Senior Care Home Services
Agencies that provide in home care for seniors are another frequently overlooked resource. They are staffed by professional caregivers, trained to work with older adults. Though not qualified to give medical aid, they can assist with the daily activities of living, such as grooming, bathing, and eating. Like friends and family, they save you time, reduce stress, and help avoid injury when moving or turning the patient. Flexible, affordable, and reliable, you can call on them for almost any type of personal care.
Beyond Memory Loss: How To Handle The Other Symptoms Of Alzheimer’s
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.
#TomorrowsDiscoveries: From Dysfunctional Cells to Disease Dr. Rong Li
Dr. Li and her team investigate how cells consolidate their damaged proteins and prevent them from spreading freely, in order to understand how to better treat diseases such as Alzheimers and ALS. Another of their interests is how chromosomes are divided up when one cell becomes two. Learning more about how the process can go wrong could lend insight into cancer development.
What Are Final Stage Care Options For Alzheimers
Caring for someone with Alzheimers can be a monumental task. Home care may not be sufficient even with additional assistance.
Some areas that need utmost care include foods and fluids, bowel and bladder function, skin and body health, infections and pneumonia, and pain and illness.
Here are some things to keep in mind:
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Very Mild Impairment Or Common Forgetfulness
Alzheimers disease mainly affects older adults over the age of 65. At this age, its common to have slight functional difficulties such as forgetfulness.
But for people with stage 2 Alzheimers, this decline will happen more quickly than it will for similarly aged people without Alzheimers. For example, a person may forget familiar words, a family members name, or where they placed something.
Caregiver support: Symptoms at stage 2 wont interfere with work or social activities. Memory troubles are still very mild and may not be apparent to friends and family.
Do Hallucinations Go Away With Lewy Body Dementia
There’s currently no cure for dementia with Lewy bodies or any treatment that will slow it down. But there are treatments that can help control some of the symptoms, possibly for several years. Treatments include: medicines to reduce hallucinations, confusion, drowsiness, movement problems and disturbed sleep.
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Considering Cultural Spiritual Or Religious Beliefs And Practices At End Of Life
When a person is in the later stages of dementia and nearing the end of their life, their care should be based around how they are feeling, and any cultural, spiritual or religious beliefs and practices.
Everyone supporting the person should use their knowledge of the person and any advance care planning the person has put in place.
Power of attorney
Being Your Loved Ones Prosthetic Memory
A person-centered approach emphasizes a patients strength, resiliency and functionality rather than their deficits, or the state of their disease. This is something that caregivers and especially loved ones and family members can take into their own hands.
Knowing who that person is, and weaving that into everything you do how can that allow the person to function more because youre focusing on strengths rather than deficits, Fazio said.
One way to do that is to be a prosthetic memory for your loved one, Fazio said. Sharing old photographs, music, favorite foods or reading books they enjoyed could help you connect with people in ways other than verbally.
Its about realizing that just because the person cant communicate memories, it doesnt mean they dont know their memories, Fazio said. We dont really know whats going on in the brain. Lets assume they know everything, but theyve lost the ability to initiate that to us.
Learn more about end stage Alzheimers and the features of a person-centered approach here.
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What Happens In The End
At the start of end-stage dementia, you may notice an increase in hospital visits or possibly the diagnosis of other conditions such as cancer or congestive heart failure. In the final 2 to 3 months of the disease, common symptoms include:
- 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.
In the final days or weeks of dementia, the patient will need 24/7 care and will likely need assistance with any activities of daily living. Symptoms include:
- 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.
The patient will likely be unable to communicate and will be bedridden. For caregivers, it will be important to notice the signs associated with the final stage of dementia as they will need to prepare themselves or the family/loved ones of the patient for whats to come. The amount of care that the patient will need increases significantly during the end-stage and preparations should be made in advance.
How Are Decisions Made At End Of Life
Many people including health and social care professionals find it difficult to talk about these issues in advance. Often the persons next of kin assume that they automatically have the final say on decisions, if the person has lost the ability to make them. However, this is not the case.
If the person with dementia has previously had open discussions about their future decisions, wishes and preferences , it will be much easier to act on these when they are no longer able to decide for themselves. The person may have expressed these using one or more of the following:
- Advance decision to refuse treatment. This is a legally binding document.
- Advance statement of wishes . This is not legally binding, but it should be taken into account.
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Incontinence And Toilet Issues
Another example of end-stage dementia signs is toilet problems and incontinence. As the illness progresses, there is a possibility that the person will EXPERIENCE some accidents while trying to use the washroom.
It can be anything from the occasional urine or fecal leaks or a total loss of control when the person needs to use the toilet.
Many factors can cause this, such as:
- Forgetting where the facilities are or forgetting to visit the toilet in time
- Not recognizing the need to use the toilet
- Prostate gland issues, etc.
To avoid inconvenience, there are many incontinence products that patients with dementia can use.
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 is not 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 cannot 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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Common Symptoms And Complications Treatment Options
As the disease progresses people with dementia become more and more dependent on other persons for almost all daily activities, care and treatment, t suffering considerable limitations in the last year . As shown above people with advanced dementia suffer a range of complex needs and symptoms, and symptom burden is similar to people with cancer or frailty . People with advanced dementia rarely express their needs and burdensome symptoms spontaneously, relying on their caregiversâ sensitive perception and interpretations of their verbal and nonverbal signs.
Recognizing Approaching End Of Life
People with advanced dementia suffer from a number of distressing symptoms . In their last 12 months, nursing homes residents with dementia suffer most common from restrictions in mobility, pain, and sleeping disorder. Further frequent symptoms at the end-of-life could be identified problems with eating, trouble with breathing, apathy and anxiety. Contrary to this sleep disturbances, challenging behavior, agitation and depressive episodes occurred less frequently . Increases in distressing symptoms such as febrile infections and problems with eating and swallowing may be indicators for death in the next six months . Clinical complications such as respiratory infections are associated with highest symptom burden . Other results showed increased mortality coinciding with low body weight or low Body Mass Index . Prognostic assessment tools all include at least one criterion related to nutritional status, such as reduced appetite, inadequate food intake, malnutrition, or weight loss .
Physicians associated unexpected death with suffering and poor quality of life . Expecting death within the coming months showed positive effects on quality of end-of-life care. Prognosis estimation under six months was associated with fewer burdensome interventions in people with dementia . Among people with dementia explicitly expected to die a lower symptom burden was noticed and all of them received morphine .
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Palliative Care In Advanced Dementia
- 1Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
- 2Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf , Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
- 3Clinical Trials Center , Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
- 4Center for Health Services Research, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
Common Types Of Dementia
Most people who have dementia experience problems with cognitive skills, depression, indifference, and a lack of interest in doing things.
People with Lewy body dementia and Alzheimer’s disease may have similar early symptoms. Memory loss is common in both conditions, for example. Lewy body dementia also commonly causes fluctuations in arousal, hallucinations, sleep problems, and difficulty walking.
In contrast, people in the early stages of frontotemporal dementia usually don’t have memory problems. Instead, they might have obvious changes in personality and behavior.
Vascular dementia, which occurs as a result of having many strokes throughout the brain, can cause problems understanding concepts, emotional and personality changes, and memory problems. This type of dementia may accompany other types, making the decline more severe.
And chronic traumatic encephalopathy , which occurs after repeated head trauma, often begins to cause symptoms years after the traumatic brain injuries, with a significant progression of mood changes, personality changes, and a decline in memory and cognitive skills.
With Lewy body dementia, frontotemporal dementia, vascular dementia, and CTE, the memory problems may respond to cues/reminders, while in Alzheimer’s there is often a forgetting of recent events altogether.
In the final stage of all types of dementia, a person goes through a major decline in everyday functioning.
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Does The Type Of Dementia Affect Life Expectancy
The type of dementia a person has can also affect how long they live with dementia. These figures for the number of years a person may live after a diagnosis are just averages and some people live longer than this.
This information may be upsetting to read and think about but it is very important to remember that, with the right support, people with dementia can live well at all stages.
Preclinical Alzheimers Or No Impairment
You may only know about your risk of Alzheimers disease due to your family history. Or a doctor may identify biomarkers that indicate your risk.
If youre at risk of Alzheimers, a doctor will interview you about memory difficulties. 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.
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How Do You Deal With Lewy Body Hallucinations
Your doctor may use cholinesterase inhibitors, such as donepezil and rivastigmine, to treat the cognitive symptoms of Lewy body dementia. They can also be effective in treating visual hallucinations and other psychiatric symptoms. Levodopa may help with movement and rigidity in some people with LBD.
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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End Stage Alzheimers: What To Expect And How To Build Resiliency
Alzheimers disease can be a long haul, with some symptoms taking years and even decades to progress. By the time a patient is in end stage Alzheimers, however, the signs are clear. Theyve progressed to severe dementia, and will likely need around-the-clock care for physical and mental needs.
Reaching the end stage of the disease can be devastating. But experts and researchers are now exploring ways that resiliency, and a person-centered approach, can actually help people function better for longer in this final stage. Heres what to expect in end stage Alzheimers, and how experts hope new approaches can have a positive effect.
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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What Foods Are Bad For Dementia
The MIND diet specifically limits red meat, butter and margarine, cheese, pastries and sweets, and fried or fast food. You should have fewer than 4 servings a week of red meat, less than a tablespoon of butter a day, and less than a serving a week of each of the following: whole-fat cheese, fried food, and fast food.
What Are The Symptoms Of Dementia 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.
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Be Aware Of Their Eating And Drinking
The person may have lost their appetite or have difficulties swallowing safely. In the last days, the person may stop eating or drinking. This can be very distressing to watch, but it is normal for people approaching the end of life.
You should offer the person food and drink for as long as it is safe and they show an interest. Its important to keep the persons mouth comfortable provide sips of fluids and keep lips moist and clean.