Support For Dementia Caregivers At The End Of Life
Caring for people with Alzheimers or other dementias at home can be demanding and stressful for the family caregiver. Depression is a problem for some family caregivers, as is fatigue, because many feel they are always on call. Family caregivers may have to cut back on work hours or leave work altogether because of their caregiving responsibilities.
Many family members taking care of a person with advanced dementia at home feel relief when death happensfor themselves and for the person who died. It is important to realize such feelings are normal. Hospicewhether used at home or in a facility gives family caregivers needed support near the end of life, as well as help with their grief, both before and after their family member dies.
What About Excessive Sleep
Seemingly excessive sleep may be unavoidable. As symptoms of dementia become more severe, especially in the later stages of the disease, sleeping more during both day and nighttime is common. This is because as brain function deteriorates the body loses strength, turning simple actions, like merely listening and trying to communicate, into exhausting ordeals that sap strength.
It is also possible that medications, particularly antipsychotics and antidepressants, will cause side effects that include increased sleepiness.
If someone in the earlier stages of dementia is unexpectedly sleepier than normal, it is important to speak with a doctor. Difficulty sleeping, rather than excessive sleep, is much more common in early-stage dementia, and drowsiness may indicate something else is wrong, like infection or adverse reactions to medication.
Studies have indicated that Dementia with Lewy Bodies , a form of dementia associated with how the brain processes protein, has shown higher rates of drowsiness during the day than Alzheimers or other dementias. Tiredness in these cases can be unrelated to how well a person slept the night before.
What Is Sleep Pressure
Sleep pressure is the increasing need to sleep after being awake for a long time. The longer a person has been awake for, the more likely that they will feel sleepy, and the more deeply they are likely to sleep. As a person sleeps, the pressure to sleep gradually wears off and they become more likely to wake up.
Some stimulants, such as caffeine, work by blocking the chemicals that make a person feel sleepy.
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Dementia And Alzheimers Disease
There is a great misunderstanding about the difference between dementia and Alzheimers disease. The reason for the confusion may come from the fact that both conditions target a patients memory and thought process. Let us help you clear things out by describing each degenerative issue.
Dementia is the main form of a mental syndrome that affects a persons memory and way of thinking. It is a syndrome because it is difficult to diagnose, but a cluster of symptoms define it.
Alzheimers disease, on the other hand, is the main cause of dementia. This degenerative and irreversible condition targets the brain as it damages the brain cells that affect a persons memory, behavior, thought process, and even wake/sleep cycle.
So simply put, all Alzheimers patients have dementia, but not all patients with dementia have Alzheimers.
What Happens In Alzheimers Disease
Scientists believe that Alzheimer’s disease may be caused by an abnormal buildup of proteins: beta-amyloid and tau. Beta-amyloid buildup forms plaques around brain cells. Tau deposits form twisted fibers called tangles within brain cells. As these proteins accumulate in and around the brain cells, the brain starts to lose its ability to function properly, this leads to loss of brain tissue, and eventually, the brain dies. The tissue damage also causes the affected parts of the brain to shrink.
Initially plaques and tangles damage parts of the brain that control memory, thought, and language. Later they spread and damage other parts of the brain.
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Tau: A Direct Driver Of Cognitive Decline
In the study, Dr. Grinberg and the team analyzed the brains of 13 deceased people who had Alzheimers disease, as well as those of seven deceased individuals who had not experienced clinical neurodegeneration. The researchers obtained these samples from UCSFs Neurodegenerative Disease Brain Bank.
The team found that, in comparison with healthy brains, those affected by Alzheimers disease had a high level of tau across three regions that are key to staying awake, namely the locus coeruleus, the lateral hypothalamic area, and the tuberomammillary nucleus. Not only this, but these regions had actually lost 75% of their neurons.
Its remarkable because its not just a single brain nucleus thats degenerating, but the whole wakefulness-promoting network, notes the studys lead author, Jun Oh.
Crucially, this means that the brain has no way to compensate because all of these functionally related cell types are being destroyed at the same time, Oh explains.
For further clarification, the researchers went on to conduct a postmortem analysis of brain samples from seven people who had progressive supranuclear palsy and corticobasal disease. These are two forms of dementia that are characterized specifically by the overaccumulation of tau protein.
In these samples, the scientists did not find the same loss of neurons in areas connected with states of wakefulness, which suggests that this destructive loss may only occur in Alzheimers disease.
Is It Normal For Those With Dementia Sleep Alot During The Day
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.
The later stages of dementia
The later stages of dementia can be a challenging time both for the person experiencing dementia and for those close to them.
Some medications may contribute to sleepiness. These include some anti psychotics, 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.
What should I do if a person with dementia is sleeping a lot?
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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
- Incontinence
- 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.
What To Do If Alzheimers Patients Sleep A Lot
This idea of patients sleeping a lot and not performing any activity or physiologic need like eating, drinking, and speaking may alarm both caregivers and relatives. It is understandable to panic or be concerned, especially if you have known these people to have been active most of their lives.
If the patient sleeps a lot but is easily woken if they need to eat or drink their medications, there is no need to get concerned as of the moment, this is just a normal symptom of their disease and we could expect this to get worse over time. Just try and allow him to follow an everyday routine so he can grow accustomed to what he needs to do at a certain time. You can also a good tip to turn off all the lights at night so the patients brain gets triggered to sleep.
If the patient chooses to sleep all through the day and this could pose harm to his condition since he would rather snooze than eat or drink, then you must ask his doctor about what steps to take so he does not compromise his health because of his diseases symptom.
Please visit Sleep Clinic Melbourne today if you experience these issues. Click on the link to visit their site.
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Sleep Aids: Medications Melatonin And Dementia
In some cases, the doctor may prescribe medications to help your loved one sleep. However, older adults with cognitive impairment are more likely to experience side effects from sleep-inducing drugs, so those medications arent usually recommended for long-term use.
Some studies show melatonin may improve sleep in people with mild to moderate dementia. It may also help reduce agitation and confusion late in the day. Check with your loved ones doctor before starting any over-the-counter supplements or sleep aids.
Difficulty Forming The Words To Speak
When people who used to be fluent and could speak smoothly stop being able to produce language that way, this may be a sign of dementia, says Rankin. Despite this symptom, patients are often crystal clear in other areas. They can run a business, manage their family, or draw beautifully, but they have increased difficulty actually forming the words to speak.
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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.
Symptoms Specific To Vascular Dementia
Vascular dementia is the second most common cause of dementia, after Alzheimer’s. Some people have both vascular dementia and Alzheimer’s disease, often called “mixed dementia”.
Symptoms of vascular dementia are similar to Alzheimer’s disease, although memory loss may not be as obvious in the early stages.
Symptoms can sometimes develop suddenly and quickly get worse, but they can also develop gradually over many months or years.
Specific symptoms can include:
- stroke-like symptoms: including muscle weakness or temporary paralysis on one side of the body
- movement problems difficulty walking or a change in the way a person walks
- thinking problems having difficulty with attention, planning and reasoning
- mood changes depression and a tendency to become more emotional
Read more about vascular dementia.
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Does Quality Of Sleep Matter For People With Dementia
The quality of a person’s sleep gradually deteriorates as they get older. They tend to get less deep or slow-wave sleep, which helps to keep the brain healthy and refreshed.
Even though a person with dementia may end up sleeping more than a typical person of their age even as much as 1415 hours a day it is unlikely to all be good quality sleep.
Sleeping a lot can also be influenced by peoples sleeping patterns before they had dementia, as some people need more sleep than others.
Sleeping For Longer May Be An Early Sign Of Dementia
22 February 2017
Neurology: Prolonged sleep duration as a marker of early neurodegeneration predicting incident dementia
A new study by researchers in the US has suggested that a shift towards longer periods of sleep may indicate the early stages of dementia. The results are published today in the journal Neurology.
The Framingham Heart Study is a large population study that has been following a group of people and their children since 1948, producing a wealth of information about heart disease and other conditions. In this new study, the researchers looked at the existing data to understand how sleep could be linked with dementia. They looked at the self-reported sleep duration of 2,457 people in the study, to see whether variation in how long people sleep for was associated with variation in the risk of developing dementia.
The researchers looked back at how many hours of sleep participants thought they had in a day and how this changed between two points, 13 years apart. Ten years after these sleep assessments, the researchers looked to see who had developed dementia. Over the 10 years of follow up, 234 people in the study developed dementia, of which 181 were diagnosed with Alzheimers disease.
Dr Rosa Sancho, Head of Research at Alzheimers Research UK, said:
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My Mum Suffers From Dementia And Excessive Sleep She Sleeps During The Day And Sleeps Very Little At Night Is It Ok To Let Her Sleep All Day
If possible we recommend encouraging her to take fewer and shorter day time naps, at the same time and place if possible . Keeping to a routine full of activities can help keep her awake during the day, and work some way towards night-time sleep problems. Try regularly getting her up for short walks and maximise daylight in rooms. Sensitively wake her up if she does fall asleep outside of a routine nap time.
How Sleep May Help Decrease Risk Of Dementia
The new study is to draw a link between sleep quantity and quality and dementia, but it is one of the largest to do so, according to Stephanie Stahl, a sleep disorder specialist with Indiana University Health.
We know that getting insufficient sleep or getting poor quality sleep increases the risk of dementia, Stahl, who was not involved in the new research, told HuffPost. This is a larger scale study, so it definitely adds value to the evidence.
Researchers are still unraveling how exactly the sleep-and-dementia connection might come together, but they have several theories in mind.
During sleep, our brain is allowed to clear toxins and that includes beta- amyloid, Stahl said. Beta-amyloid is a brain protein that can clump together and is often a hallmark of Alzheimers disease.
Also, our sleep is really important for us to consolidate our memories, Stahl added. In addition, sleep disruption leads to inflammation and that can lead to clogging of the arteries, and that includes those arteries in the brain.
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Talk With A Senior Living Advisor
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As dementia progresses, sleep problems along with other difficult dementia symptoms tend to get worse. This may be a good time to evaluate whether you need additional support to help ensure your loved ones health and safety and your own. Learning what to expect at each stage of dementia can help you plan for adequate care.
Heres what you should know when caring for someone with dementia and sleep problems:
- Dont use physical restraints. Many people believe its best to restrain their loved ones in bed at night to prevent wandering. This may do more harm than good. Instead, if you have a bed with guard rails, raise the rails. This may help to deter them from climbing out of bed and wandering.
- Dont do it alone. Consider taking shifts with another family member or looking into respite care. Respite care, or short-term care, gives you a chance to take a break while providing a safe environment for your loved one.
- Reduce stimulation. To allow for a calming, soothing environment, avoid loud noises or a lot of activity during the evening and night.
- Prioritize your health and rest. Taking care of a loved one with dementia and sleep problems may take a toll on your own mental health. Consider getting help from family members or exploring other care options, such as memory care, which provides 24-hour specialized care for people with memory loss.
Eating Nonfood Objects And Rancid Foods
One surprising early sign of dementia is eating nonfood objects or foods that are rancid or spoiled. This is partly because the person forgets what to do with the things in front of them. For example, dementia patients might try to eat the flower in a vase on a restaurant table because they know they are there to eat, but dont know what the flower is doing there, says Rankin. Unlike some other Alzheimers symptoms or dementia symptoms, this one has few other likely explanations.
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