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.
The Woman Who Recovered From Dementia
The author’s mother with her granddaughters. The retired psychiatrist’s cognitive symptoms improved immediately after brain surgery two years ago. Photo / Supplied
When my mother, Pauline, was 70, she lost her sense of balance. She started walking with an odd shuffling gait, taking short steps and barely lifting her feet off the ground. She often took my hand, holding it and squeezing my fingers.
Her decline was precipitous. She fell repeatedly. She stopped driving, and she could no longer ride her bike in a straight line along the C&O Canal. The woman who taught me the sidestroke couldn’t even stand in the shallow end of the pool. “I feel like I’m drowning,” she’d say.
A retired psychiatrist, my mother had numerous advantages – education, resources and insurance – but, still, getting the right diagnosis took nearly 10 years. Each expert saw the problem through the narrow prism of a single specialty.
Surgeons recommended surgery. Neurologists screened for common incurable conditions. The answer was under their noses, in my mother’s hunches and her family history. But it took a long time before someone connected the dots.
My mother was using a walker by the time she was told she had a rare condition that causes gait problems and cognitive loss, and is one of the few treatable forms of dementia.
The bad news was that it had taken so long to get the diagnosis that some of the damage might not be reversible.
How Can You Cope With Being The Caretaker Of Someone With Dementia
It is important for someone who is the primary caregiver of a patient with dementia to have a strong network of support. This is needed both to aid in caring for the patient and to give the caregiver some intermittent relief. In the early stages, many caregivers function more as a helper or guide, providing reminders for different tasks. Later in the disease, caregivers may have to supply basic care to the patient, including assistance with bathing, dressing, and going to the bathroom.
Obtaining power of attorney status for financial and medical matters and determining when a patient is no longer able to perform certain activities, such as driving, are difficult but necessary actions. Local Alzheimer’s Association chapters are often helpful in completing these tasks. Enlisting the help of a patient’s physician or mandating an on-the-road driving assessment can place the responsibility of determining when a patient is no longer safe to drive on someone other than a caregiver or family member, as driving is often an action that many patients attempt to perform far past the time when it is safe to continue. There are many sources of assistance for caregivers of patients with dementia:
Alzheimer’s and Dementia Caregiver CenterAlzheimer’s Association
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Can You Treat Dementia After Stroke
With vascular dementia, there is hope for improvement through cognitive rehabilitation, which is possible thanks to neuroplasticity.
Neuroplasticity is the process the brain uses to rewire itself and form new connections, as well as strengthen existing connections. When part of the brain sustains damage after a stroke, neuroplasticity allows healthy areas of the brain to take over. However, it does not occur without your help.
In order for neuroplasticity to work, the brain needs to see a demand for a function. For example, the brain wont improve at the skill of riding a bike unless you attempt to ride a bike in the first place, because this shows a demand for that function. To apply this concept to cognitive health, this is where cognitive rehabilitation exercises come into play.
Cognitive exercises draw upon desired thinking skills, such as memory and attention. When the brain sees a demand for these skills, it will attempt to adapt. For example, by practicing memory exercises, the brain perceives the demand for the function of memory, and it responds by creating and strengthening neural pathways responsible for memory.
Dying From Dementia With Late
The death of your loved one can be a hard concept to wrap your head around and accept. But knowing what to expect can help you when your loved one has late-stage dementia. It might help to know what will happen in the future so that you can be prepared emotionally and logistically.
This article discusses how dementia progresses and what to expect during late-stage dementia.
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What Is Alzheimer’s Disease
Alzheimers disease is a brain disorder that cannot be stopped or reversed. The disease severely affects memory, thinking, learning and organizing skills and eventually affects a persons ability to carry out simple daily activities. Alzheimers disease is not a normal part of the aging process.
Alzheimers is a disease whose symptoms worsen over time. In fact, scientists believe the disease process may go on for 10 years or longer before the first symptoms of Alzheimers disease appear.
When memory problems do begin to be noticeable, they are often identified as mild cognitive impairment . At this stage, intellectual function is affected but the ability to function and live independently remain intact as the brain compensates for disease-related changes.
In some people, MCI can hold steady at this stage. However, people with MCI are at high risk for progressing to dementia. Alzheimers disease is the most common form of dementia. With dementia, in contrast to MCI, daily function is affected.
As dementia due to Alzheimers disease progresses to late stages, affected individuals cannot carry on a conversation, recognize family and friends, or care for themselves.
What Are The Early And Later Signs And Symptoms Of Dementia
Early signs of dementia may include:
- Simple forgetfulness
- Problems performing tasks or activities that were previously done without effort.
- Difficulty with learning new material is frequently one of the earliest signs of dementia.
Many patients with early Alzheimer’s disease or other types of dementia are unaware that they have any problem. As the disease progresses, behavioral changes can become evident.
- Patients have difficulty performing basic tasks, such as getting dressed or using the bathroom.
- Some patients begin to forget pieces of information about themselves, including their address or telephone number, or even their date of birth.
- They may have difficulty understanding what is occurring around them.
- Some patients have problems remembering to eat and may develop pronounced weight loss.
- In the late stages of dementia, patients often cannot recognize family members and their ability to communicate effectively is markedly impaired.
- They are no longer able to effectively care for themselves and require assistance for all activities of daily living.
- Over time, patients can forget how to walk or even how to sit up.
The stages of dementia are loosely grouped into mild, moderate, and severe categories by some doctors. However, there is another system of staging for dementia.
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How Will This Benefit People With Dementia
Clinicians and researchers are increasingly aware that delirium could play a role in making dementia symptoms worse. Therefore finding a way to help people with dementia to recover from delirium could help to prevent the worsening of symptoms and enable people to live better.;
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Lifestyle Changes To Improve Vascular Dementia Symptoms
A diagnosis of dementia is scary. But its important to remember that many people with dementia can lead healthy, fulfilling lives for years after the diagnosis. Dont give up on life! As much as possible, continue to look after your physical and emotional health, do the things you love to do, and spend time with family and friends.
The same strategies used to keep your brain healthy as you age and prevent the onset of dementia can also be used to improve symptoms.
Find new ways to get moving. Research suggests that even a leisurely 30-minute walk every day may reduce the risk of vascular dementia and help slow its progression. Regular exercise can also help control your weight, relieve stress, and boost your overall health and happiness.
Create a network of support. Seeking help and encouragement from friends, family, health care experts, and support groups can improve your outlook and your health. And its never to late to make new friends and expand your network.
Eat for heart health. Heart disease and stroke share many of the same risk factors, such as high LDL cholesterol , low HDL cholesterol , and high blood pressure. Adopting a heart-healthy diet may help to improve or slow down your dementia symptoms.
Make it a point to have more fun.Laughing, playing, and enjoying yourself are great ways to reduce stress and worry. Joy can energize you and inspire lifestyle changes that may prevent further strokes and compensate for memory and cognitive losses.
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Hip Fractures In People With Dementia
People with dementia have a higher chance of experiencing a hip fracture. People with dementia who live in their own homes and take;antipsychotic medications;are also more likely to fracture their hips. And not surprisingly, those with;both dementia and osteoporosis have the greatest risk for a hip fracture, according to some research.;
Those with dementia who fracture their hip also have a higher likelihood of developing delirium during their hospital stay. If delirium develops, it can lead to longer hospitalizations, poorer recovery in terms of mobility and longer facility care. The recovery and rehabilitation of someone with dementia after a hip fracture can be complicated by memory loss. Often, a weight-bearing limit is placed on someone after surgery and the individual with dementia may not remember that she can’t just get up and walk.
Mortality rates in people who fracture their hip are between 12-33% after one year.
When an older adult with Alzheimer’s or other dementia experiences a hip fracture, several complications are possible.
- Less likely to rehabilitate to their previous level of functioning
- More likely to require ongoing facility care
- The higher rate of death following a hip fracture
- More likely to develop pneumonia related to decreased mobility
- Less likely to receive adequate pain medication, potentially increasing narcotic use when severe hip pain develops
Stem Cells And Dementia
Stem cells are “building block” cells. They can develop into many different cell types, including brain or nerve cells.
Scientists have taken skin cells from people with certain types of dementia, such as Alzheimer’s disease, and “reprogrammed” them into stem cells in the lab. They’ve then triggered these stem cells to become brain cells.
These brain cells can also be used to test potential treatments at a very early stage.
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What Does This Project Involve
This project takes a multidisciplinary approach to understanding how to help people to recover from delirium after they are released from hospital.;
There are two projects involved with this partnership. The first project will focus on how to help people recover their memory and thinking abilities after they experience delirium.;
The researchers involved in this project will do an in-depth review of the existing literature on delirium recovery, and find out what can be done to prevent decline in memory and thinking. They will then work with nursing, psychology and medical professionals to develop potential strategies to help people to recover from delirium. They will also work with people affected by dementia and their families to develop and test these strategies. The strategies will then be tested with a small group of people with dementia who have experienced delirium.
The second project will focus on how to help people to physically recover from delirium. This is because many people will lose some of their strength and mobility after delirium, and be increasingly reliant on other people.;
This project will again review the existing literature and work with experts in the field, in this case including physiotherapists and occupational therapists. They will use the information to develop tests that can be used within NHS settings to find out how well someone is recovering physically after experiencing delirium.;
Tips For Dementia Care
Dementia can be challenging for both patients and caregivers but knowing what to expect can help ease the journey. Caregivers may not be able to anticipate the level of dementia on a daily basis, but they can be prepared to manage the varying symptoms of dementia as they progress.
The different stages of dementia require different degrees of caregiving. 2 With mild dementia, people may still be able to function independently, however, theyll experience memory lapses that affect daily life, such as forgetting words or where things are located.
People experiencing moderate dementia will likely need more assistance in their daily lives as it becomes harder for them to perform daily activities and self-care. They may hallucinate, get lost easily and forget where they are, and not remember what day of the week it is.
Someone with severe dementia will likely lose their ability to communicate and need full-time daily assistance with tasks such as eating and dressing. They may not remember their own name or the names of others. Physical activity and ability may be seriously impaired and they may be more susceptible to infections, such as pneumonia.
Resources:
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How Can Hip Fractures Be Prevented
Reduce Falls: Falls can happen so quickly, but by reviewing some of the common causes of falls and taking precautions, you may be able to prevent some of them. If a fall does happen, you should spend some time trying to figure out the root cause in order to reduce the chance of it happening again.
Regular Exercise: Physical exercise can help maintain balance, muscle tone, and bone strength, and some research has shown that exercise also can slow down cognitive decline in people with dementia. Falls and a resulting fracture are less likely to occur in those whose bodies are stronger and whose minds can evaluate safety issues.;;
Medications to Strengthen Bones: Some physicians might prescribe medications such as calcium supplements to try to make the bones more resistant to fractures.
Medications that help people sleep at night may seem like a great solution for the person with insomnia, but they come with a higher risk of falls. Some physicians recommend instead that a natural supplement such as melatonin be taken to hopefully decrease the risk of falls and fractures. Be sure to ask your doctor before taking any over-the-counter medications or supplements.
How Is Alzheimers Disease Diagnosed
These tests are used to diagnose Alzheimers disease or to rule out other medical conditions that cause symptoms similar to Alzheimers disease:
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Why Did We Fund This Project
Comments from members of our Research Network:
‘The proposal appears to be highly relevant and potentially of great importance.’
‘This is a good application addressing a priority area. It has clear aims, a robust methodology, and good plans for dissemination . It could have a significant impact, and I strongly support it.’
‘Delirium can have devastating effects for those with dementia in the short and long term. I am pleased to see that there is to be further research.’
Rehabilitation For People With Dementia Following A Hip Fracture Operation
Background
Hip fracture is an injury primarily of elderly people, which is usually caused by a fall. It can affect a person’s ability to walk, perform activities of daily living, and remain independent. Hip fracture is more common in people with dementia, and these individuals can find it more difficult to recover because they are at greater risk of becoming more confused and developing additional complications such as pressure sores and chest infections after surgery. They may also find it more difficult to express pain and discomfort.
Review question
We wanted to learn whether different ways of treating people with dementia following hip fracture might affect how well they recover and what the associated costs of their recovery might be. This is an update of a previous Cochrane Review.
Study characteristics
We searched for randomised controlled trials that compared any model of enhanced care and rehabilitation for people with dementia after hip fracture versus the usual care provided in the trial setting. The latest search was performed on 16 October 2019.
Key findings
Quality of the evidence
There may be some benefits from the care models studied, but the currently available research is insufficient to determine the best ways to care for people with dementia after a hip fracture operation.
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