Help And Advice For Carers
If you;care for someone with dementia, you may find it helpful to read more about:
Carer’s breaks and respite care;;this can allow you to take breaks from caring
Benefits for carers; such as allowances and tax credits that may be available
Page last reviewed: 05 March 2020 Next review due: 05 March 2023
What Are The Signs That Someone With Dementia Is Dying
It is difficult to know when a person with dementia is coming to the end of their life. ;However, there are some symptoms that may indicate the person is at the end of their life including:
- limited speech
- needing help with everyday activities
- eating less and swallowing difficulties
- incontinence and becoming bed bound.
When these are combined with frailty, recurrent infections and/or pressure ulcers, the person is likely to be nearing the end of their life. If the person has another life limiting condition , their condition is likely to worsen in a more predictable way.
When a person gets to within a few days or hours of dying, further changes are common. These include:
- deteriorating more quickly
- irregular breathing
- cold hands and feet.
These are part of the dying process, and its important to be aware of them so that you can help family and friends understand what is happening.
When a person with dementia is at the end of life its important to support the person to be as comfortable as possible until they die
For more information, see our page, Signs that someone is in their last days or hours.
Dementia Is A Terminal Illness Study
In the first study to rigorously describe the clinical course of advanced dementia, a leading cause of death among Americans, researchers in the US concluded that dementia is a terminal illness and is insufficiently recognized as such, resulting in many patients not receiving the palliative care that aims to improve the comfort of the terminally ill.
The study was the work of lead author Dr Susan L Mitchell and colleagues and is published online in the 15 October issue of the New England Journal of Medicine, NEJM. Mitchell a senior scientist at the Institute for Aging Research of Hebrew SeniorLife, an affiliate of Harvard Medical School in Boston, Massachusetts, where she is also Associate Professor of Medicine.
Today there are more than 5 million Americans living with dementia, and this number is expected to treble over the next 40 years, with worldwide numbers rising to more than 35 million by 2050, according to a recent study by Alzheimers Disease International.
People with dementia, of which the most common form is Alzheimers disease, have trouble with daily living: they suffer from memory loss, find it difficult to communicate, their personality changes, and they cant reason or make decisions.
Mitchell told the press that:
They hope their findings stress the need to improve the quality of end of life care in nursing homes to relieve the suffering of patients with advanced dementia and improve communication with their family members.
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Caregiving In The Early Stages
Although most of your loved ones immediate medical needs can be managed on their own in the early stages, you may need to assist with tasks associated with memory or problem-solving. You may need to remind them of their doctors appointments and to set up the next appointment, along with taking their medications on time and getting refills as needed. You may need to assist them in managing their finances and keeping up with social and work obligations. At times, they may also need help remembering places, people, words, and names. In the early stages, you will want to encourage them to:
- Maintain their independence
- Establish a routine to delay the disease from worsening
Treatments For Vascular Dementia
There’s currently;no cure for vascular dementia and there’s no way to reverse any loss of brain cells that happened before;the condition;was diagnosed.
But treatment can sometimes help slow down vascular dementia.
Treatment aims to tackle the underlying cause, which;may reduce the speed at which brain cells are lost.
This will often involve:
- taking medicines, such as those used to treat high blood pressure, lower cholesterol;or prevent;blood clots
Other treatments,;including physiotherapy, occupational therapy, dementia activities and;psychological therapies,;can;help reduce the impact of any existing problems.
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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.
Ds1500 Form For Terminal Illness
Leswi said:Anybody come across this before? Mum is considered to be on end of life care and we are keeping her at home. Today GP said he will complete this form which will be a weekly benefit to help pay towards care. I have read somewhere that this automatically makes care at home free. We were going through CHC process but wonder I f this is necessary now? Been fighting for couple more care visits so hopefully this paperwork will change things. We are not self funding.
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Caring For A Person With Late
If you are caring at home for someone who is in the later stages of dementia the Aged Care Assessment Team can help with advice and referrals for all aspects of care. You can contact your nearest ACAT by calling the number listed in the Age Page of your telephone directory. Your doctor or hospital can also help you to contact your local ACAT.;
How Might Dementia Affect People Towards The End Of Life
Dementia is progressive, which means it gets worse over time. In the last year of life, its likely to have a big impact on the persons abilities including memory, communication and everyday activities. The speed at which someone will get worse will depend on the type of dementia they have and who they are as an individual.;
The symptoms of later stage dementia include the following:
A person with later stage dementia often deteriorates slowly over many months. They gradually become more frail, and will need more help with everyday activities such as eating, dressing, washing and using the toilet. People may experience weight loss, as swallowing and chewing become more difficult.;
A person with later-stage dementia may also have symptoms that suggest they are close to death, but continue to live with these symptoms for many months. This can make it difficult for the person and their family to plan for the end of life. It also makes it difficult for those supporting them professionally.;
For more information on supporting someone with later stage dementia see Alzheimers Society factsheet, The later stages of dementia ;.
Also Check: What Is Vascular Dementia Life Expectancy
Plagues And Tangles To Cause Dementia
Doctors believe that tangles and plagues are two abnormal structures, which mainly cause damage to the nerve cells present in the human brain. Plaques refer to deposits of a protein fragment named beta-amyloid that causes formation of spaces in between different nerve cells. On the other side, tangles constitute twisted fibers of another type of protein named tau that forms within the cells. Thus, with the passage of time, the patients suffering from dementia problem suffer relatively higher damages in their brain and fail to work in a proper or in a regular way, as before.
What Are Vascular Dementia Symptoms
The symptoms of vascular dementia may vary. It will totally depend on the part of the brain that does not receive enough blood. These symptoms may sometimes overlap with other types of dementia.
Several studies report that many people with cognitive deficits directly correlated to vascular dementia also have Alzheimers disease. Vascular cognitive impairment is the hallmark of this disease.
Among the most common symptoms, we can find the following:
- Confusion
- Reduced ability to concentrate and to organize thoughts
- Inability to analyze daily life situations;
- Restlessness and agitation
- The slower speed of thought
- Slurry speech
- Depression or apathy
The presentation of these symptoms may be very variable. They can go on noticeable steps, or they can progress gradually. There is no certainty with this disease as it can overlap with other degenerative diseases of the brain.
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Life Expectancy And Vascular Dementia
Repeated small strokes can damage the brain and cause vascular dementia. Its the second most common cause of the disease. The pattern of disease progression is different from the gradual deterioration of Alzheimers disease. The symptoms may be steady for a while, then suddenly get worse followed by a further period of stability. This reflects times when blood clots interrupt the blood supply to the brain, causing damage.
Because people with vascular dementia is linked to strokes, people affected often have other illnesses and may have worse general health. Research suggests that the average life expectancy is around four years. However, sudden or severe deterioration can happen when there is a further stroke.
Stage : Second Last Stage Middle Vascular Dementia
Individuals in this severe stage begin to lose memory and usually recollect things happened and things they did in their past. They become more delusional and even cannot remember close friends and family members names. Some bodily changes also turn up including incontinence, difficulty with muscle and motor functions and difficulty with controlling bladder flow. They need assistance to do daily activities and finish tasks. These signs and symptoms are enough to diagnose middle vascular dementia.
Weight loss: Almost all of the people with vascular dementia lose weight in the later stages of this disorder, although sometimes some people eat so much and put on weight. In fact, weight loss can affect their immune system, making the people fight infections more difficultly. It can also increase the possibility of falling. Ensure that they consume enough food and water. They can need encouragement with drinking and eating. Besides, problems with swallowing and chewing are common as their muscles no longer work properly.
Problems with continence: Many people cannot control their bladder and bowels. This can occur most or all of the time.
This is also a stage one on the list of vascular dementia stages that people should not miss out but consider changing their lifestyles to prevent themselves from getting this disorder.
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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.
Does Vascular Dementia Affect Eyesight
People with dementia can have visual difficulties caused by the brain but still have healthy eyes. That is problems perceiving what they see rather than how sharply they see it. Dementias that may have a direct impact on vision are: Lewy Body, Posterior Cortical Atrophy, Alzheimers and Vascular Dementia.
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Place Of Care In The Last Phase Of Life
In developing palliative care for people with advanced dementia, it is important to consider circumstances of care such as place of care or where the person dies. The majority of people with early stage dementia live at home with family members caring for them. Approximately one third of people with dementia are cared for in nursing homes . A survey identified dementia in 68% of nursing home residents with only slightly more than half having recorded diagnosis and with more than half suffering from advanced dementia . People in the advanced stages of dementia spend most of their time in nursing homes . The likelihood of nursing home admission increases with age and severity of behavioural symptoms high burden of family carers is also associated with nursing home admission . People with migration background are less often cared for in nursing homes .
Stage : Mid Stage Semi Severe Vascular Dementia
Another one on the list of the vascular dementia stages that I would like to reveal in this article today and want you and my other readers to know if you are considering whether they get this disorder or not.
Loss of mobility: Many people gradually lose the ability of walking and performing everyday tasks. One of the first signs is that they walk unsteadily. They can also seem slower, bump into things and fall objects. Some people even become confined to a chair or bed. People who are caring for people with vascular dementia should ask for an advice from a community nurse or a therapist to aid mobility.
Memory loss: This symptom is very severe in the stages of vascular dementia. Patients may not be able to recognize other people who are close to them and even their own reflection. Also, they may not be able to find their way home around familiar surroundings or identify objects they use every day. However, occasionally, they may experience sudden flashes of recognition. They may believe that they are in a time from their past and may look for something or somebody from that time. For those around them, it may be helpful to try talking with them about the past. Even when they have severe memory loss, they still can appreciate or respond to music, touch and scent. Thus, continue to talk to them, even when they cannot respond.
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Caregiving In The Late Stages
According to the Alzheimers Association, the later stages will be the most difficult, as your loved one is now very frail and relies on you for most of their daily care. At this late stage, encouraging your loved one to eat and sleep will grow increasingly difficult. During this time, they may lose the ability to walk steadily, so an occupational therapist may help them stay mobile without falling. Gather a team of experts to help you, like a speech therapist to help with communication and a nutritionist to recommend the best food and alternative food options, like blended meals, smoothies, and finger foods, that boost the immunity and are packed with nutrition. Incontinence, severe memory loss and disorientation, immune system problems, repetitive movements, and strange or unusual behavior must all be managed during this stage as well.
Watching a loved one live with dementia is never easy. With the proper tools, you can help them navigate their symptoms to live an enriching life. Staying on top of the latest research with Google alerts and attending seminars from expert speakers and medical professionals will keep you up-to-date on new treatments and care techniques. Most importantly, find a supportive community. There are many support groups for caregivers where you can share your successes, frustrations, fears, and joys with other caregivers. Remember, you are not alone!
Early And Middle Stages Of Vascular Dementia
Some symptoms may be similar to those of other types of dementia. Memory loss is common in the early stages of Alzheimer’s, but is not usually the main early symptom of vascular dementia.
The most common cognitive symptoms in the early stages of vascular dementia are:
- problems with planning or organising, making decisions or solving problems
- difficulties following a series of steps
- slower speed of thought
- problems concentrating, including short periods of sudden confusion.
A person in the early stages of vascular dementia may also have difficulties with:
- memory – problems recalling recent events
- language – eg speech may become less fluent
- visuospatial skills – problems perceiving objects in three dimensions.
As well as these cognitive symptoms, it is common for someone with early vascular dementia to experience mood changes, such as apathy, depression or anxiety. Depression is common, partly because people with vascular dementia may be aware of the difficulties the condition is causing. A person with vascular dementia may also become generally more emotional. They may be prone to rapid mood swings and being unusually tearful or happy.
Need advice on managing behaviour changes?
Read our top tips for managing and reducing out of character behaviour.;
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Can Dementia Get Worse Suddenly
Dementia is a progressive condition, meaning that it gets worse over time. The speed of deterioration differs between individuals. Age, general health and the underlying disease causing brain damage will all affect the pattern of progression. However, for some people the decline can be sudden and rapid.
Tips For Managing Dementia End
Because individuals with advanced dementia will often have difficulty communicating, it is important that caregivers keep a close eye on their loved one for signs of pain or discomfort. These signs may include moaning or yelling, restlessness or an inability to sleep, grimacing, or sweating. This may also signal that its time to call hospice or a palliative care team to help with the pain management.
If an individual with end-stage dementia is having trouble sitting up without assistance, hospice can provide a hospital bed or other equipment to lift their head.
Perhaps the hardest thing for families is when a loved one with dementia is no longer able to eat or swallow. Because an individual with dementia is unable to understand the benefits of feeding tubes or IV drips, they will often be incredibly distressed and attempt to remove them, causing added pain and risk of infection. Instead, focusing on keeping the individual comfortable. Supporting them with mouth care to prevent their mouth from becoming dry will allow them to make their final transition in peace.
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