Stage : Severe Dementia
Stage 7 is considered the final stage on the Global Deterioration Scale. At this stage, the person has lost all ability to speak or communicate effectively. The individual may utter a few words or phrases, but they will not likely relate to his or her current environment. Individuals need assistance with the majority of daily living activities. They will need to be helped with not only bathing, dressing and meal preparation, but also eating and toileting. In the final stages of Alzheimers disease, individuals often lose the ability to swallow.
Severe dementia individuals are also at an increased risk for developing infections including pneumonia. Motor skills, including the ability to walk, occur at this stage. Angry outbursts are more widespread as the individual feels extreme agitation. Dementia individuals with these signs need around-the-clock care. This stage could last upwards of two years.
Support For People With Dementia And Carers
UCL covid-19 decision aid – a tool to support carers of people living with dementia to make difficult decisions during covid-19
Alzheimers Society end of life care information for patients and families
Alzheimers Society information and fact sheets on all aspects of dementia including what is dementia, types of dementia and living well with dementia
Alzheimer Scotland specialist services for patients and carers
Dementia UK expert one-on-one advice and support to families living with dementia via Admiral Nurses
The Later Stage Of Dementia
People with later-stage dementia will eventually need full-time care and support with daily living and personal care, such as eating, washing and dressing. Whatever kind of dementia a person has, their life expectancy is on average lower.
The progression and stages of dementia
Dementia is a life-limiting condition and there is information about later-stage dementia and life expectancy on this page. Some people may find this upsetting and difficult to think about.
For more general information about the different stages of dementia, see The progression and stages of dementia page.
By the later stage of dementia, the condition will have a severe impact on most aspects of a persons life. The person will eventually need full-time care and support with daily living and personal care, such as eating, washing and dressing. This support can be provided by care at home but is more often given in a care home setting.
Symptoms of all kinds are likely to cause the person considerable difficulties in this stage, but altered perception and physical problems are often the most noticeable. By the late stage, the symptoms of all types of dementia become very similar.
The later stage of dementia tends to be the shortest. On average it lasts about one to two years.
Are you supporting a person with later-stage dementia?
Get practical advice and tips on supporting a person with later-stage dementia.
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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 Is Dementia Treated
Treatment of dementia depends on its cause. For example, dementia that has developed due to vitamin deficiency can be treated with vitamin supplements and hence is reversible. Other causes of dementia such as depression, thyroid problems can also be treated.
For progressive dementias, including Alzheimer’s disease, no treatment can halt its progression, and research is still going on to find out the same. But, some medications may temporarily help relieve its symptoms such as memory loss and confusion. These are:
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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.
How To Get Extra Help And Support
Apply for a needs assessment from the adult social services department of your local council. This will help to identify where you might benefit from help, such as with meals or housework.
A needs assessment should be done face to face. It’s a good idea to have a relative or friend with you, if you’re not sure what your needs might be. They can also take notes for you.
Read more about applying for a needs assessment
Join an online forum, such as Alzheimers Society Talking Point. Online forums are a good way to share your experiences of living with dementia and advice on how to continue living independently.
Read more about help and support for people with dementia.
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Building A New Life After Diagnosis
Despite the progressive and terminal nature of dementia, many people do find ways to cope with the diagnosis and get on with their lives.
Some people find a sense of purpose after diagnosis through joining with others to campaign for a better deal for people with dementia . Others prefer to carry on doing things they have always done such as gardening, going to the pub or fishing.
It is important that a younger person has the chance to try something new. Some might want to explore their creative side and become artists or singers. Others may want to try something more active and adventurous , visit a place they have never been, or take on a new role or responsibility . The point is to help the person find an activity that is meaningful for them and to assist them to do it.
What Should Be Your Role As A Caregiver In The End
During the final stage of dementia, the affected individual becomes completely dependent on the people around them to carry out basic activities.
If a person is a caregiver, they need to take care of the patient regarding certain important aspects, including:
The appetite of the affected individual may decrease in the final stages of dementia due to the inability to stay physically active. They may forget to eat food or drink fluids.
To help ensure that the person in the final stage of dementia receives adequate nutrition, try the following tips:
Bowel and bladder function
The patient may eventually lose control of bladder and bowel function in the final stage of dementia.
To maintain bowel and bladder function, try the following tips:
Skin and bone health
A patient with end-stage Alzheimers disease can eventually become bedridden or chair-bound. This can result in skin breakdown, pressure sores, and freezing of joints .
To keep the skin healthy and bones functioning, try the following tips:
Good oral hygiene reduces the risk of bacteria in the mouth that can lead to infections, including pneumonia. Brush the patients teeth every time after the patient eats. If the patient wears dentures, remove them and clean them every night.
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Is It Typical For People With Dementia To Sleep A Lot During The Dayblog
People with dementia, especially those in the later stages, can often spend a lot of time sleeping. This can sometimes be worrying for carers, friends and family. Find out why a person with dementia might sleep more than an average person of their age.
It is quite common for a person with dementia, especially in the later stages, to spend a lot of their time sleeping both during the day and night. This can sometimes be distressing for the persons family and friends, as they may worry that something is wrong.
Sleeping more and more is a common feature of later-stage dementia. As the disease progresses, the damage to a persons brain becomes more extensive and they gradually become weaker and frailer over time.
As a result, a person with dementia may find it quite exhausting to do relatively simple tasks like communicating, eating or trying to understand what is going on around them. This can make the person sleep more during the day as their symptoms become more severe.
Some medications may contribute to sleepiness. These include some antipsychotics, antidepressants, antihistamines and of course sleeping pills.
Sleeping disorders unrelated to dementia, such as having breathing that occasionally stops during sleep , can also contribute to sleeping for longer.
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There is a lot of talk about the emotional pain patients and caregivers suffer when a loved one loses memories to Alzheimers. But what about the other symptoms? Here are tips from a Johns Hopkins expert on what to watch for and how to manage.
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Caring For Those With Dementia
Researcher Murna Downs, PhD, says most people don’t recognize that dementia is a disease people live with, and not just a death sentence.
Downs’ research focuses on quality-of-life issues among dementia patients.
“People with dementia live a long time, and we now know that there is a lot of awareness,” she says. “People assume that if someone doesn’t know where they are they have no other capacity for thinking and feeling. But people with dementia continue to think and to laugh and to feel the rain on their faces, and to try to make sense of their world.”
She adds that patients are often isolated because family members or other caregivers fail to recognize their need for interaction and stimulation.
“The therapeutic potential of human contact cannot be underestimated,” she says. “You would never put a small child in a chair and let them sit there all day with nothing to do. Children need stimulation and human contact and so do people with dementia.”
SOURCES: Xie, J. BMJ Online First, Jan. 11, 2008. Carol Brayne,professor, lecturer in epidemiology, department of public health and primarycare, Institute of Public Health, University of Cambridge, England. MurnaDowns, PhD, professor in dementia studies, Bradford Dementia Group, Universityof Bradford, England Ferri, C.P. Lancet, 2005 vol 366: pp2112-2117.
What Are The Symptoms
Each person is unique and will experience dementia in their own way. The different types of dementia tend to affect people differently, especially in the early stages.
A person with dementia will often have cognitive symptoms . They will often have problems with some of the following:
- Day-to-day memory difficulty recalling events that happened recently.
- Repetition repeating the same question or conversation frequently in a short space of time.
- Concentrating, planning or organising difficulties making decisions, solving problems or carrying out a sequence of tasks .
- Language difficulties following a conversation or finding the right word for something.
- Visuospatial skills – problems judging distances and seeing objects in three dimensions.
- Orientation – losing track of the day or date, or becoming confused about where they are.
Some people have other symptoms including movement problems, hallucinations or behaviour changes.
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Alzheimers And Dementia Life Expectancy Calculator
Following a dementia diagnosis, its understandable that many individuals want to know the answer to the question: How long do I have to live? The answer might be scary, but understanding the way cognitive diseases progress will ultimately help you plan your approaches to health care and budgeting.
As there are many different types of dementia, the average life expectancy varies greatly. When you factor in underlying health conditions, access to care, and early diagnosis, the answer can be somewhat hard to pin down. Because of this, it is best to use the information in this article as a reference or guide instead of a definitive answer.
Information from this chart was obtained from Alzheimers.org.
Sleep For People Who Have Dementia With Lewy Bodies And Parkinsons Disease
The type of dementia you have can affect your sleep.
People who have dementia caused by Lewy body disease, such as Parkinsons disease or dementia with Lewy bodies are often sleepy by day but have very restless and disturbed nights. They can suffer from confusion, nightmares and hallucinations. Insomnia, sleep apnoea and restless legs are common symptoms.
A person affected with these types of dementia may often unknowingly act out their dreams by shouting and moving around in bed.
They can even cause injury to themselves and/or their sleeping partner. This is called rapid eye movement sleep behaviour disorder or RBD, and tends to happen from the earliest stages of the disease onwards.
This can be exhausting and often leaves the person feeling like they havent slept at all, so they are very tired and sleepy during the day.
It can be hard to stay awake during the day after a poor nights sleep but, if possible, its best to try to limit sleep during the day to small bursts or catnaps. Otherwise the persons body clock can become very confused and this makes sleeping well during the night even harder.
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Difficulties Getting A Diagnosis
A 2008 Alzheimers Society report quotes one GP saying to a female patient,
You cant have dementia, youre too young.
This quote reveals that doctors and other professionals quite often may not even consider that a person under 65 could have dementia they may be more likely to think there is nothing wrong or that the person is depressed. In many areas, it may be unclear which medical consultant is responsible for the assessment and diagnosis of young onset dementia should it be a psychiatrist working with adults with mental health problems, or should it be an old age psychiatrist who specialises in working with older adults? GPs may not know this information. For all these reasons, obtaining a diagnosis is often a particularly drawn-out and distressing process for younger people.
What Is Frontal Lobe Dementia
The frontal lobes of the brain are located as the name suggests at the front of the brain. Loosely speaking, it contains what we call the higher functions of the brain. These are the areas of the brain responsible for emotions, understanding, speech some types of movement, planning and judgement in other words the things which make you a person, and personality. Like all dementias the people who develop symptoms face a slow loss of self and those who care for them, losing the person they care for by slow degrees.
Frontal lobe dementia is also known as frontotemporal dementia , or frontotemporal degeneration, it is an overarching term for several categories of a loss of brain function. The changes to the brain are caused by an abnormal build-up of tau proteins, which stop the brain cells from functioning properly, so they die. In frontal lobe dementia parts of the frontal and temporal lobes of the brain are damaged. It was previously known as Picks disease after the doctor Arnold Pick who identified and first documented the symptoms in a patient over a hundred years ago in 1892.
Unlike the most widely diagnosed form of dementia, Alzheimers disease, frontal lobe dementia occurs at a much younger age and is partly genetic. That means while there is no certainty that if you have had a close blood relative with FLD you will get it too, your chances of developing it are much higher than for other members of the population.
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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.