Moderate Dementia Or Moderately Severe Decline
Stage 5 lasts about 1 1/2 years and requires a lot of support. Those who dont have enough support often experience feelings of anger and suspicion.
People in this stage will remember their own names and close family members, but major events, weather conditions, or their current address can be difficult to recall. Theyll also show some confusion regarding time or place and have difficulty counting backward.
Caregiver support: People will need assistance with daily tasks and can no longer live independently. Personal hygiene and eating wont be an issue yet, but they may have trouble picking the right clothing for the weather or taking care of finances.
How Hospice Can Help With End
In addition to helping you in recognizing the signs of dying in the elderly with dementia, bringing in hospice care will help with the physical and emotional demands of caregiving. Nurses will be able to adjust medication and care plans as the individuals needs change. Aides can help with bathing, grooming, and other personal care. Social workers can help organize resources for the patient and family. Chaplains and bereavement specials can help the family with any emotional or spiritual needs. Additionally, family members can contact hospice at any time, and do not need to wait until it is recommended by the patient’s physician.
To learn more about the criteria for hospice eligibility or to schedule a consultation, please contact Crossroads using the blue Help Center bar on this page for more information on how we can help provide support to individuals with dementia and their families.
Signs And Symptoms Of Alzheimer’s Disease
Alzheimer’s disease is a progressive condition, which means the symptoms develop gradually over many years and eventually become more severe. It affects multiple brain functions.
The first sign of Alzheimer’s disease is usually minor memory problems.
For example, this could be forgetting about recent conversations or events, and forgetting the names of places and objects.
As the condition develops, memory problems become more severe and further symptoms can develop, such as:
- confusion, disorientation and getting lost in familiar places
- difficulty planning or making decisions
- problems with speech and language
- problems moving around without assistance or performing self-care tasks
- personality changes, such as becoming aggressive, demanding and suspicious of others
- hallucinations and delusions
- low mood or anxiety
Read more about the symptoms of Alzheimer’s disease.
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What Are The Risk Factors For Dementia
Risk factors for dementia include:
- Age: This is the strongest risk factor. Your chance of dementia increases as you age. Most cases affect people over the age of 65.
- Family history: If you have biological parents or siblings with dementia, youre more likely to develop dementia.
- Down syndrome: If you have Down syndrome, youre at risk of developing early-onset Alzheimers disease by middle age.
- Poor heart health: If you have high cholesterol levels, high blood pressure, atherosclerosis or smoke, you increase your risk of dementia. These health problems, as well as diabetes, affect your blood vessels. Damaged blood vessels can lead to reduced blood flow and strokes.
- Race and ethnicity: If youre a Black person, you have twice the risk as a white person for developing dementia. If youre a Hispanic person, youre 1.5 times more likely than a white person to develop dementia.
- Brain injury: If youve had a severe brain injury, youre at a higher risk for dementia.
Dying From Dementia With Late
Brigid Dwyer, MD, is a board-certified neurologist and an Assistant Professor of Neurology at Boston University School of Medicine.
Knowing what to expect can help when your loved one has late-stage dementia. The death of your loved one can be a hard concept to wrap your head around and accept. It’s important to understand what’s coming in the future so you can prepare emotionally and practically.
This article explains how dementia progresses and what happens during late-stage dementia.
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Late Stage Alzheimers: What To Expect
Alzheimers disease affects every aspect of personality and behavior. Patients become forgetful. They struggle to talk, lose control of their emotions, and neglect basic tasks. By the time they enter late stage Alzheimers, they will no longer be able to function on their own. Whereas before they retained some limited autonomy, now patients depend entirely on their family. Motor skills become fatally compromised, placing even greater demands on caregivers. While there will still be moments of happiness, families must be prepared for the hard choices they face in order to ensure their loved ones physical and emotional wellbeing.
Whats The Difference Between Dementia And Alzheimers Disease
Dementia is a description of the state of a persons mental function and not a specific disease. Dementia is an umbrella category describing mental decline thats severe enough to interfere with daily living.
There are many underlying causes of dementia, including Alzheimers disease and Parkinsons disease. Alzheimers disease is the most common underlying cause of dementia.
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Common Types Of Dementia
Most people who have dementia experience problems with cognitive skills, depression, indifference, and a lack of interest in doing things.
People with Lewy body dementia and Alzheimer’s disease may have similar early symptoms. Memory loss is common in both conditions, for example. Lewy body dementia also commonly causes fluctuations in arousal, hallucinations, sleep problems, and difficulty walking.
In contrast, people in the early stages of frontotemporal dementia usually don’t have memory problems. Instead, they might have obvious changes in personality and behavior.
Vascular dementia, which occurs as a result of having many strokes throughout the brain, can cause problems understanding concepts, emotional and personality changes, and memory problems. This type of dementia may accompany other types, making the decline more severe.
And chronic traumatic encephalopathy , which occurs after repeated head trauma, often begins to cause symptoms years after the traumatic brain injuries, with a significant progression of mood changes, personality changes, and a decline in memory and cognitive skills.
With Lewy body dementia, frontotemporal dementia, vascular dementia, and CTE, the memory problems may respond to cues/reminders, while in Alzheimer’s there is often a forgetting of recent events altogether.
In the final stage of all types of dementia, a person goes through a major decline in everyday functioning.
Are There Any Treatments For Dementia
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.
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Resist The Urge To Reorient
Do not correct a patient if they get confused. For example, they might mistake their son for their husband. When this happens, play along. You are unlikely to win an argument with an Alzheimers patient and pointing out their mistake will only embarrass them. Rather, humor them and either change the subject or distract them with an activity.
This is especially true if they ask about someone who has died. The truth is going to be hard on them. Alzheimers patients can still grieve, but they cannot move on. After a few minutes they will forget and ask again. If you persist in telling them the truth, you will force them to relive their grief at its most painful. For this reason, it is better to tell them everything is fine.
What Are The Causes Of Dementia
Dementia is caused by damage to your brain. Dementia affects your brains nerve cells, which destroys your brains ability to communicate with its various areas. Dementia can also result from blocked blood flow to your brain, depriving it of needed oxygen and nutrients. Without oxygen and nutrients, brain tissue dies.
Damage to your brain results in different symptoms, depending on the area of your brain affected. Some dementias arent reversible and will worsen over time. Other dementias are due to other medical conditions that also affect your brain. Another group of health issues can result in dementia-like symptoms. Many of these conditions are treatable, and the dementia symptoms are reversible.
All of the possible causes of dementia are discussed in the question, Are there different types of dementia?
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Support Their Cultural And Spiritual Needs
Its good to be aware of the persons cultural and spiritual needs and make sure these are respected and supported. You can make use of any advance care plans or documents, friends and family input and your knowledge of the person. Its important to try and meet these needs as much as possible, they are just as important as medical care.
Staying Connected To The Person With Alzheimer’s
When persons with late-stage Alzheimer’s have lost most of their cognitive abilities, they experience the world through their senses. Although you may not be able to communicate with them verbally, there are many things you can do to show the person reassurance and love. Focus on what the person is still able to do or what the person still enjoys.
Comfort by touchHold the patient’s hand give a gentle massage to the hands, legs or feet, give a kiss or brush his or her hair.
Stimulate the sensesThe person may enjoy the smell of a favorite perfume, flower, food or scented lotion or the feel of stroking a beloved pet or fabrics with different textures. If the person can walk with assistance or uses a wheelchair, he or she may enjoy going outside to see a garden or watch birds. You can also position the person to gaze outside a window, being careful that the sun is not too bright or will make the person too warm.
Use your voice to soothSpeak gently and with affection. Your tone can help the person feel safe and relaxed.
Play music and videosChoose music the patient once enjoyed when he or she was a young adult or something from his or her ethnic or spiritual background. Videos can also be relaxing. Try selecting one with scenes of nature and soft calming sounds.
Read to the personEven if the person does not understand the words, the tone and rhythm of your voice can be soothing. Read a favorite story, poem, scripture passage, blessing, etc.
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Disproportionate Impact On Women
Globally, dementia has a disproportionate impact on women. Sixty-five percent of total deaths due to dementia are women, and disability-adjusted life years due to dementia are roughly 60% higher in women than in men. Additionally, women providethe majority of informal care for people living with dementia, accounting for 70% of carer hours.
Caring For A Person With Late
If you are caring at home for someone who is in the later stages of dementia the Aged Care Assessment Team can help with advice and referrals for all aspects of care. You can contact your nearest ACAT by calling the number listed in the Age Page of your telephone directory. Your doctor or hospital can also help you to contact your local ACAT.
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When The Person With Alzheimers Can’t Move
During the later stages of Alzheimers disease, a person may lose the ability to move and spend much of his or her time in a bed or chair. This lack of movement can cause problems such as pressure sores or bedsores, and stiffness of the arms, hands, and legs.
If the person with Alzheimers cannot move around on his or her own, contact a home health aide, physical therapist, or nurse for help. These professionals can show you how to move the person safely, such as changing positions in bed or in a chair.
A physical therapist can also show you how to move the person’s body joints using range-of-motion exercises. During these exercises, you hold the person’s arms or legs, one at a time, and move and bend it several times a day. Movement prevents stiffness of the arms, hands, and legs. It also prevents pressure sores or bedsores.
To make the person more comfortable:
To keep from hurting yourself when moving someone with Alzheimer’s disease:
How Is Alzheimers Disease Treated
Medical management can improve quality of life for individuals living with Alzheimers disease and for their caregivers. There is currently no known cure for Alzheimers disease. Treatment addresses several areas:
- Helping people maintain brain health.
- Managing behavioral symptoms.
- Slowing or delaying symptoms of the disease.
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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:
Recognizing Pain Or Illness
Promoting quality of life means keeping those in the late stage of Alzheimer’s disease comfortable. However, persons in this stage of the disease have difficulty communicating their pain. Here are some ways to recognize pain:
Look for physical signs that can indicate illnessSigns such as pale or flushed skin tone dry, pale gums mouth sores vomiting feverish skin or swelling of any part of the body.
Pay attention to nonverbal signs and body languageSigns such as wincing, moving about in discomfort, etc.
Be alert for changes in behaviorAnxiety, agitation, shouting and sleep disturbances can all indicate pain.
Consult your physician to determine the cause of the person’s pain and what can be done about it.
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Who Has Alzheimers Disease
- In 2020, as many as 5.8 million Americans were living with Alzheimers disease.1
- Younger people may get Alzheimers disease, but it is less common.
- The number of people living with the disease doubles every 5 years beyond age 65.
- This number is projected to nearly triple to 14 million people by 2060.1
- Symptoms of the disease can first appear after age 60, and the risk increases with age.
Stage : Moderately Severe Decline
Your loved one might start to lose track of where they are and what time it is. They might have trouble remembering their address, phone number, or where they went to school. They could get confused about what kind of clothes to wear for the day or season.
You can help by laying out their clothing in the morning. It can help them dress by themselves and keep a sense of independence.
If they repeat the same question, answer with an even, reassuring voice. They might be asking the question less to get an answer and more to just know you’re there.
Even if your loved one can’t remember facts and details, they might still be able to tell a story. Invite them to use their imagination at those times.
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Are There Treatments To Help With Late Stage Dementia
Currently, there are no treatments that can slow or reverse late-stage dementia.
If your loved one with dementia is experiencing any pain, contact your doctor to see if they recommend any over the counter or prescription medication to help with this.
You can also work with anoccupational therapist in your area specializing in dementia to help. Speech therapy may be an option to help with speech and movement issues.
There may be a time when hospice should be considered. If youre considering hospice care for your loved one, speak with your doctor and they can help you get this set up so that your loved one can be comfortable
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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