Caregiving During The Middle Stages
As cognitive function begins to decline in a more obvious way, patients could show symptoms like:
Easily losing track of time or whereabouts
Withdrawing from family and friends
Being scared of being alone or in new places
If a patient is still living at home or is in an independent or assisted living community, you might consider the beginning steps of moving them to a memory care facility.
As a caregiver, you might recognize that the patient:
Needs more help completing daily tasks
Is becoming less independent and
Needs frequent reminders
While you search for a memory care facility, continue to provide love, support, and companionship as needed.
How To Care For Loved Ones With Dementia
Do you have a loved one with dementia?
If so, you might be wondering what you can do to provide the best care possible for them.
Each stage of dementia comes with different symptoms and therefore patients will have different needs as they progress through from early dementia where symptoms are mild, to late dementia where the symptoms are more severe.
What Are The Main Types Of Dementia
Alzheimers disease is the most common cause of dementia, accounting for around 2 out of every 3 of cases in older people. Vascular dementia is another common form, while dementia with Lewy bodies and frontotemporal dementia are less common.
It is possible to have more than one type of dementia at the same time. Alzheimers is sometimes seen with vascular dementia or dementia with Lewy bodies. You might hear this called mixed dementia.
The symptoms of dementia vary depending on the disease, or diseases, causing it. You can read more about the symptoms associated with different types of dementia on the Alzheimers Society website .
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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.
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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Stage : Mild Dementia
At this stage, individuals may start to become socially withdrawn and show changes in personality and mood. Denial of symptoms as a defense mechanism is commonly seen in stage 4. Behaviors to look for include:
- Difficulty remembering things about one’s personal history
- Difficulty recognizing faces and people
In stage 4 dementia, individuals have no trouble recognizing familiar faces or traveling to familiar locations. However, patients in this stage will often avoid challenging situations in order to hide symptoms or prevent stress or anxiety.
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.
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Stage : Very Severe Mental Decline/severe Dementia Quality Of Life: Very Severe Impact
Your loved one will not remember any of the past or recognize loved ones. He or she will have likely lost the ability to make healthcare decisions. You will need 24-hour care in the home for day-to-day activities. You may see your loved one:
- Lose the ability to speak, eat or swallow.
- Not be able to use the toilet or get dressed without help.
- Not be able to walk or sit without help.
- Loss of language skills throughout this stage
- Lose all bladder and bowel control.
- Loss of muscle control
The Seven Stages Of Dementia
One of the most difficult things to hear about dementia is that, in most cases, dementia is irreversible and incurable. However, with an early diagnosis and proper care, the progression of some forms of dementia can be managed and slowed down. The cognitive decline that accompanies dementia conditions does not happen all at once – the progression of dementia can be divided into seven distinct, identifiable stages.
Learning about the stages of dementia can help with identifying signs and symptoms early on, as well as assisting sufferers and caretakers in knowing what to expect in further stages. The earlier dementia is diagnosed, the sooner treatment can start.
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Medication And Its Side Effects
Many patients with Alzheimers Disease and other dementias take prescription drugs that can temporarily improve dementia symptoms. Although primarily prescribed for Alzheimers patients, cholinesterase inhibitors are sometimes prescribed for vascular Dementia, Lewey Body dementia, and Parkinsons Disease Dementia. These medications, including Aricept, Exelon, and Razadyne, work by boosting chemicals involved in memory and judgment. Memantine works by regulating glutamate activity and is only prescribed to Alzheimers patients.
Doctors may also prescribe medications to treat depression, sleep disturbances, agitation, hallucinations, and other medical problems. Some drugs prescribed for behavioral problems in dementia patients can have severe side effects and may increase confusion or present other problems.
Side effects of cholinesterase inhibitors include nausea, vomiting, diarrhea, slowed her rate, fainting, and sleep problems. Memantine can produce dizziness.
Caring For Dementia Patients
Many individuals in the earlier stagesof Dementia are able to maintain some of their own care. However, as Dementiaprogresses, you must make changes in the daily routine of your loved one. Forsome, transitioning to senior independent living is the answer. Thistype of care allows you or your loved one to live as independently as possibleyet get help with cooking and cleaning as well as bathing and other personalgrooming tasks.
Senior independent living is appropriate for those in the early stages of Dementia, as well as for some in the earlier middle stages. In the early stages, a caregiver can help with appointment reminders, names of people, developing a daily to-do list, and coping strategies to help the patient live as independently as possible. You should also develop a long-term care plan at this point.
During middle-stage dementia, patients need more help. At first, your loved one may only need a cue or a prompt, but eventually, hands-on assistance and additional services will be required during senior home care. As patients progress toward late-stage Dementia, they start losing the ability to communicate appropriately, become unable to drive, and eventually must have constant supervision as leaving the patient alone will be unsafe.
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Stage : Moderately Severe Cognitive Decline
Stage 5 is when your loved one is likely to need help with routine tasks, like dressing or bathing. They may require a home caregiver or to move to a memory care community. Other symptoms include:
- Memory loss of personal details and current events
- Reduced mental acuity and problem-solving ability
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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Request A Hospice Evaluation
The patients neurologist or personal physician may recommend hospice when the time is right. But as anyone who has faced a serious illness knows, patients and family members often must act as their own advocates to receive the care they need and deserve.
You, your loved one or your trusted physician may request an evaluation to see if hospice care for dementia is an appropriate option for care. Call 844.831.0028 to see how hospice can help.
Do Dementia Patients Tell The Truth
That happens because dementia prevents people from properly processing and retaining information. Plus, having short-term memory issues means they’ll probably soon forget the conversation, so it will come up again. Telling the truth each time forces them to experience fresh distress over and over again.
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The 7 Stages Of Dementia
Living with and understanding Dementia stages can be difficult. Here we offer a more clearly defined picture of the whole Dementia journey. What are the signs of Dementia to look out for in a loved one? And if you do spot these signals of Dementia, what actions can you take?
How Can Healthcare Professionals Help At This Stage
Healthcare professionals can explain these changes so you understand what is happening.
Healthcare professionals can also take steps to reduce the persons pain or distress, often using medication.
If the person cant swallow, then medication can be provided through patches on the skin, small injections or syringe pumps that provide a steady flow of medication through a small needle under the persons skin. Speak to a GP or another health professional about this.
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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.
You can use our My Learning form to reflect on how this page has helped with your continuing professional development.
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.
On this page:
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The Later Stage Of Dementia
People with later-stage dementia will eventually need full-time care and support with daily living and personal care, such as eating, washing and dressing. Whatever kind of dementia a person has, their life expectancy is on average lower.
The progression and stages of dementia
Dementia is a life-limiting condition and there is information about later-stage dementia and life expectancy on this page. Some people may find this upsetting and difficult to think about.
For more general information about the different stages of dementia, see The progression and stages of dementia page.
By the later stage of dementia, the condition will have a severe impact on most aspects of a persons life. The person will eventually need full-time care and support with daily living and personal care, such as eating, washing and dressing. This support can be provided by care at home but is more often given in a care home setting.
Symptoms of all kinds are likely to cause the person considerable difficulties in this stage, but altered perception and physical problems are often the most noticeable. By the late stage, the symptoms of all types of dementia become very similar.
The later stage of dementia tends to be the shortest. On average it lasts about one to two years.
Are you supporting a person with later-stage dementia?
Get practical advice and tips on supporting a person with later-stage dementia.
What Are The Seven Stages Of Dementia
Dementia is most often diagnosed using a global scale that assesses the varying stages of memory loss and the ability of the brain to function properly.
If youre wondering what are the 7 stages of vascular dementia?, or most other forms of dementia, there is a general way to find out.
This scale, the Global Deterioration Scale for Assessment of Primary Degenerative Dementia , identifies the seven stages of dementia and has proven to be the most useful test for specifically diagnosing Alzheimers disease. It can be helpful for other forms of dementia diagnoses as well.
If you or someone you love is suffering from dementia, you might consider moving them to an assisted living facility. Senior Services of America operates independent living, assisted living, and memory care communities in many locations.
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Where To Care For A Person In The Last Stages Of Dementia
When your loved one moves into the last stages of Dementia, you have a number of options for his or her care. The best time to decide about where they should spend the last months of their life should occur during the earlier stages when the patient can still participate in the decision. Moving dementia patients in the later stages can have significant challenges for both patients and caregivers. Dementia patients can receive support in the following settings:
Traditional home Your lovedone can continue to live in his or her own home as long as they receiveappropriate care services and the proper medical equipment is available for use
Assisted living The same asabove but in a building where the patient has a private appointment, and memorycare and other services are provided
Nursing home Onky appropriateif the patient has other accompanying health issues
Those experiencing late-stage Dementia often have more frequent hospital stays, but staying for a long time in a hospital setting is generally unfeasible. When dementia patients have entered the terminal phase of their lives, their caregivers can elect to obtain hospice services, either in the home or at a stand-alone hospice facility, to keep their loved ones as comfortable as possible.
Support Family And Loved Ones
It is vital that the persons family and loved ones are aware that the person may be in the last few days or hours of life. Share information in a gentle and sensitive manner, drawing on those staff who have the strongest relationships with the person and their family. Giving family members space to explore their feelings and concerns is a critical part of good end-of-life care.
Often, family and loved ones want to be present when the person dies. They should know that changes can happen suddenly and the person may die, for example, when they have just popped out of the room to use the bathroom.
Sometimes, family members may not want to be present at the death. Family and relatives should never feel that they should stay, but always give them the opportunity to stay and to be involved in care as they wish.
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