Stages : Very Severe Decline
Stage seven is the final stage of Alzheimers. Because the disease is a terminal illness, people in stage seven are nearing death. In stage seven of the disease, people lose the ability to communicate or respond to their environment. While they may still be able to utter words and phrases, they have no insight into their condition and need assistance with all activities of daily living. In the final stages of Alzheimers, people may lose their ability to swallow.
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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.
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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Tips For Managing Dementia End
Because individuals with advanced dementia will often have difficulty communicating, it is important that caregivers keep a close eye on their loved one for signs of pain or discomfort. These signs may include moaning or yelling, restlessness or an inability to sleep, grimacing, or sweating. This may also signal that its time to call hospice or a palliative care team to help with the pain management.
If an individual with end-stage dementia is having trouble sitting up without assistance, hospice can provide a hospital bed or other equipment to lift their head.
Perhaps the hardest thing for families is when a loved one with dementia is no longer able to eat or swallow. Because an individual with dementia is unable to understand the benefits of feeding tubes or IV drips, they will often be incredibly distressed and attempt to remove them, causing added pain and risk of infection. Instead, focusing on keeping the individual comfortable. Supporting them with mouth care to prevent their mouth from becoming dry will allow them to make their final transition in peace.
Palliative Care In Advanced Dementia
- 1Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
- 2Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf , Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
- 3Clinical Trials Center , Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
- 4Center for Health Services Research, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
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How Can The Fast Scale Help Determine What Type Of Dementia My Loved One Has
One interesting thing about the FAST Scale is that, if the individual has Alzheimers disease, any changes they experience will be in sequence that is, FAST stages wont be skipped over. If the individual loses certain abilities listed at a later stage but still retain abilities from an earlier stage . This is incredibly helpful, because it means their situation can potentially be treatable.
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.
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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.
Be Aware Of Their Eating And Drinking
The person may have lost their appetite or have difficulties swallowing safely. In the last days, the person may stop eating or drinking. This can be very distressing to watch, but it is normal for people approaching the end of life.
You should offer the person food and drink for as long as it is safe and they show an interest. Its important to keep the persons mouth comfortable provide sips of fluids and keep lips moist and clean.
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What Are The Early Signs Of Dementia
The onset of dementia is not obvious because the early signs can be vague and quite subtle. The early symptoms usually depend on the kind of dementia that one has and therefore can vary greatly from one person to the next.
Even though the signs can vary, there are some that are quite common and they include:
- Depression, apathy, and withdrawal
- Memory issues, especially when it comes to the most recent events
- Inability to handle the everyday tasks
At times, it is easy to miss to appreciate that the above symptoms could be an indication of something that is not right. Yet there are those who assume that the signs are normal and are associated with aging. It is also possible for one to develop the symptoms in a gradual manner and they may go unnoticed for quite some time.
People may not act even when they can tell that something is definitely wrong. It is important to have a checklist of all signs related to dementia and get the person the needed help when several of such signs are observed. It is important to get a more detailed assessment.
Memory loss and dementia: while it is normal to forget some things and remember later, persons with dementia tend to forget more frequently and they do not remember later.
Tasks: distractions can happen and you may forget to, say, serve one part of the family meal. For a person that has dementia, preparing the meal could be problematic and they may actually forget some of the steps that are involved.
Stage : Severe Decline
People with the sixth stage of Alzheimers need constant supervision and frequently require professional care. Symptoms include:
- Confusion or unawareness of environment and surroundings
- Inability to recognize faces except for the closest friends and relatives
- Inability to remember most details of personal history
- Loss of bladder and bowel control
- Major personality changes and potential behavior problems
- The need for assistance with activities of daily living such as toileting and bathing
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What Can Help Someone Through The End Stage Of Dementia
Although this is a difficult diagnosis for a family to face, there are concrete actions to take when you or your loved one is facing decline.
Offer Touch and Human Contact
Human contact and touch are the most basic of human needs and in the end-stages of dementia, these interactions can be extremely beneficial.
Offering a hand to hold or even the caress of an arm or cheek can bring untold comfort.
There are scientific studies that have shown that touch can lessen both physical discomfort as well as emotional pain.
For example, this Stanford University study about touch found that touch reduces physical and emotional pain Interpersonal touch and social support can influence physical health, mental well-being and pain.
Provide Physical Comfort and Care
Making the decision to use caregivers outside of the family, and the decision to use a facilitys care comes with a host of benefits.
The benefits of a senior care facility include:
Medical supervision of acute and chronic health symptoms
Care team coordination
Try to Meet Spiritual and Cultural Needs
At Senior Services America communities, our team members strive to understand your loved ones wishes in reference to:
Pain management and comfort care
What Does Stage 5 Look Like
In Stage 5, the person with dementia has progressed to the middle stage and can no longer live independently. They can still perform some basic tasks, such as being able to feed themselves, but someone else has to prepare the meals for them. At this stage, problematic behaviors can start to occur, such as confusion, wandering, hallucinations and suspiciousness. The person with dementia will require a full-time caregiver and will become more and more dependent.
What Are The Signs That Someone With Dementia Is Dying
It is difficult to know when a person with dementia is coming to the end of their life. However, there are some symptoms that may indicate the person is at the end of their life including:
- limited speech
- needing help with everyday activities
- eating less and swallowing difficulties
- incontinence and becoming bed bound.
When these are combined with frailty, recurrent infections and/or pressure ulcers, the person is likely to be nearing the end of their life. If the person has another life limiting condition , their condition is likely to worsen in a more predictable way.
When a person gets to within a few days or hours of dying, further changes are common. These include:
- deteriorating more quickly
- irregular breathing
- cold hands and feet.
These are part of the dying process, and its important to be aware of them so that you can help family and friends understand what is happening.
When a person with dementia is at the end of life its important to support the person to be as comfortable as possible until they die
For more information, see our page, Signs that someone is in their last days or hours.
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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End Stage Of Dementia
The end stage of dementia is the most difficult stage for those suffering from the disease, and also for family members, caregivers, and healthcare professionals. Victims lose what is left of their intellectual and physical capabilities and become completely dependent on others. The model is still shifting in considering end stage dementia an end of life condition experts are pushing this model in order to advocate for better pain and distress management for those suffering at their end.
Provide Physical Comfort And Care
Assess the person to ensure they are not in discomfort or restless, and offer the kind of care described in the above section . Reduce any interventions to only what is necessary, for example change the persons position every few hours or when they need changing.
Give regular mouth care. This can be done hourly to prevent the persons mouth from becoming dry. Apply Vaseline to keep lips moist.
Give eye care, for example use a soft piece of wet clean gauze to prevent the persons eyes from looking sticky.
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Signs Of Dying In The Elderly With Dementia
Dementia is a general term for a chronic or persistent decline in mental processes including memory loss, impaired reasoning, and personality changes. Alzheimers disease is the most common form of dementia, accounting for 60-80% of all cases of dementia. It is also the 6th leading cause of death in the United States, and over 5 million Americans are currently living with Alzheimers disease.
Alzheimers disease and most progressive dementias do not have a cure. While the disease inevitably worsens over time, that timeline can vary greatly from one patient to the next.
Caring for a loved one can be challenging and stressful, as the individuals personality changes and cognitive function declines. They may even stop recognizing their nearest and dearest friends and relatives. As dementia progresses, the individual will require more and more care. As a family caregiver, its important to be able to recognize the signs of dying in elderly with dementia. Hospice can help by offering care wherever the individual resides, providing physical, emotional and spiritual care to the patient and support their family.
Dementia Stages: How Fast Dementia Progresses Stages Of Dementia And More
Dementia is a progressive impairment of cognitive function caused by damage to the brain. Over time, a person with dementia will have increased difficulty with memory, understanding, communication, and reasoning.
Healthcare providers frequently speak about a persons dementia in terms of stages. This can be helpful for communicating with family or other healthcare providers regarding the persons illness, and it is important for determining an appropriate care plan.
How Fast Does Dementia Progress?
It is important to note that dementia progresses at different speeds for every person, and for different types of dementia. The most well-known form of dementia, Alzheimers disease, is just one specific type of dementia, and tends to have the slowest progression of all types. Some factors that affect the rate of progression include:
- Repeated infections
What are the Stages of Dementia?
There are a few different systems used to grade dementia — at the most basic there is early, moderate, and end. Many providers use the system developed by Dr. Barry Reisberg of New York University which includes 7 stages. The Reisberg scale is also known as the GDS or Global Deterioration Scale for Assessment of Primary Degenerative Dementia. This scale focuses primarily on cognitive abilities.
Dementia Stages in the Reisberg Scale
Dementia Stages in the FAST Scale
Dementia Stages in the CDR Scale
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What Stage Of Dementia Is Word Salad
As Alzheimer’s progresses, individuals may form less coherent sentences, more fragmented thoughts, and eventually produce what sounds like word salad. Caregivers should be patient, try to decipher what they can, and gently attempt to get the person to expand on what they are trying to communicate.
Eating And Drinking/eating Problems
Over the course of the disease difficulties in eating become more and more manifest with consequently reduced food intake and need for support with eating and drinking. People with advanced dementia have problems to swallow adequately. Moreover, they tend to keep food in their mouths, stop chewing or spit out food. In the last month of life difficulty with swallowing was found in 42% of persons and 32% exhibited observable weight loss . Advanced dementia is a risk factor for aspiration followed by pneumonia . Instances of reduced food intake dictate that acute medical events need to be examined, as possible causes for eating problems, these include. acute infections, pain, inadequate oral health, medication related side effects, and stroke . Dementia is often accompanied by deterioration in oral health and oral hygiene which, among other possibilities, may be induced by medication side effects of dry oral mucosa and possible subsequent damage to the oral cavity and teeth. Living with sore mouth is very burdensome, causes pain, hinders use of dental prosthesis and often reduces food intake of people with advanced dementia. Educating caregivers about oral hygiene has great potential for improving the oral health of people with dementia .
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