How Long Does The Later Stage Of Dementia Last

What Is The Life Expectancy For Someone With Dementia

This is an incredibly difficult question to answer as there are many influencing factors, including the persons age and gender, the type of dementia and the stage of the condition at diagnosis. The average life expectancy after diagnosis for someone with Alzheimers, the most common form of dementia is 10 years. However, dementia progresses differently in everyone, meaning people can live anywhere from 2 years to 26 years after diagnosis.

The main way in which health care professionals estimate dementia life expectancy is by using the Global Deterioration Scale , also called the Reisberg Scale. It shows the average time someone is expected to live depending on which stage of dementia they are at.

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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.

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.

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What Does Best Practice Look Like Introducing The Priorities For Care Of The Dying Person

There are five priorities:

• Recognise: The possibility that a person may die within the next few days or hours is recognised and communicated clearly, decisions made and actions taken in accordance with the persons needs and wishes, and these are regularly reviewed and decisions revised accordingly. Always consider reversible causes, for example, infection, dehydration, hypercalcaemia.
• Communicate: Sensitive communication takes place between staff and the dying person, and those identified as important to them.
• Involve: The dying person, and those identified as important to them, are involved in decisions about treatment and care to the extent that the dying person wants.
• Support: The needs of families and others identified as important to the dying person are actively explored, respected and met as far as possible.
• Plan & Do: An individual plan of care, which includes food and drink, symptom control and psychological, social and spiritual support, is agreed, coordinated and delivered with compassion.

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.

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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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Are There Treatments To Help With Late Stage Dementia

Currently, there are no treatments that can slow or reverse late-stage dementia.

If your loved one with dementia is experiencing any pain, contact your doctor to see if they recommend any over the counter or prescription medication to help with this.

You can also work with an occupational therapist in your area specializing in dementia to help. Speech therapy may be an option to help with speech and movement issues.

There may be a time when hospice should be considered. If youre considering hospice care for your loved one, speak with your doctor and they can help you get this set up so that your loved one can be comfortable

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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End Stage Of Dementia

The end stage of dementia is the most difficult stage for those suffering from the disease, and also for family members, caregivers, and healthcare professionals. Victims lose what is left of their intellectual and physical capabilities and become completely dependent on others. The model is still shifting in considering end stage dementia an end of life condition experts are pushing this model in order to advocate for better pain and distress management for those suffering at their end.

A Word About Progression

Alzheimers typically progresses slowly and transitions from mild to severe symptoms. The rate of progression varies widely between people. People with Alzheimers live an average of 4 to 8 years after their diagnosis, but some people live more than 20 years.

The risk of progressing to a higher stage increases with age. For example, in a

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Stage : Moderate Dementia

Patients in stage 5 need some assistance in order to carry out their daily lives. The main sign for stage 5 dementia is the inability to remember major details such as the name of a close family member or a home address. Patients may become disoriented about the time and place, have trouble making decisions, and forget basic information about themselves, such as a telephone number or address.

While moderate dementia can interfere with basic functioning, patients at this stage do not need assistance with basic functions such as using the bathroom or eating. Patients also still have the ability to remember their own names and generally the names of spouses and children.

Scales For Rating Dementia

Rather than simply using early stage,middle-stage, and late-stage dementia as descriptors, there are scales that provide a more comprehensive description. These scales help better understand the different stages of Alzheimers disease based on how well a person thinks and functions . These scales are the Global Deterioration Scale for Assessment of Primary Degenerative Dementia, the Functional Assessment Staging Test, and the Clinical Dementia Rating.

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Global Deterioration Scale / Reisberg Scale

The most commonly used scale is often referred to simply as GDS, or by its more formal name, the Reisberg Scale . The GDS divides into seven stages based on the amount of cognitive decline. This test is most relevant for people who have Alzheimers disease because some other types of dementia do not always include memory loss.

Someone in stages 1-3 does not typically exhibit enough symptoms for a dementia diagnosis. By the time a diagnosis has been made, a dementia patient is typically in stage 4 or beyond. Stage 4 is considered early dementia, stages 5 and 6 are considered middle dementia, and stage 7 is considered late dementia.

Clinical Dementia Rating

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Tests For Vascular Dementia

There’s no single test for vascular dementia.

The tests that are needed to make a diagnosis include:

• an assessment of symptoms for example, whether these are typical symptoms of vascular dementia
• a full medical history, including asking about a history of conditions related to vascular dementia, such as strokes or high blood pressure
• an assessment of mental abilities this will usually involve several tasks and questions
• a brain scan, such as an MRI scan or CT scan, to look for any changes that have happened in your brain

Find out more about the tests used to diagnose dementia.

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
• Incontinence

• Hands/feet cold to the touch
• Can no longer swallow

• Sweating
• 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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Preclinical Alzheimers Or No Impairment

You may only know about your risk of Alzheimers disease due to your family history. Or, your doctor may identify biomarkers that indicate your risk.

If youre at risk of Alzheimers, your doctor will interview you about memory problems. However, there will be no noticeable symptoms during the first stage, which can last for years or decades.

Abnormal accumulation of a type of protein called tau in the fluid around your brain and spinal cord is associated with the development of Alzheimers disease. Changes in the levels of this protein can occur about 15 years before symptoms start.

Caregiver support: Someone in this stage is fully independent. They may not even know they have the disease.

Mild Impairment Or Decline

The symptoms of Alzheimers are less clear during stage 3. While the entire stage lasts about 7 years, the symptoms will slowly become clearer over a period of 2 to 4 years. Only people close to someone in this stage may notice the signs. Work quality will decline, and they may have trouble learning new skills.

Other examples of stage 3 signs include:

• getting lost even when traveling a familiar route
• finding it hard to remember the right words or names
• being unable to remember what you just read
• not remembering new names or people
• misplacing or losing a valuable object

Your doctor or clinician may also have to conduct a more intense interview than usual to discover cases of memory loss.

Caregiver support: At this stage, someone with Alzheimers may need counseling, especially if they have complex job responsibilities. They may experience mild to moderate anxiety and denial.

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Outlook For Vascular Dementia

Vascular dementia will usually get worse over time. This can happen in sudden steps, with periods in between where the symptoms do not change much, but it’s difficult to predict when this will happen.

Home-based help will usually be needed, and some people will eventually need care in a nursing home.

Although treatment can help, vascular dementia can significantly shorten life expectancy.

But this is highly variable, and many people live for several years with the condition, or die from some other cause.

If you or a loved one has been diagnosed with dementia, remember that you’re not alone. The NHS and social services, as well as voluntary organisations, can provide advice and support for you and your family.

Support Their Cultural And Spiritual Needs

Its good to be aware of the persons cultural and spiritual needs and make sure these are respected and supported. You can make use of any advance care plans or documents, friends and family input and your knowledge of the person. Its important to try and meet these needs as much as possible, they are just as important as medical care.

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What Are Signs Of The Dying Process For End

At the end of their illness, some of the signs that they are transitioning may include:

• Less communication

• Raspy breathing/rattle in the chest

• In and out of awareness of surroundings

It is not unusual for a loved one to be unaware of these symptoms. Medical professionals can help ensure that dementia patients are as physically comfortable as possible in the last days and weeks of their life.

Handling the emotional distress that sometimes comes when dealing with dementia may even involve assistance outside of a physician or their team. A clergy member, or other cultural spiritual leader may be able to provide support to both you, and your loved ones, as the end-stages continue.

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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Medical Interventions In Late

If someone is in the later stages of dementia and becomes seriously ill, there may be discussion about whether to actively treat their illness. Ways of intervening may include resuscitation after a heart attack, antibiotic treatment for pneumonia, or giving food or liquids by mouth.

Giving or withholding treatment is a serious decision to make for someone else and is not an easy one to make. You need to consider:

Sometimes the decision can only be made by a guardian appointed by a tribunal or court. Each state and territory has different regulations but medical staff or Dementia Australia can advise you about appropriate contacts.

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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