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What Are The Last Stages Of Vascular Dementia

Are There Any Treatments

Four Stages of Dementia: The Final Stage

There are treatments that can help with the symptoms of some forms of dementia for a period of time, but there are currently no treatments that slow, halt or reverse the changes in the brain caused by the diseases. There are currently no treatments specifically for vascular dementia or frontotemporal dementia.

In the case of vascular dementia, a doctor may prescribe medication to treat underlying cardiovascular risk factors like high blood pressure or diabetes. Physiotherapy, speech therapy or occupational therapy may be offered to help with speech or movement problems. Non-drug treatments such as cognitive therapies may be available and can help some people with dementia to manage their symptoms.

Alzheimer’s Society   has more information on treatments for dementia.

What Is The Final Stage Of Vascular Dementia

While there are no defined stages of vascular dementia, the disease does eventually end with death, explains the Alzheimer’s Association. As with other forms of dementia, vascular dementia shortens a person’s life expectancy. Research suggests that a person who develops dementia as a result of a stroke lives for three years on average. Cognitive changes occasionally improve as the brain reproduces new cells and blood vessels that establish new roles.

Vascular dementia, the result of conditions that limit blood flow to the brain, can range from mild to severe in its impact on thinking skills, notes the Alzheimer’s Association. Symptoms of vascular dementia that immediately follow a stroke may include a loss of vision, disorientation, confusion, and a difficulty speaking or understanding speech. Depending on where blood flow is reduced, memory loss may or may not occur. These symptoms often coincide with other notable signs of a stroke, such as headaches and paralysis on one side of the body.

The U.S. Food and Drug Administration has not approved any medications for treatment of vascular dementia, as of 2015. Treatment generally involves lessening the risk factors for further damage to the brain’s blood vessels, claims the Alzheimer’s Association. Some suggestions include avoiding smoking and alcohol, maintaining a healthy weight, establishing a well-balanced diet, exercising, and keeping blood pressure within the recommended levels.

Can Treatment Slow The Stages Of Vascular Dementia

While there’s no guaranteed treatment for vascular dementia, researchers suggest that taking good care of your heart and your brain may be able to reduce the chance of, or slow, further progression. This includes maintaining a healthy blood pressure, exercising regularly, not smoking, and eating a healthy diet.

Stage 2: Very Mild Cognitive Decline

Stage 2 can vary between typical age-related memory problems that most seniors face, such as forgetting specific dates or slower recall of a name or word. Or this stage could include some of the beginning signs of dementia that are often not obvious to doctors and loved ones. Some of the side effects that correspond with stage 2 include:

  • Forgetting everyday phrases or names
  • Forgetting the location of important objects

Becoming Sleepy And Other Changes That May Occur

stages of vascular dementia chart

A person close to death will become increasingly sleepy. Most people will slip into unconsciousness and die peacefully and quietly in their sleep. Occasionally some people may become more agitated as death approaches. If this is the case, healthcare professionals will talk to you and, having ensured pain and other symptoms are controlled with appropriate medication, will administer some sedation. This may be given at first by an injection and at regular intervals if required, depending upon how the person responds to it.

Stage 3: Mild Cognitive Decline

Stage 3 is where dementia or Alzheimers disease symptoms can become more noticeable to friends and family. This stage will not have a major impact on your loved ones everyday life, but signs can include:

  • Trouble with complex tasks and problem-solving
  • Memory loss and forgetfulness
  • Asking the same question repeatedly
  • Diminished work performance
  • Denial

Caregiving In The Middle Stages

According to the Alzheimers Association, this can be the most prolonged period you will face as a caregiver. The symptoms associated with the middle stage can continue for most of your loved ones later years. During this time, you will need to learn to develop patience, flexibility, and understanding as their day-to-day functions become more difficult to achieve. Your loved one might need assistance with ADLs, act out in strange ways, or grow frustrated and angry with you, which can be stressful. Be sure to take care of yourself and reach out to family, friends, and other support services to make this transition smoother.

What Are The Warning Signs That Life Is Nearing An End

When an elderly person with dementia is almost bearing their end, it can be very traumatic especially for the loved ones. It is important to have an idea of what signs one needs to expect when the end comes as this can give you some sort of comfort.

When you think of a condition such as Alzheimers disease, a person can live for over 10 years with it. It is possible to make the person happy over those years. Since we are not immortals, at some point life does come to an end when you have dementia and it is something that one needs to be prepared for especially if they are caregivers.

Handling the final stage of dementia is much easier, especially when you are aware of the things that you should expect. It is important to give the person the kind of care that will award him or her dignified and peaceful death.

Usually, when a person is about to reach the end, the dementia symptoms usually get worse and this can be quite upsetting. Some of the things that you may notice include:

  • Limited mobility so they may have to be bed bound
  • Limited speech or no speech at all
  • Double incontinence
  • Difficulties swallowing and eating

It is important to note that the above symptoms do not really mean that the person will just die. There are people who can have such symptoms for quite some time. You should also remember that about two-thirds of dementia patients succumb to other ailments such as pneumonia.

Some of the other signs that can indicate that death is indeed close include:

Support Care Staff And Colleagues

Dementia LAST Stage Before Death ~ ABCs of Dementia FAQs: L

It is important to remember that staff caring for a person in the last hours and days of their life may find this to be emotionally challenging or distressing. This may be especially so for those who have worked with the person for some time and who have built a meaningful relationship with that person and their family. Those newer to care work, or who have little previous experience of care at the end of life, may find this a worrying or stressful time. It is important that care staff are given support by managers and colleagues, are able to ask for advice and reassurance where needed, and have the space to acknowledge their feelings.

See End of life care and carers’ needs for more information.

Stage 4: Early Stage Moderate Vascular Dementia

This is also one of the most important vascular dementia stages that everyone should not look down but watch out carefully for good! This stage is the only one wherein the signs and symptoms are clear for the first time. This is because the condition has advanced to the 4th stage and is very clear and evident. People suffering from vascular dementia in this stage tend to stay away from their family and friends. They find it hard to frame sentences and maintain a conversation.

Learn More: How To Prevent Memory Loss In Old Age With 21 Practical Tips

This stage will last for 2-3 years before everything gets more serious if there is no treatment. The most effective way to treat this condition is to stimulate the individual who are suffering from this disorder to join a community workshop. At this place, he or she will be instructed to play games, which have effect on sharpening the motor and memory skills. In this stage, individual will be diagnosed with moderate vascular dementia.

This is actually also one out of the vascular dementia stages that a lot of people in the world have been diagnosed and have been trying to minimize the damages.

How To Test For Dementia

There is no single test that can determine a person is suffering from dementia. The doctor can diagnose different types of dementia such as Alzheimers based on their medical history.

This has to be done very carefully. In addition, the doctor may conduct laboratory tests, physical examinations, and changes in the way the patient thinks.

When all things are considered carefully, a doctor can be able to determine that a person is actually suffering from dementia with certainty. Determining the type of dementia can be hard, especially due to the fact that brain changes and symptoms that are associated with the different types of dementias sometimes overlap.

It is normal for the doctor to give a diagnosis of dementia without really specifying the type. In such a case, it is important for the patient to visit a specialist in this area like a psychologist or neurologist for a more specific diagnosis.

Vascular Dementia Prognosis And Progression

This extensive overview of vascular dementia prognosis and progression gives you a better understanding of the development of the disease during the early, middle and late stages.

Vascular dementia is a condition that occurs when a particular part of your brain does not get enough nutrients and blood.

Also known as multi-infarct dementia, studies show that it has quickly risen to become the second most common cause of dementia in golden-agers.

When Do Dementia Patients Stop Eating

stages of vascular dementia chart

When a patient stops or refuses to eat, things can be very depressing for the caregiver. Drinking and eating are complex and have to do with a control center that is within the brain, which controls the muscles in the throat and neck area.

Dementia affects this part of the brain as it progresses and things like choking, coughing, grimacing as one swallows, clearing the throat, movements that are exaggerated, especially of the tongue and mouth, refusing to swallow, and spitting the food can be seen. This usually happens in the later stages of the disease.

How Does Vascular Dementia Progress

Vascular dementia does not always have a typical progression that might be classified into stages, although its symptoms can generally be classified as fitting in the early stages, middle stages, or late stages of dementia.

Early stages of vascular dementia often includeimpaired memory, difficulty with executive functioning, word-finding difficulty, and a decline in attention. Mood and personality changes may also be seen in vascular dementia, and some people experience a decline in balance and walking.

Recognise And Meet Spiritual And Cultural Needs

Care providers also need to be attentive to meeting a persons spiritual or cultural needs at the end of life. For one person, this may involve making sure they have contact with a religious leader in the last days or hours of their life, while another may want their favourite composers music to be played quietly but continuously throughout the period. This information should be recorded clearly, and should not come as a surprise to care staff who will know the person their life history, preferences and nature well. You should also discuss these aspects with the persons family or friends.

Towards The End Of Life

It can be very difficult for family and carers to prepare for the end, but by thinking about it and making some plans, it may be a little easier. When someone reaches the final stages of life one of the main concerns is to ensure that they are comfortable and as pain free as possible. If you are concerned that the person with dementia may be in some pain or discomfort, discuss this with the doctor and nursing staff. 

What Are The Symptoms

What to Expect with Late Stage Dementia Symptoms (My Experience)

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.

Vascular Dementia Life Expectancy

With an increase in age, various conditions and diseases become more prevalent. Alzheimers and cynical behaviors are common in the elderly population, behaviors that come with older age. One of the most commonly experienced conditions is Vascular Dementia, a condition that can seem confusing and frightening to those who have no idea what it is.

How Can You Recognise When A Person Is Dying

Recognising when a person with advanced dementia is dying may not always be easy as they may have many general signs and symptoms of dying already. For example, some common signs and symptoms seen in people dying are:

  • profound weakness
  • needing assistance with all care
  • disorientation to time or place
  • agitated or restless
  • difficulty concentrating.

People with advanced dementia may show some of these signs and symptoms for months or even years making it hard to tell if the person is approaching death. However, if these symptoms become much worse over a period of two to three weeks, or even days or hours, it is important that a doctor or nurse sees the person. If the doctor or nurse thinks that the person is deteriorating or nearing the end of life and it would be in the persons best interest to be cared for in their own home, a care home or hospice then discuss this information with the persons family. They should also be given an explanation of why the deterioration is happening and the care that is going to be given. When death is expected it is usally not of benefit for the purpose with dementia to be sent to hospital: the death is more likely to be traumatic, unsupported and complicated by other medical events .

When the dying process is established, the person may experience further changes:

  • losing consciousness
  • no longer able to swallow
  • terminal restlessness
  • changes to breathing pattern and circulation .

Who Is At Risk For Vascular Dementia

Some risk factors for vascular dementia can be managed; others, like age and gender, cannot. Among all factors, high blood pressure carries the greatest risk; vascular dementia almost never occurs without it.

Likewise, a high risk of stroke goes hand in hand with risk for vascular dementia. One-quarter to one-third of strokes are thought to result in some degree of dementia. People who smoke, consume excessive amounts of alcohol, have diabetes, or heart disease also have a higher rate of the condition.

Vascular dementia most commonly occurs in people between the ages of 60 and 75. Men seem to be more vulnerable than women, and the condition affects African-Americans more often than other races. People whose age, sex, or race puts them at increased risk of vascular dementia have that much more reason to manage risk factors within their control.

What You Can Do For Your Loved One

Seven Stages of Dementia

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.

Helping Someone With Vascular Dementia

Caring for a person with vascular dementia can be very stressful for both you and your loved one. You can make the situation easier by providing a stable and supportive environment.

  • Modify the caregiving environment to reduce potential stressors that can create agitation and disorientation in a dementia patient.
  • Avoid loud or unidentifiable noises, shadowy lighting, mirrors or other reflecting surfaces, garish or highly contrasting colors, and patterned wallpaper.
  • Use calming music or play the persons favorite type of music as a way to relax the patient when agitated.

What Happens In The Later Stages Of Dementia

  • Progressive loss of memoryThis can be a particularly disturbing time for family and carers as the person with dementia may fail to recognise close family members.
  • Increased loss of physical abilitiesMost people with dementia gradually lose their ability to walk, wash, dress and feed themselves. Other illnesses such as stroke or arthritis may also affect them. Eventually the person will be confined to a bed or a chair.
  • Increased difficulty communicatingA person with dementia will have increasing difficulty in understanding what is said or what is going on around them. They may gradually lose their speech, or repeat a few words or cry out from time to time. But continuing to communicate with them is very important. Remember, although many abilities are lost as dementia progresses, some – such as the sense of touch and ability to respond to emotions – remain.
  • Problems eatingIt is common for people in the later stages of dementia to lose a considerable amount of weight. People may forget how to eat or drink, or may not recognise the food they are given. Some people become unable to swallow properly. Providing nutrition supplements may need to be considered. If a person has swallowing difficulties, or is not consuming food or drink over a significant period of time and their health is affected, nutrition supplements may be considered for consumption other than by mouth.

Vascular Dementia Is One Of The Most Wide

When these cognitive problems affect a persons daily life, it is a strong indication that they have vascular dementia.

Diagnosis of vascular dementia is sometimes difficult.

This is because there are no tests that show that an individual has the disease. Doctors will, however, study the symptoms that a person is displaying to confirm whether they have the condition or not.

The medical experts must first rule out any illnesses that have the same symptoms, such as depression or Alzheimers disease.

Thyroid and vitamin deficiencies, side effects of medications, or an array of infections may also cause symptoms.

Could This Be You

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The person youre caring for has been living with dementia for a long time perhaps many years. Youve both had your fair share of problems but, youve coped admirably well. However:

They now need round-the-clock care They rarely talk or have little conversation They no longer recognise you or any of their nearest and dearest

The final stages of dementia can be incredibly hard for family and friends, but its important to be realistic about what you can or cant cope with, and to accept any help that youre offered. Family carers are often under a great deal of strain during this part of the journey, so make sure not to neglect your own health or needs.

What Do Elderly People Think About Life And Death

As we get older, death seems to be nearer than when we are younger. In as much as anyone can die regardless of age, for an older person, it seems like it is more likely to happen, especially when dealing with different health conditions that the body does not handle as it used to in the younger years.

For older persons, death does not always spell sorrow and terror, as is the case with younger people. Many of the older people are contented with what the short-term future has for them. You may think that people may get anxious as they become older, but this is not the case. Older people do not have much sadness and anxiety, especially related to death. They are actually more positive about life and death.

As we grow older, our perspective shifts. This is when you realize that things are not as they always seem. Most people fear death because they feel that they will lose the things that they have been working so hard to get over the years. However, for older people, this attachment to things acquired is not really pronounced. This is how some of the fear of death actually melts away.

When you look around you and you realize that there are things that are a part of you that will outlive you actually help in a major way. This could be the legacy we have in children or gardens planted. There are yet others who place value on their country, their religion, or families that live on even after they are gone.

Stages Of Frontotemporal Dementia

The rate at which FTD progresses varies greatly and research has found that the differences between different types of FTD become less obvious as dementia progresses. Those who originally exhibited symptoms of behavioural variants may eventually experience language difficulties and similarly, a person originally diagnosed with a language variant of FTD will typically develop behavioural problems. The symptoms and signs of behavioural variant frontotemporal dementia are generally unaware of their behaviour and will rely on their loved ones to identify new and unusual characteristics.

Mild

Unlike Alzheimers, the early stage of frontotemporal dementia doesnt usually affect memory or cognitive functioning. Someone with FTD may go walking without obvious purpose but, unlike someone with Alzheimers, will return home without getting lost.

During the early stages of behavioural FTD, changes to personality and behaviour become noticeable. Typical behavioural changes include:

  • Becoming uncharacteristically selfish or apathetic
  • Acting impulsively
  • Confusion regarding the meaning of familiar words,
  • Difficulty in finding the right word
  • Difficulty with recognising familiar objects

Severe

In the later stages of all types of FTD, more structures of the brain become damaged. Someone living with later stages of FTD usually experiences symptoms that are similar to the later stages of Alzheimers disease such as:

Physical Difficulties In The Later Stages Of Dementia

The physical changes of late-stage dementia are partly why the person is likely to need much more support with daily living. At this stage they may:

  • walk more slowly, with a shuffle and less steadily eventually they may spend more time in a chair or in bed
  • be at increased risk of falls
  • need a lot of help with eating and so lose weight
  • have difficulty swallowing 
  • be incontinent losing control of their bladder and bowels.

The persons reduced mobility, in particular, raises their chances of blood clots and infections. These can be very serious or even fatal so it is vital that the person is supported to be as mobile as they can.

Support Family And Loved Ones

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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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