Talking With A Doctor
After considering the persons symptoms and ordering screening tests, the doctor may offer a preliminary diagnosis or refer the person to a Cognitive Dementia and Memory Service clinic, neurologist, geriatrician or psychiatrist.Some people may be resistant to the idea of visiting a doctor. In some cases, people do not realise, or else they deny, that there is anything wrong with them. This can be due to the brain changes of dementia that interfere with the ability to recognise or appreciate the changes occurring. Others have an insight of the changes, but may be afraid of having their fears confirmed.One of the most effective ways to overcome this problem is to find another reason for a visit to the doctor. Perhaps suggest a check-up for a symptom that the person is willing to acknowledge, such as blood pressure, or suggest a review of a long-term condition or medication.Another way is to suggest that it is time for both of you to have a physical check-up. Any expressed anxiety by the person is an excellent opportunity to suggest a visit to the doctor. Be sure to provide a lot of reassurance. A calm, caring attitude at this time can help overcome the person’s very real worries and fears.Sometimes, your friend or family member may refuse to visit the doctor to ask about their symptoms. You can take a number of actions to get support including:
- talking with other carers who may have had to deal with similar situations
- contacting your local Aged Care Assessment Team
Do Try To Be Forgiving And Patient
Do not forget that dementia is the condition that results in irrational behavior and causes dementia sufferers to act the way they do. The patients demand plenty of patience and forgiveness from the people looking after them. Have the heart to let things go instead of carrying grudges around for something that the patient may not be in control of.
Stage 5: Moderate Dementia
Patients in stage 5 need some assistance in order to carry out their daily lives. The main sign for stage 5 dementia is the inability to remember major details such as the name of a close family member or a home address. Patients may become disoriented about the time and place, have trouble making decisions, and forget basic information about themselves, such as a telephone number or address.
While moderate dementia can interfere with basic functioning, patients at this stage do not need assistance with basic functions such as using the bathroom or eating. Patients also still have the ability to remember their own names and generally the names of spouses and children.
What Are The Signs Of End
It is important for caregivers to know when an individual with dementia is close to the end of their life, because it helps ensure they receive the right amount of care at the right time. It can be difficult to know exactly when this time is due to the variable nature of dementias progression, but understanding common end-of-life symptoms of seniors with dementia can help. Below is a timeline of signs of dying in elderly people with dementia:
Final Six Months
- A diagnosis of another condition such as cancer, congestive heart failure or COPD
- An increase in hospital visits or admissions
Final Two-to-Three Months
- 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
- 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
Patients with dementia are eligible to receive hospice care if they have a diagnosis of six months or less to live if the disease progresses in a typical fashion. Once a patient begins experiencing any of the above symptoms, it is time to speak with a hospice professional about how they can help provide added care and support.
What Conditions Can Be Mistaken For Dementia
The term dementia refers to a specific group of symptoms related to a decline in mental ability. Often, people who experience subtle short-term memory changes, are easily confused, or exhibit different behaviors or personality traits are mistakenly thought to have dementia. These symptoms could be the result of a variety of other conditions or disorders, including other neurocognitive disorders such as Parkinsons disease, brain growths or tumors, mild cognitive impairment , and mood disorders, like depression.
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Symptoms In The Later Stages
People in the later stages of dementia become increasingly frail and depend more on other people for support. As dementia progresses and causes changes to the person’s brain, they may struggle to do many of the things they used to. However, even in the later stages the person may experience moments of lucidity and some of their abilities may return temporarily.
The person’s reactions are likely to be influenced by their environment and how they feel. For example, they may react more positively if they are in a familiar environment or one where they feel comfortable.
People in the later stages of dementia often experience problems with the following:
- changes in behaviour.
Boredom And Dementia Patients
Dementia dramatically affects a persons entire being, and its progression is impossible to stop. A person living with one of the various diseases that cause dementia may experience symptoms from memory loss to speech problems and vision decline, but the greatest complaints are boredom and loneliness.
Why do boredom and loneliness top the list? In most cases, caregivers are at a loss of how to provide dementia-related care. Dementia symptoms have changed the relationship between caregiver and loved one, and its common to feel at a loss of what to do. When you can no longer have a conversation with Mom like you used to, or Dads agitation has made visits with him feel negative, you might start to pull away. You visit the senior home less frequently, or your interactions with your loved start to become limited to basic personal care. And thats the problem. Mom or Dad is still here. They still need love, engagement, and attention. Its up to you to adjust your methods to connect with them in a new way. The care partner role demands lots of creativity.
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How Long Do Dementia Patients Live After Diagnosis
Dementia symptoms typically progress slowly. People with dementia will progress from mild to severe dementia at varying speeds and may be diagnosed earlier or later in life. Some people with dementia may live for up to 20 years after their diagnosis, though according to the Alzheimer’s Association research shows that the average person lives for four to eight years after a diagnosis of dementia. It’s important to point out that the diagnosis of dementia is often missed, delayed, or diagnosed when the illness is moderate or advanced. The impact of that variable may not be accurately reflected in the research regarding the years of life post-diagnosis.
How To Choose The Most Appropriate Activities For A Loved One With Dementia
Selecting activities for a loved one with dementia is a very personal choice and should be based on your care recipients interests and abilities. With so many excellent ideas in this post and other sources, most caregivers will find a few activities that are meaningful and enjoyable for their loved one. When selecting your activities, here are a few things to keep in mind.
- Choose the Right Time for Each Activity. When starting an activity with a loved one, make sure that they are not particularly anxious or preoccupied with other things. If the time is not right for an activity, its usually best to postpone it and switch gears to a less-stressful activity. When the time is right, choose a clutter-free area to avoid distractions. It may also be helpful to plan activities based on the time of day. For example, you can choose gentle and relaxing activities like listening to music in the evening hours before bed.
- Adapt Activities to Match Abilities. Its a good idea to check with your loved ones healthcare providers to ensure that a new activity or exercise is safe for your loved one. Also, start small and give the person time to make progress, which will make the effort more rewarding. Activities that involve creativity like art are especially useful, as you will have something to display and enjoy after finishing.
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 ;.
Support For Families And Carers
Dealing with these behaviours day in and day out is not easy. It is essential that you seek support for yourself from an understanding family member, a friend, a professional or a support group.
Keep in mind that feelings of distress, frustration, guilt, exhaustion and exasperation are quite normal.
Do Keep Eye Contact When Speaking
Communicating with a dementia patient requires a lot of patience, especially during later stages of dementia. It is vital to ensure that you talk in a place that has good lighting, a place that is quiet and without too many distractions. Do not try and stand over the person you are talking to, but rather try to be at their level and keep eye contact at all times. Take care to make sure that body language is relaxed and open. Prepare to spend quality time with the person so that they do not feel rushed or like they are a bother.
Are There Any Treatments
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.
Sensory Toys And Activities For Seniors With Dementia
Sensory stimulation;challenges the 5 senses in new ways in;dementia patients;and this can help spark old memories. Sensory activities and toys can help dementia patients recall positive emotions and memories.
Here are some of the sensory toys and products that dementia patients can enjoy:
- Stroking an animal;
Dementia Symptoms: What Caregivers Should Know
As a caregiver, you may find certain dementia symptoms frustrating, baffling, and sometimes frightening. But what is the other side of the story? What is your mother doing — and feeling — when they put their wedding ring in the freezer or accuse you of stealing from them? Here are some clues to understanding dementia behavior.
- Anxiety and Depression. It can be difficult for a caregiver to see a loved one â who may have been generally optimistic and easygoing when they were well — become anxious or depressed. Both are common dementia symptoms, and itâs hardly surprising. While their memories may fade, people with dementia are aware of whatâs happening to them, at least in the early stages. They know that they have an incurable, degenerative disease. They can feel the scope of their world becoming more and more confined as they lose freedoms like driving. They know that theyâre losing part of themselves too.âPrior to having this disease, I wasnât a person who needed to ask for help much,â says Becklenberg. âBut now I do, and itâs been a blow to my self-assurance and self-esteem. I canât participate fully in life like I used to, and itâs a huge loss.â
- Wandering. Itâs not uncommon for a person with dementia to wander â to walk out of the house in a seemingly random direction. Caregivers can find this dementia symptom mysterious. Why would a loved one leave the safety of their home to wander through unfamiliar streets?
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Distraction: Singing & Reading
For some people, a distraction can be a good way to get the chore done. Its kind of a different communication style that helps in distressing situations. For example, if a patient and/or loved one likes;singing,;starting him/her singing could allow the;caregiver and/or family member;to ease into;bathing time with a gesture.
Singing actually can help tremendously with memory loss patients and/or loved ones who;can no longer talk, or have trouble finding words to form sentences, because they are usually still able to sing a song. Often, they can remember the lyrics of a song from beginning to end.
Many patients and/or loved ones can still read as well. Singing and reading can give the person great joy and hearing a loved ones voice can very comforting for family members.
Things Not To Say To Someone With Dementia
Speaking to an elderly loved one with dementia can be difficult and emotionally draining. Alzheimers and dementia can lead to conversations that dont make sense, are inappropriate or uncomfortable, and may upset a family caregiver. However, over time, its important to adapt to the seniors behavior, and understand that their condition doesnt change who they are.
For senior caregivers, its important to always respond with patience. Here are some things to remember not to say to someone with dementia, and what you can say instead.
1. Youre wrong
For experienced caregivers, this one may seem evident. However, for someone who hasnt dealt with loss of cognitive function before, it can be hard to go along with something a loved one says that clearly isnt true. Theres no benefit to arguing, though, and its best to avoid upsetting a senior with dementia, who is already in a vulnerable emotional state due to confusion.
Instead, change the subject.
Its best to distract, not disagree. If an elderly loved one makes a wrong comment, dont try to fight them on it; just change the subject and talk about something else ideally, something pleasant, to change their focus. There are plenty of things not to say to someone with dementia, but if theres one to remember, its anything that sounds like youre wrong.
2. Do you remember?
Instead, say: I remember
3. They passed away.
4. I told you
Instead, repeat what you said.
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End Of Life Dementia Care And Covid
Older adults and people with serious underlying medical conditions are at higher risk for severe illness from COVID-19. Older adults also have the highest rates of dementia. Given the risks that older adults face from both COVID-19 and dementia, its important to understand how to protect yourself and your loved one. Find more information about dementia and COVID-19 from the CDC.
When a dementia like Alzheimers disease is first diagnosed, if everyone understands that there is no cure, then plans for the end of life can be made before thinking and speaking abilities fail and the person with Alzheimers can no longer legally complete documents like advance directives.
End-of-life care decisions are more complicated for caregivers if the dying person has not expressed the kind of care he or she would prefer. Someone newly diagnosed with Alzheimers disease might not be able to imagine the later stages of the disease.
How To Handle Dementia And Racism
While some of the inappropriate things that come out of dementia patients mouths tend to be off the wall or even comical, other comments are deeply hurtful to those around them. These remarks are the product of interacting with the world as usual but without any social filters. A senior with cognitive impairment may comment on a persons attractiveness, weight, clothing, accent or even race. The first few items on this list can come across as downright rude, but offensive remarks about ones race or ethnicity cross a very serious line and must be addressed swiftly and sensibly by caregivers.
This is often an issue with elder care providers like in-home care agencies, adult day care centers and senior living communities where the comprehensive staff is comprised of people from diverse backgrounds and interacts with clients and residents on a regular basis. A dementia patient may comment on a persons race or ethnicity or even use racial slurs. While we dementia caregivers quickly learn to laugh off an odd statement or redirect repeated questions, these kind of remarks cannot be swept under the rug.
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