Stage : 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.
Stage : Very Mild Changes
You still might not notice anything amiss in your loved one’s behavior, but they may be picking up on small differences, things that even a doctor doesn’t catch. This could include forgetting words or misplacing objects.
At this stage, subtle symptoms of Alzheimer’s don’t interfere with their ability to work or live independently.
Keep in mind that these symptoms might not be Alzheimer’s at all, but simply normal changes from aging.
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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Stage : 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
How Many Stages Of Dementia Are There
There are several different types of Dementia, with Alzheimers disease being the most common.; Though when it comes to the different stages of Dementia, we can typically categorise the trajectory of the disease as mild, moderate or severe.
Although this three stage model is useful for providing an overview of early, middle and final stages of Dementia, most people prefer a seven stage model that breaks cognitive decline down into seven specific categories. The progression of Dementia will be different for everyone, but knowing where a loved one falls on this scale can help to identify signs and symptoms, whilst also determining the most appropriate care plan. So, what are the 7 stages of Dementia?
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Can You Die From Dementia
Dementia is usually considered a disorder affecting memory and is associated with aging. In the initial stages, this could be true. Loss of memory is one of the earliest signs of the disease.
However, according to experts, dementia is a fatal brain failure that needs to be taken seriously like other terminal diseases that kill a patient slowly. It is not just an ailment that is associated with the elderly.
Even though the distinction is not really known in the medical field and to the general public, it is something that needs to be considered when one has to be treated at the very end stage of the condition.
It is believed that the fact that people are misinformed and misguided about dementia, the end stage treatment is usually made very aggressive.
The disease progresses quite slowly and the fact that it affects so many people means that it should be taken seriously. Dementia is a collection or a consequence of different diseases like Alzheimers disease, vascular dementia, and Parkinsons disease. In later stages, you can tell the type of dementia that is affecting a certain patient.
The patient can have eating problems, pneumonia, fever, pain, and difficulty breathing, which are all caused by the failure of the brain. In the end, dementia involves so many other parts of the body.
It is important to appreciate that the brain is the engine of our bodies. It controls everything, including metabolism, gastrointestinal tract, the lungs, and even the heart.
Pneumonia Fever Eating Problems Common
Pneumonia, fever, and an eating problem were the most common complications in the final months of life, and 41% of patients had at least one aggressive treatment including hospitalization, a visit to the ER, intravenous treatment, or a feeding tube.
âThere is a lack of recognition that dementia is a terminal illness and this has a big impact on the quality of care patients receive,â Mitchell says. âWe found that a high percentage of patients had distressing symptoms toward the end of life.â
More than 5 million Americans suffer from Alzheimerâs dementia, and this figure is expected to triple over the next four decades as baby boomers reach old age. Alzheimerâs is the most common cause of dementia.
In the late stages of the disease, patients are often bedridden and can no longer communicate their needs, recognize close family members, or perform basic functions like feeding themselves and going to the bathroom.
In an editorial published with the study, geriatrician and dementia researcher Greg A. Sachs, MD, of the Indiana University Center for Aging Research, recalls his maternal grandmotherâs struggle with advanced Alzheimerâs disease.
Her final months in a nursing home included repeated courses of antibiotics for infections and restraints to control her agitation. Her condition so distressed Sachsâ mother that she stopped taking her children when she visited.
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Common Early Symptoms Of Dementia
Different types of dementia can affect people differently, and everyone will experience symptoms in their own way.
However, there are some common early symptoms that may appear some time before a diagnosis of dementia. These include:
- memory loss
- difficulty concentrating
- finding it hard to carry out familiar daily tasks, such as getting confused over the;correct change when shopping
- struggling to follow a conversation or find the right word
- being confused about time and place
- mood changes
These symptoms are often mild and may get worse only very gradually. It’s often;termed “mild cognitive impairment” as the symptoms are not severe enough to be diagnosed as dementia.
You might not notice these symptoms;if you have them, and family and friends may not notice or take them seriously for some time. In some people, these symptoms will remain the same and not worsen. But some people with MCI;will go on to develop dementia.
Dementia is not a natural part of ageing. This is why it’s important to talk to a GP sooner rather than later if you’re worried about memory problems or other symptoms.
Recognising When Someone Is Reaching The End Of Their Life
Read about some of the signs that a person with dementia is nearing their death, and how you can support yourself as a carer, friend or relative.
It is important to know when a person with dementia is nearing the end of their life because it can help in giving them the right care. However it can be difficult to know when this time is.
This uncertainty can have a big impact on how the persons family feel, and may also affect how they feel themselves.
There are symptoms in the later stages of dementia that can suggest the person is reaching the final stage of their illness. These include:
- speech limited to single words or phrases that may not make sense,
- needing help with most everyday activities,
- eating less and having difficulties swallowing,
- bowel and bladder incontinence,
- being unable to walk or stand, problems sitting up and controlling the head, and becoming bed-bound.
It is likely that a person with dementia is nearing the end of their life if they have these symptoms, along with other problems such as frailty, infections that keep coming back, and pressure ulcers .;
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 ;.
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.
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Stage : Age Associated Memory Impairment
This stage features occasional lapses of memory most frequently seen in:
- Forgetting where one has placed an object
- Forgetting names that were once very familiar
Oftentimes, this mild decline in memory is merely normal age-related cognitive decline, but it can also be one of the earliest signs of degenerative dementia. At this stage, signs are still virtually undetectable through clinical testing. Concern for early onset of dementia should arise with respect to other symptoms.
The Start Of The Dying Process
As someones condition worsens and they get to within a few days or hours of dying, further changes are common. The person will often:
- deteriorate more quickly than before
- lose consciousness
- develop an irregular breathing pattern
- have cold hands and feet.
These changes are part of the dying process. Healthcare professionals can explain these changes so you understand what is happening. The person is often unaware of what is happening, and they should not be in pain or distress.
Medication can be used to treat the persons symptoms. If the person cant swallow, there are other ways of providing this, such as medication patches on the skin, small injections or syringe drivers . Speak to a GP or another health professional about this.
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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.
Early Middle And Late
Many people dont know that dementia is actually a syndrome, rather than a disease, where a persons cognitive tasks, memory, and reason begin to decline. While dementia can occur as an umbrella symptom to several conditions, Alzheimers is the most common and well known of those.
Alzheimers is often divided into three stages: early, middle, and late. These three stages provide an overall idea of how an individuals abilities may change once symptoms appear.
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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.
Symptoms Specific To Vascular Dementia
Vascular dementia is the second most common cause of dementia, after Alzheimer’s. Some people have both vascular dementia and Alzheimer’s disease, often called “mixed dementia”.
Symptoms of vascular dementia are similar to Alzheimer’s disease, although memory loss may not be as;obvious in the early stages.
Symptoms can sometimes develop suddenly and quickly get worse,;but they can also develop gradually over many months or years.
Specific symptoms can include:
- stroke-like symptoms: including muscle weakness or temporary paralysis on one side of the body
- movement problems; difficulty walking or a change in the way a person walks
- thinking problems; having difficulty with attention, planning and reasoning
- mood changes; depression and a tendency to become more emotional
Read more about vascular dementia.
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Too Few Patients Getting Comfort Care
Geriatrician Laurel Coleman, MD, of the Maine Medical Center and the Beacon Hospice tells WebMD that the study will help physicians and family members understand what to expect.
Coleman is a member of the Alzheimerâs Association national board of directors.
âThe fact that the study is in such a prominent journal means that it will reach a wide audience,â she says. âThat is a very good thing. These are conversations that families want to have. Families want to know how to limit burden and discomfort.â
Mitchell and colleagues found that family members who understood their loved oneâs poor prognosis were much less likely to agree to medical interventions designed to prolong life.
Economics help explain why so many advanced dementia patients get these medical treatments, Sachs says.
When a patient gets sick with pneumonia, fever, or some other illness, they become more difficult and expensive to care for.
âThe economic incentives pretty much all line up in favor of transferring patients from the nursing home to hospitals,â he says. âThings are really set up to favor burdensome, aggressive treatment and not enough patients are getting treatments that focus on making them more comfortable at the end of life.â
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.
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