alzheimers , and severe Alzheimers .
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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.;
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.
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How To Connect With The Person
Communicating with a person with late-stage Alzheimers disease can take effort and patience. Though that persons ability to respond may be limited, it is important to continue to interact:
- Continue to visit with the person even if responses are limited.
- Try to speak calmly and slowly; be aware of the tone and volume of your voice.
- Consider sharing familiar stories with the person.
- Make eye contact, say the persons name and smile.
- Use other methods of communication besides speaking, such as gentle touching or massage.
- Have the person listen to music or calming nature sounds.
Learn more about how to communicate with a person who has Alzheimer’s disease.
Stage : Mild Dementia Due To Alzheimers Disease
The symptoms of Alzheimers disease during this stage are still mild; however, close friends and family may begin to notice signs and symptoms of the disease. Work quality will begin to suffer, and the individual is likely to experience problems when trying to learn something new. Although stage three lasts for approximately seven years, symptoms will become more apparent over a span of two to four years. Its during stage three that Alzheimers disease is most often diagnosed, as it becomes apparent to family and medical professionals that the individual is having significant trouble with memory and thinking, so much so, that it impacts day-to-day activities.
In stage three, an individual may require counseling. They may have mild to moderate denial, depression and anxiety. As this stage progresses and their symptoms worsen, they may require caregiving assistance in their home or in a senior care community.
In stage three, individuals may experience:
How To Find Help For Caregiving
As the person moves through the stages of Alzheimer’s, he or she will need more care. You may not be able to meet all his or her needs at home anymore. It’s important to know your limits, take care of yourself, and to seek help whenever you need it. Learn more about getting help with Alzheimer’s caregiving and finding ways to care for yourself. If caring for the person has become too much for you, you can also learn more about finding long-term care for a person with Alzheimer’s.;
General Overview Of Alzheimer Disease Stages
For those who are diagnosed with Alzheimers disease, symptoms typically manifest when a person reaches their 70s, but for those who develop early-onset Alzheimers disease , symptoms can develop as early as a persons 30s.
When it comes to Alzheimers disease, life expectancy can range from a few years to as many as 20. It really depends on the overall health of the individual and the severity of their symptoms. There is one factor, however, that has a major impact on life expectancy the age when symptoms appear. Those diagnosed at the age of 65 have a life expectancy of 8.3 years, whereas, someone at the age of 90 has a shorter life expectancy of 3.4 years.
In the typical progression of Alzheimers disease, the mild or early stages last approximately two to four years. The moderate or middle stages lasts anywhere from two to 10 years. And the severe or late stages typically last one to three years. Doing the math, you see that there is a wide range of years in which the disease can progress between five to 17 years for the typical progression of Alzheimers disease.
Alzheimers disease is the most common cause of dementia. In its early stages, Alzheimers disease may interfere with some day-to-day activities. As it progresses into the later stages, however, an individual with Alzheimers disease will be completely dependent on others to accomplish even the most basic tasks.
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Caring For Someone With Dementia Towards The End Of Life
Please be aware – this;information is for healthcare professionals.;We also have;information for the public.;
You can use our My Learning form ; to reflect on how this page has helped with your continuing professional development.
People with dementia may experience problems with thinking, memory, behaviour and mobility. It can be difficult to recognise when someone with dementia is nearing the end of their life. You can support the person by communicating with them and helping them with any symptoms they have. If possible, its a good idea to plan the persons care in advance to help understand what they want from their care.
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How To Cope With The Late Stages Of Alzheimer’s Disease
However, in late-stage Alzheimer’s disease, the disease begins to considerably affect parts of the brain that control bodily systems, such as motor coordination, bowel, and bladder function, and even breathing. The late stage of Alzheimer’s usually requires rigorous, around-the-clock care, and it can last from several weeks to several years.
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Stage : Mild Cognitive Impairment
Clear cognitive problems begin to manifest in stage 3. A few signs of stage 3 dementia include:
- Getting lost easily
- Noticeably poor performance at work
- Forgetting the names of family members and close friends
- Difficulty retaining information read in a book or passage
- Losing or misplacing important objects
- Difficulty concentrating
Patients often start to experience mild to moderate anxiety as these symptoms increasingly interfere with day to day life. Patients who may be in this stage of dementia are encouraged to have a clinical interview with a clinician for proper diagnosis.
Factors That Influence The Time Between Alzheimers Stages
Theres a noticeably large time range in terms of how long people live with Alzheimers, which is due to the variances in peoples overall health and levels of support. Seniors with high levels of support at home tend to go through each stage more slowly and live longer than people without help. Most people can live for several years with late-stage Alzheimers, but it does require their families to make decisions about how to provide high-quality care. Helping your loved one receive proper nutrition and prevent injuries allows him or her to enjoy a higher quality of life in this final stage.
It can be extremely helpful to enlist the help of a professional caregiver with specialized training in Alzheimers care, which includes unique methods designed to boost cognitive health. The type of in-home careseniors need can vary. Some need assistance a few hours a day, while others require more extensive around-the-clock assistance. At Home Care Assistance, we tailor our care plans based on each seniors individual care needs, and the plans can be adjusted at any time.
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Alma And Silvias Story
Alma had been forgetful for years, but even after her family knew that Alzheimers disease was the cause of her forgetfulness, they never talked about what the future would bring. As time passed and the disease eroded Almas memory and ability to think and speak, she became less and less able to share her concerns and wishes with those close to her.
This made it hard for her daughter Silvia to know what Alma needed or wanted. When the doctors asked about feeding tubes or antibiotics to treat pneumonia, Silvia didnt know how to best reflect her mothers wishes. Her decisions had to be based on what she knew about her moms values, rather than on what Alma actually said she wanted.
Quality of life is an important issue when making healthcare decisions for people with dementia. For example, medicines are available that may delay or keep symptoms from becoming worse for a little while. Medicines also may help control some behavioral symptoms in people with mild-to-moderate Alzheimers disease.
However, some caregivers might not want drugs prescribed for people in the later stages of Alzheimers. They may believe that the persons quality of life is already so poor that the medicine is unlikely to make a difference. If the drug has serious side effects, they may be even more likely to decide against it.
Resiliency In End Stage Alzheimers
But Fazio said that not all hope has to be lost in this final stage. As researchers learn more about the disease, theyre discovering that end stage Alzheimers can look very different for each individual and a lot may have to do with environmental factors.
Theres research saying what are some of the environmental factors that can make people more functional later into the disease, he said. Both social and physical approaches can support someone into being more functional .
He notes these environmental factors revolve around a person-centered approach, which hes focused on in his own research.
How can I help perform to the best of their ability for as long as possible? Fazio said. Its a new area of research, and being talked about in the psycho-social world. Theres a lot of different things youd see about the impact of this disease negative things like stress and burden. Now you see the research community shifting, and saying, how can we look at a more comprehensive view of this disease? We know theres stress and burden, impairment, that people are progressive. Yet we also see theyre showing resiliency and improved quality of life. How can we learn from that and replicate it?
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Are There Any Treatments
There are treatments that can help with the symptoms of some forms of dementia for a period of time, but there are currently no treatments that slow, halt or reverse the changes in the brain caused by the diseases. There are currently no treatments specifically for vascular dementia or frontotemporal dementia.
In the case of vascular dementia, a doctor may prescribe medication to treat underlying cardiovascular risk factors like high blood pressure or diabetes. Physiotherapy, speech therapy or occupational therapy may be offered to help with speech or movement problems. Non-drug treatments such as cognitive therapies may be available and can help some people with dementia to manage their symptoms.
Alzheimer’s Society ; has more information on treatments for dementia.
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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