Stage : Moderate Decline
During this period, the problems in thinking and reasoning that you noticed in stage 3 get more obvious, and new issues appear. Your friend or family member might:
- Forget details about themselves
- Have trouble putting the right date and amount on a check
- Forget what month or season it is
- Have trouble cooking meals or even ordering from a menu
- Struggle to use the telephone
- Not understand what is said to them
- Struggle to do tasks with multiple steps like cleaning the house.
You can help with everyday chores and their safety. Make sure they aren’t driving anymore, and that no one tries to take advantage of them financially.
Stage : Very Mild Cognitive Decline
Individuals may feel as if they have memory lapses, especially in forgetting familiar words or names or the location of keys, eyeglasses or other everyday objects. But these problems are not evident during a medical examination or apparent to friends, family, or co-workers.
- Word- or name-finding problems noticeable to family or close associates
- Performance issues in social or work settings noticeable to family, friends or co-workers
- Reading a passage and retaining little material
- Losing or misplacing a valuable object
How Long Will A Person With Dementia Live For
Whatever type of dementia a person has, their life expectancy is on average lower. This is why dementia is called a life-limiting condition. This can be very upsetting to think about.
However, its important to remember that, no matter how a persons dementia changes over time, there are ways to live well with the condition.
Good support can make a huge difference to the persons quality of life at all stages of dementia.
How long a person lives with dementia varies greatly from person to person. It depends on many factors, such as the ones listed on The progression and stages of dementia page.
Other factors include:
- how far dementia had progressed when the person was diagnosed
- what other serious health conditions the person with dementia has such as diabetes, cancer, or heart problems
- how old the person was when their symptoms started older people are more likely than younger people to have other health conditions that may lower their life expectancy. A person in their 90s who is diagnosed with dementia is more likely to die from other health problems before they reach the later stages than is a person diagnosed in their 70s.
How To Cope With The Late Stages Of Alzheimer’s Disease
However, in late-stage Alzheimer’s disease, the disease begins to considerably affect parts of the brain that control bodily systems, such as motor coordination, bowel, and bladder function, and even breathing. The late stage of Alzheimer’s usually requires rigorous, around-the-clock care, and it can last from several weeks to several years.
What Are The Average Life Expectancy Figures For The Most Common Types Of Dementia
The average life expectancy figures for the most common types of dementia are as follows:
- Alzheimers disease around eight to 10 years. Life expectancy is less if the person is diagnosed in their 80s or 90s. A few people with Alzheimers live for longer, sometimes for 15 or even 20 years.
- Vascular dementia around five years. This is lower than the average for Alzheimers mostly because someone with vascular dementia is more likely to die from a stroke or heart attack than from the dementia itself.
- Dementia with Lewy bodies about six years. This is slightly less than the average for Alzheimers disease. The physical symptoms of DLB increase a persons risk of falls and infections.
- Frontotemporal dementia about six to eight years. If a person has FTD mixed with motor neurone disease a movement disorder, their dementia tends to progress much quicker. Life expectancy for people who have both conditions is on average about two to three years after diagnosis.
To find out about the support available to someone at the end of their life, and to their carers, family and friends, see our End of life care information.
You can also call Alzheimers Society on 0333 150 3456 for personalised advice and support on living well with dementia, at any stage.
Dementia Connect support line
- Page last reviewed:
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How To Ensure The Person Eats Well
In the later stages of Alzheimers disease, many people lose interest in food and caregivers may notice changes in how or when they eat. They may not be aware of mealtimes, know when they’ve had enough food, or remember to cook. If they are not eating enough different kinds of foods, they may not be getting the nutrients they need to stay healthy.
Here are some suggestions to help a person with late-stage Alzheimer’s eat better. Remember that these are just tipstry different things and see what works best for the person:
- Serve bigger portions at breakfast because it’s the first meal of the day.
- Offer several smaller meals throughout the day.
- Serve meals at the same time each day.
- Make the eating area quiet. Turn off the TV or radio.
- Control between-meal snacks. Lock the refrigerator door and food cabinets if necessary.
- If the person has dentures, make sure they fit. Loose dentures or dentures with bumps or cracks may cause choking or pain, making it harder to eat. Remove poorly fitting dentures until the person can get some that fit.
- Let the person’s doctor know if they lose a lot of weight, for example, if he or she loses 10 pounds in a month.
You can also try different ways of preparing the person’s plate. For example:
If the person needs help eating, you might try to:
When choosing foods to eat and liquids to drink, these suggestions might help:
Facts About Alzheimer Disease
Alzheimer disease is becoming more common as the general population gets older and lives longer. Alzheimer disease usually affects people older than 65. A small number of people have early-onset Alzheimer disease, which starts when they are in their 30s or 40s.
People live for an average of 8 years after their symptoms appear. But the disease can progress quickly in some people and slowly in others. Some people live as long as 20 years with the disease.
No one knows what causes Alzheimer disease. Genes, environment, lifestyle, and overall health may all play a role.
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Distribute Advance Directive Documents
Give copies of the documents to family members, physicians and other heath care providers. Have advance directives placed in the medical records of the person with AD. If he or she is transferred to a different care setting, such as a residential care facility or hospital make sure the staff has copies as well.
Mild Alzheimers Or Moderate Decline
Stage 4 lasts about two years and marks the beginning of diagnosable Alzheimers disease. You or your loved one will have more trouble with complex but everyday tasks. Mood changes such as withdrawal and denial are more evident. Decreased emotional response is also frequent, especially in a challenging situation.
New signs of decline that appear in stage 4 may include:
- losing memory of personal history
- trouble with handling finances and bills
- inability to count backward from 100 by 7s
A clinician will also look for a decline in areas mentioned in stage 3, but theres often no change since then.
Caregiver support: Itll still be possible for someone to recall weather conditions, important events, and addresses. But they may ask for help with other tasks such as writing checks, ordering food, and buying groceries.
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If They Can No Longer Make Informed Decisions:
If your loved one is no longer able to make informed decisions for themselves, it is up to you and the rest of their family to act in their best interests. Whenever possible, prioritize their wishesif they are knownfirst and foremost. In any cases where your loved one did not specify a course of action, be sure to consider their cultural background, religious beliefs, family values, and anything else you know about them that can provide clues to what they would want to be done.
Do not feel that you have to make these decisions alone. Rely on professional advice whenever plausibleask doctors and nurses what they recommend, and ask attorneys or financial planners for help with paperwork. Consider holding a family meeting to discuss what should be done and make a plan together. If family members disagree strongly about your loved ones wishes, social services or mediation services may be helpful in resolving conflict.
How Does Dementia Reduce Life Expectancy
Dementia reduces life expectancy in two ways.
First, some of the diseases that are closely linked to Alzheimers disease and vascular dementia, such as diabetes and cardiovascular disease can mean a lower life expectancy. For example, vascular dementia is closely linked to heart disease and stroke. A person with vascular dementia is at risk of dying at any stage of dementia, from one of these.
The other way that dementia reduces life expectancy is through the effects of severe disease.
These all make them much more likely to develop other medical problems that can lead to death, such as infections or cardiovascular problems .
This is why the later stage of dementia is often the shortest.
A person with dementia can also die at any stage from another condition not closely related to their dementia. Cancer and lung disease are common examples.
Navigating The Last Stages Of Alzheimers
Perhaps your mother has just received her diagnosis, after weeks of feeling unusually forgetful and foggy-minded. Or perhaps your husband has been living with it for years and youve begun to notice his symptoms worsening, his strength fading and his ability to speak slowly reducing down to a handful of random words and disjointed phrases. No matter where you are in the Alzheimers journey, its never an easy path to walk. But looking ahead, difficult though it may be, can help give you clarity.
Knowing what to expect from the last stages of Alzheimersand especially understanding how to recognize when your loved one has reached that part of the journeyis an important step. It helps you prepare for whats to come so that youll be better equipped to handle it. And settling your loved ones end-of-life arrangements ahead of time can help give you direction and ease your burden of responsibility when grief may be at its most poignant.
Stage : No Impairment
Since Alzheimer’s is a silent disease that creeps up on someone, it begins with no symptoms of impairment. Even if your loved one is in the early stages of Alzheimer’s, there might be no symptoms. However, only a brain imaging test and professional diagnosis can reveal if the individual has Alzheimer’s.
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Skilled Nursing Facility Care
Medicare will also pay for up to 100 days in a skilled nursing facility. The first 20 days are fully covered, but for days 21 through 100, a $105 daily co-payment is required. This co-payment may be covered by Medigap insurance. The patient must have been hospitalized for at least 3 days prior to entering the skilled nursing facility, and generally, must be admitted to the facility within 30 days after leaving the hospital.
Understanding When Less Aggressive Treatment Is Appropriate
Families of Alzheimer’s patients face enormous pressure to use all available medical technology to keep the person with AD alive, in many cases, causing them to make decisions that may not be the expressed wishes of or in the best interests of the patient. Many people with dementia may express wishes ahead of time not to be kept alive artificially.
On July 5, 2000, Dr. R. Sean Morrison and Dr. Albert L. Siu of the Mount Sinai School of Medicine in New York published a report in the Journal of the American Medical Association stating that patients with advanced dementia were much more likely to die within six months of pneumonia or a hip facture than those patients who were mentally intact who got equal care. Dr. Morrison said, “These are people with a terminal diagnosis, but physicians and families focus on the acute illness and ignore that this is occurring in the setting of a terminal illness with an average survival of six months.”
Persons with late-stage Alzheimer’s disease frequently develop eating and swallowing difficulties and lose weight. When a person refuses or is no longer able to eat or drink, decisions may need to be made about artificial nutrition and hydration.
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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.
What You Can Do For Your Loved One
As an individual with dementia declines, you can help them by providing a loving and supportive presence. Sit with them. Hold their hand. Play music they enjoy.
One of the greatest gifts you can give your loved one is helping to get their affairs in order. Ensure that financial and healthcare powers of attorney are put in place, so you can make decisions when your loved one is no longer able. Look into funeral arrangements before you need them, so you dont need to make important decisions in a time of crisis.
Talk to your loved ones physician about the possibility of palliative care support in the home and hospice care when your loved one is ready.
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Very Mild Impairment Or Normal Forgetfulness
Alzheimers disease affects mainly older adults, over the age of 65 years. At this age, its common to have slight functional difficulties like forgetfulness.
But for stage 2 Alzheimers, the decline will happen at a greater rate than similarly aged people without Alzheimers. For example, they 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.
What You Can Do To Help
You can help your loved ones regardless of the Alzheimer’s stage. As soon as you notice any symptoms, keep an eye on them before the stages progress further. The earlier you notice the signs, the sooner you can help them in the process. Dealing with Alzheimer’s can be very tough on people who live with it. However, you can assist them throughout all stages and make the journey simpler for them.
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Mild Impairment Or Decline
The symptoms of Alzheimers are less clear during stage 3. While the entire stage lasts about seven years, the symptoms will slowly become clearer over a period of two to four years. Only people close to someone in this stage may notice the signs. Work quality will decline, and they may have trouble learning new skills.
Other examples of stage 3 signs include:
- getting lost even when traveling a familiar route
- finding it hard to remember the right words or names
- being unable to remember what you just read
- not remembering new names or people
- misplacing or losing a valuable object
Your doctor or clinician may also have to conduct a more intense interview than usual to discover cases of memory loss.
Caregiver support: At this stage, someone with Alzheimers may need counseling, especially if they have complex job responsibilities. They may experience mild to moderate anxiety and denial.
Preclinical Alzheimers Or No Impairment
You may only know about your risk for Alzheimers disease due to family history. Or your doctor may identify biomarkers that indicate your risk.
Your doctor will interview you about memory problems, if youre at risk for Alzheimers. But there will be no noticeable symptoms during the first stage, which can last for years or decades.
Caregiver support: Someone in this stage is fully independent. They may not even know they have the disease.
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Weigh The Burdens And Benefits Of Treatments
Talk with the medical care team about the burdens and benefits of using or refusing care treatments. Find out if the treatment will improve the person’s condition or comfort and for how long, and if it will pose excessive physical or psychological burdens. Compare any recommended treatments with the person’s wishes for end-of-life care.
Stage : Normal Outward Behavior
Alzheimerâs disease usually starts silently, with brain changes that begin years before anyone notices a problem. When your loved one is in this early phase, they won’t have any symptoms that you can spot. Only a PET scan, an imaging test that shows how the brain is working, can reveal whether they have Alzheimer’s.
As they move into the next six stages, your friend or relative with Alzheimer’s will see more and more changes in their thinking and reasoning.
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Dental Skin And Foot Problems
Dental, skin, and foot problems may take place in early and moderate stages of Alzheimer’s disease, but most often happen during late-stage Alzheimer’s disease.
Dental problems. As Alzheimer’s disease symptoms worsen, people will need help taking care of their teeth or dentures. Brushing and flossing help to maintain oral health and reduce bacteria in the mouth, which may decrease the risk of pneumonia.
Make sure the person’s teeth and teeth surfaces are gently brushed at least twice a day with fluoride toothpaste. The last brushing session should take place after the evening meal or after any medication is given at night. You may find that using a child’s size toothbrush is easier for the person.It is also best to floss once per day, if possible. If this is distressing to the person, an interdental brush, which is a small brush designed to clean between the teeth. Try to check the person’s mouth for any problems such as:
- Food “pocketed” in the cheek or on the roof of the mouth
Be sure to take the person for regular dental checkups for as long as possible. Some people need medicine to calm them before they can see the dentist. Calling the dentist beforehand to discuss potential sensitivities may also be helpful.
Skin problems. Once the person stops walking or stays in one position too long, he or she may get skin or pressure sores. To prevent them, you can:
To check for pressure sores: