What Are The Lewy Body Dementia Stages
Lewy body dementia stages generally begin with motor impairment before progressing to more obvious signs of dementia, including forgetfulness, confusion, a loss of speech and a blank facial expression. Some who are stricken with this brain disorder may also experience hallucinations, sleep disorders and body tremors in the beginning stages. Symptoms vary among individuals with this progressive condition, with some who are in the early stages showing either no signs of dementia or exhibiting very fleeting symptoms. Individuals in the early stages also may experience symptoms similar to someone in the latter stages, such as incontinence and difficulty swallowing. Not every person with Lewy body dementia experiences the same symptoms the stages of this condition, therefore, tend to vary from person to person and are not always predictable.
As a progressive brain disorder, the Lewy body dementia stages can occur quite rapidly. In its earliest stages, symptoms may fluctuate from day to day or even from moment to moment. A person may appear fine one moment, but suddenly experience an onset of extreme confusion the next.
Treatments For Dementia With Lewy Bodies
There’s currently no cure for dementia with Lewy bodies or any treatment that will slow it down.
But there are treatments that can help control some of the symptoms, possibly for several years.
- medicines to reduce hallucinations, confusion, drowsiness, movement problems and disturbed sleep
- therapies such as physiotherapy, occupational therapy and speech and language therapy for problems with movement, everyday tasks, and communication
- psychological therapies, such as cognitive stimulation
- dementia activities, such as memory cafes
Is Artificial Nutrition And Hydration A Good Idea
Most health professionals now feel that a person with advanced dementia and in the end stage of their illness should not be fed by tubes or drips. This is because inserting tubes or IV drips requires hospital admission, which can be very distressing for the person. They may then pull out the tubes and drips, and the site of the tubes and drips can become infected and sore.
He was very distressed in hospital and kept pulling out his tubes he didnt understand what was happening to him and they didnt know how to help him.
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The Final Stages Of Lewy Body Dementia
- Death is typically a result of pneumonia or other infection, which the body cannot fight off even with the use of antibiotics. Pneumonia is typically caused by aspiration . Other infections can be localized , open pressure ulcers or wounds , skin injuries , or contractures , the use of tubes or catheters . Still other infections can be or systemic, called sepsis, an infection in the blood stream. Other causes of death include malnutrition and dehydration, complications following falls , pulmonary emboli , or heart failure.
Behaviors Seen In Parkinsons Disease Dementia
As dementia progresses, managing disorientation, confusion, agitation, and impulsivity can be a key component of care.
Some patients experience hallucinations or delusions as a complication of Parkinsons disease. These may be frightening and debilitating. Approximately 50 percent of those with the disease may experience them.
The best thing to do when giving care to someone experiencing hallucinations or delusions from Parkinsons disease dementia is to keep them calm and reduce their stress.
Take note of their symptoms and what they were doing before they exhibited signs of hallucinating and then let their doctor know.
This element of the disease can be particularly challenging for caregivers. Patients may become unable to care for themselves or be left alone.
Some ways to make caregiving easier include:
- sticking to a normal routine whenever possible
- being extra comforting after any medical procedures
- limiting distractions
- using curtains, nightlights, and clocks to help stick to a regular sleep schedule
- remembering that the behaviors are a factor of the disease and not the person
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Lewy Body Dementia Canada
Learn to live best with LBD
Im no fan of applying the concept of stages or phases to predict the trajectory of a person with Lewy Body Dementia . Ive witnessed far, far too much variation. Precipitous drops. Miraculous recoveries. Dizzying variations. I consider it a continuum. And not a linear one.
So I never apply stages, phases or expectations. The only one I knew for certain, was the very end. The rest was a wild ride indeed.
Lewy Body Dementia life expectancy is impossible to predict.
But theres a constant desire by people desperate for answers, for a clue to where theyre going, whats next, how to plan or just get by. And for that reason, I present the best one Ive found.
I defer to the exceptional work of an exceptionally resourceful and committed duo, Sue Lewis and June Christensen, who exhaustively compiled the document based on input from approximately 300 members of an online group called Lewy Body Caring Spouses in 2006.
In my view, this is the best description of a possible sequence, categorized into five groupings of symptoms, which will always have a great deal of overlap.
Keep in mind these categories and their contents are potential. Personally, I shy away from the phrase stage and use something like earlier or later in the sequence of symptoms, which can fluctuate shockingly. This is a subtle, but important difference to me.
What Causes Parkinsons Disease Dementia
A chemical messenger in the brain called dopamine helps control and coordinate muscle movement. Over time, Parkinsons disease destroys the nerve cells that make dopamine.
Without this chemical messenger, the nerve cells cant properly relay instructions to the body. This causes a loss of muscle function and coordination. Researchers dont know why these brain cells disappear.
Parkinsons disease also causes dramatic changes in a part of your brain that controls movement.
Those with Parkinsons disease often experience motor symptoms as a preliminary sign of the condition. Tremors are one of the most common first symptoms of Parkinsons disease.
As the disease progresses and spreads in your brain, it can affect the parts of your brain responsible for mental functions, memory, and judgment.
Over time, your brain may not be able to use these areas as efficiently as it once did. As a result, you may begin experiencing symptoms of Parkinsons disease dementia.
You have an increased risk of developing Parkinsons disease dementia if:
- youre a person with a penis
- youre older
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Clinical Challenges To The Delivery Of End
End-of-life care presents many challenges for clinicians, as well as for patients and their families. Moreover, the care of the dying patient must be considered within the context of the psychological, physical, and social experiences of a person’s life. Foremost among those who require end-of-life care are the elderly, who are prone to loneliness, who frequently underreport pain, and who have a greater sensitivity to drugs and to drug-drug interactions. Unfortunately, clinicians who are responsible for the treatment of patients at the end of life commonly lack adequate training to help guide end-of-life decisions and to deliver bad news to patients and families. They must also face their own discomfort with discussions about death and deal with poor compensation for the time spent discussing end-of-life care with patients and families. Given the unique process of each person’s death, algorithmic strategies are often inadequate to guide patients, their families, and the clinicians who care for them through this complex and emotionally challenging process.
In the following sections, we will discuss the major challenges faced by dying patients and their families. We will then comment on the difficulties clinicians face in caring for the dying patient. Lastly, we will make several recommendations for improving the care of terminally ill patients and their families.
Signs Of End Stage Dementia
As caretakers and family, it is important to know when our loved ones are close to the end of their life because of dementia. It helps us give the right amount of care while making them feel comfortable. While late-stage dementia signs might differ in individuals, understanding all the end-of-life symptoms can help everyone prepare for whats to come.
Final 6 months
- Diagnosis of another condition such as heart failure or cancer
- More hospitalizations or hospital visits
Final 2 to 3 months
- Limited speech. Usually consisted of 6 words a day or less.
- Difficulty swallowing/ chokes easily on food or drinks
- They can no longer walk or sit up on their own without assistance
- Hands/feet cold to the touch
- Can no longer swallow
- Grimacing in pain
If you see these signs, call your loved ones doctor to help manage the pain further.
Get Proper Equipment
Your loved one may require special equipment towards the end of their life, such as a hospital bed. Working with a hospice can help you get the right equipment to help your loved one be more comfortable.
Keep Them Comfortable
The most important thing you can do for your loved ones is to keep them comfortable in their final days. Towards the end, their mouth will become very dry, so supporting them with mouth care will greatly benefit them.
Get Affairs in Order
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What Is Lewy Body Dementia
Lewy body dementia is a type of brain disorder where Lewy bodies start to build up in areas of the brain.
These are microscopic deposits that damage the brain and may eventually lead to the death of the brains nerve cells.
Lewy bodies are abnormal protein deposits known as alpha-synuclein.
The build-up of these proteins can affect a persons thinking capacity, movement, bladder and bowel movements, autonomic body functions, and behavior, etc.
People with Alzheimers disease also have Lewy bodies.
The condition is diagnosed through a sequence of tests that include both neurological and physical tests. During these tests, a persons memory, visuospatial skills, and attention span undergo assessment.
At times, the doctors may also recommend MRI and CT brain scans to confirm the diagnosis along with blood tests.
The disease mostly affects individuals who are above the age of sixty though there are a few cases where a person may get it when they are younger.
Preparing Lbd Families About End Of Life
End of life factors are known to be different in LBD compared to Alzheimers disease. The progression of LBD averages 5-7 years from onset to end of life. This is considerably shorter than the 8-10 years in Alzheimers disease. Adding typically-delayed diagnosis, this results in a compressed time to address LBDs complex diagnostic, clinical and caregiving issues.
A new study highlights that Lewy body dementia families need better guidance from their healthcare professionals on end of life issues. This includes likely causes of death, timing of engaging hospice services, and what to expect at end of life.
Led by Melissa Armstrong, MD, MSc of the University of FL, Gainesville, researchers explored the end of life experiences in people with one form of LBD: dementia with Lewy bodies . The study, a collaboration with the Lewy Body Dementia Association, used an online survey about end of life experiences.
The study included caregivers, family members and friends of people who died within the previous 5 years with a DLB diagnosis. Of the 658 respondents, most were female with a median age of 50-69. The study revealed most care recipients died within 5 years of their diagnosis.
Caregivers indicated providers rarely addressed what to expect at end of life . Most conversations on end of life issues were first broached by the caregiver.
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Are There Any Stages Or Phases Of Lewy Body Dementia
Im no fan of applying the concept of stages or phases to predict the trajectory of a person with Lewy Body Dementia . Ive witnessed far, far too much variation. Precipitous drops. Miraculous recoveries. Dizzying variations. I consider it a continuum. And not a linear one. So I never apply stages, phases or expectations.
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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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
- 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.
When Should I Ask For Support
Supporting people with dementia at the end of their life requires a team approach. Often, there will be many people involved in the persons care at the end of their life. Good communication and information sharing helps to ensure the person receives the care they need.
If youre unsure about anything or have any concerns seek advice from a colleague, manager or another health care professional.
There may be certain professionals who can advise on specific issues. These may include a GP, district nurses, social workers, other care staff and specialists.
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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:
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.
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