Are You Supporting A Person With Later
Caring for someone in the later-stages of dementia can present a lot of challenging situations and emotions. Providing support with daily tasks is one thing, but supporting a loved one with personal care, and watching their behaviour and personality change can put a lot of pressure on your relationship with them.
You may feel sadness, confusion, and perhaps anger but it can be difficult to share these feelings with friends or other family members.
Joining carers groups can connect you to support from people who understand what youre going through. There are a number of online carer communities, and you may find some in-person groups in your local area too. Local groups are particularly good at organising things like coffee mornings and day trips, and may be able to help you arrange respite care when you need a break.
To find a support group, speaking to the following people is a great place to start:
- Your GP
Stage : Moderate Cognitive Decline
Stage 4 is often referred to as the mild dementia stage. When an individual enters this period, he or she will clearly demonstrate deficits when given cognitive examinations.
During Stage 4, you can expect your family member or friend to show continued difficulties with concentration as well as trouble recalling recent events. Short-term memory issues may include things like forgetting what they ate for lunch that day. Memories about past events may begin to fade or become increasingly hard to recall.
Additionally, individuals at this stage of dementia find it hard to operate independently. You may notice they cannot manage their finances, or do not pay bills consistently or on time. The person may not be able to travel alone, especially to unfamiliar areas.
Social anxiety is common during this period. If you notice your family member or friend begin to withdraw themselves from social interactions, it may be due to memory difficulties. They may not remember names and begin to forget personal histories.
Lastly, he or she may also feel in denial about the symptoms and wont want to accept medical assistance. At this stage, a diagnosis from a physician is most likely and a care plan would be recommended. A caregiver may need to assist with managing finances and driving duties. The person will also need a lot of emotional support during this difficult time. Although timeframes for this stage will vary, Stage 4 lasts an average of two years.
Factors That Affect Life Expectancy With Dementia
As with life expectancy in general, many factors affect the expected length of survival after a diagnosis of dementia. If we include everyone of all ages, average life expectancy is decreased by almost nine years by dementia, but this number can be further refined based on individual characteristics. For example, an individuals sex is a factor affecting survival after dementia, just as it affects life expectancy in general. At all ages, expected survival after a dementia diagnosis is about 1.5 years longer for women than for men. Scientists are researching the biological basis for this, and it may also be explained in part by differences in social norms .
Read Also: Color For Alzheimer’s Ribbon
How Can Healthcare Professionals Help At This Stage
Healthcare professionals can explain these changes so you understand what is happening.
Healthcare professionals can also take steps to reduce the persons pain or distress, often using medication.
If the person cant swallow, then medication can be provided through patches on the skin, small injections or syringe pumps that provide a steady flow of medication through a small needle under the persons skin. Speak to a GP or another health professional about this.
Life Expectancy For Other Forms Of Dementia
Although Alzheimers disease is our focus here, a discussion of survival should consider other dementias as well. Survival after a diagnosis of Lewy body dementia is significantly shorter than survival after a diagnosis of Alzheimers disease. Survival lengths after a diagnosis of vascular dementia or frontotemporal dementia are intermediate. Compared to dementia, a diagnosis of mild cognitive impairment is associated with a smaller reduction in life expectancy, and in many cases does not lead to Alzheimers disease and dementia.
Life expectancy after a diagnosis of Alzheimers disease varies from person to person. In the case of Genevieves mother, a white woman of age 75 at the time of her diagnosis, I estimated her expected survival to be around 6.7 years. This ballpark figure might prove correct or not since it is an estimate based on a population rather than a certainty for this individual. Having a general idea of expected survival assisted Genevieves family in facing the most probable future, planning, and valuing the preciousness of each remaining day.
Don’t Miss: Difference Between Senility And Dementia
Strengths And Limitations Of Study
The strengths of our study are a population based design, long term follow-up, and accurate diagnosis of Alzheimers dementia through structured clinical neurological evaluations with neuropsychological testing. Our study has several limitations. Firstly, adherence to lifestyle factors was determined at baseline and not updated during the follow-up because we think that lifestyle changes could be attributed to cognitive impairment as the population ages. Secondly, the proportion of people with an unhealthy lifestyle could be underestimated in our study because people with poor health are less likely to participate in research studies , or due to their overall health, they might have died before having the opportunity to participate in our study . Thirdly, assessments of lifestyle factors were based on self-report and could be prone to measurement error, although these questionnaires were validated. Fourthly, the life expectancy estimates provided in this study should not be generalized to other populations without additional research and validation.
What To Expect In The Later Stages Of Dementia
The later stages of dementia can be hard to define and everyone will go through them in their own way. Advanced dementia is likely to cause considerable difficulties in most aspects of a persons life. This means they will rely on others for much of their care.As dementia causes changes to the person’s brain, the symptoms will get worse over time. Eventually, the person with dementia may struggle to do many of the things they used to. However, even in the later stages they may experience moments of lucidity and some of their abilities may return temporarily.Our information is for anyone supporting someone in the later stages of dementia, including details on advanced dementia symptoms and the care and support available. It also includes advice on how to support the person and plan ahead for the later stages.
Read Also: What Color Is The Dementia Ribbon
What Are The Average Life Expectancy Figures For The Most Common Types Of Dementia
The average life expectancy figures for the most common types of dementia are as follows:
- Alzheimers disease around eight to 10 years. Life expectancy is less if the person is diagnosed in their 80s or 90s. A few people with Alzheimers live for longer, sometimes for 15 or even 20 years.
- Vascular dementia around five years. This is lower than the average for Alzheimers mostly because someone with vascular dementia is more likely to die from a stroke or heart attack than from the dementia itself.
- Dementia with Lewy bodies about six years. This is slightly less than the average for Alzheimers disease. The physical symptoms of DLB increase a persons risk of falls and infections.
- Frontotemporal dementia about six to eight years. If a person has FTD mixed with motor neurone disease a movement disorder, their dementia tends to progress much quicker. Life expectancy for people who have both conditions is on average about two to three years after diagnosis.
To find out about the support available to someone at the end of their life, and to their carers, family and friends, see our End of life care information.
You can also call Alzheimers Society on 0333 150 3456 for personalised advice and support on living well with dementia, at any stage.
Dementia Connect support line
Prognosis After Dementia Diagnosis
Median survival after diagnosis of dementia was 3.7 years but varied with sex and, in particular, with age at diagnosis . In women, median survival ranged from 7.7 years when diagnosed before age 70 to 2.6 years with diagnosis after the age of 90. Among men, these numbers were 5.3 years and 2.4 years, respectively. A diagnosis of dementia was thus associated with a reduction in median life expectancy of close to 60% when diagnosed between 65 and 69 years and of about 20% when diagnosed at ages 8589 years. Prognosis was not affected by educational attainment or APOE-4 carrier status .
Recommended Reading: Bob Knight Health Condition
How To Identify The 7 Stages Of Dementia
Dementia is a general term that encompasses different types of disorders, including Alzheimers disease, dementia with Lewy Bodies, frontotemporal dementia and others. While each type of dementia progresses differently, there are two general diagnostic models used to describe the progression of dementia: the three-stage model and the seven-stage model. With the latter, the decline of a patient is separated into more specific stages than the earlier. The seven-stage model is based off of the Global Deterioration Scale, an assessment tool created by Dr. Barry Reisberg to assist friends, family and caregivers with recognizing the clinical signs of the disease.
Prior to assessment, caregivers look at different behaviors demonstrated by the individual. Not only is memory assessed, but the persons judgment, sense of direction, personal care and daily activities are considered as well. Based on the severity of the dementia, a care plan can be devised by a physician and the individuals caregivers. In the earlier stages of dementia, an individual will still have independence and be able to perform many activities without assistance. When entering the later stages of dementia, the individual will need around-the-clock assistance for most daily activities.
The following is a summary of the seven stages of dementia, according to the model created by Dr. Reisberg:
Life Expectancy Of Vascular Dementia
After stroke episodes that lead to Vascular Dementia, life expectancy differ in their options. A concise age range that is expected to live to with Vascular Dementia, is unavailable, however if little action is taken to treat the condition, the expectancy can almost be cut in half. Talking to a medical professional, like a doctor, can inform people more on the condition itself, and what measures should be taken if someone has it.
Typically, cases that result in Vascular Dementia generally put life expectancies at around three years after a stroke episode. These are standard results for all stroke cases, however its pretty general for all cases. Understanding symptoms of Vascular Dementia early on can greatly increase the range of life expectancy, as long as health and care factors are taken care of in the process.
Don’t Miss: Does Diet Coke Cause Memory Loss
Stage : Severe Dementia
Stage 7 is considered the final stage on the Global Deterioration Scale. At this stage, the person has lost all ability to speak or communicate effectively. The individual may utter a few words or phrases, but they will not likely relate to his or her current environment. Individuals need assistance with the majority of daily living activities. They will need to be helped with not only bathing, dressing and meal preparation, but also eating and toileting. In the final stages of Alzheimers disease, individuals often lose the ability to swallow.
Severe dementia individuals are also at an increased risk for developing infections including pneumonia. Motor skills, including the ability to walk, occur at this stage. Angry outbursts are more widespread as the individual feels extreme agitation. Dementia individuals with these signs need around-the-clock care. This stage could last upwards of two years.
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 .
Don’t Miss: Ribbon Color For Alzheimer’s
What Are Specific Care Needs At Each Stage
An individual may not require care assistance after the initial diagnosis of dementia, but that will change as the disease progresses and symptoms become worse. There are about 16 million unpaid caregivers of people with dementia in the United States. While many caregivers are providing daily help for family members, they also hire someone to help. There are many options of care assistance, such as in-home care, adult day care, and nursing home care. There is also financial assistance available.
Early Stage DementiaAs mentioned above, in the early stage of dementia a person can function rather independently and requires little care assistance. Simple reminders of appointments and names of people may be needed. Caregivers can also assist with coping strategies to help loved ones remain as independent as possible, such as writing out a daily to-do list and a schedule for taking medications. Safety should always be considered, and if any tasks cannot be performed safely alone, supervision and assistance should be provided. During this period of dementia, its a good idea for caregivers and loved ones to discuss the future. For example, a long-term care plan should be made and financial and legal matters put in place.
Clinical Evaluation And Diagnosis Of Alzheimers Dementia
Clinical evaluation and diagnosis of Alzheimers dementia have been described in detail previously. In short, cognitive measures included 17 tests and were administered uniformly with examiners blinded to population interview and sampling category. A board certified neuropsychologist used data from these cognitive tests to summarize impairment in each of five cognitive domains, including memory, language, orientation, attention, and perception. Additionally, trained nurse clinicians performed a structured neurological examination and screened participants medical history. A board certified neurologist then reviewed all the data and re-examined each participant, emphasizing findings considered to be of clinical importance or atypical. The neurological examination was in agreement with the National Institutes of Health stroke scale.
An impairment in two or more functions on cognitive performance tests and a loss of cognitive function determined by the neurologist were required to diagnose dementia. The diagnosis of Alzheimers dementia was determined by the criteria of the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimers Disease and Related Disorders Association for probable Alzheimers disease. In the CHAP study, data on prevalent and incident Alzheimers dementia were collected up to February 2012.
Also Check: Etiology Of Alzheimer’s
Average Dementia Survival: 45 Years
Study of Dementia Patients Shows Women Live Slightly Longer Than Men
Jan. 10, 2008 — The average survival time for people diagnosed with dementia is about four and a half years, new research shows. Those diagnosed before age 70 typically live for a decade or longer.
In an effort to learn more about survival characteristics among patients with Alzheimer’s disease or other dementias, researchers from the U.K.’s University of Cambridge followed 13,000 people who were aged 65 and older for 14 years.
During the follow-up, 438 of the study participants developed dementia and 356 of these people died.
Overall, women lived slightly longer than men after a diagnosis of dementia — around 4.6 years vs. 4.1 years. And frailer patients died sooner than healthier ones.
But being married, living at home, and even degree of mental decline were not found to have a big impact on survival.
The research is published in the Jan. 11 issue of the journal BMJ Online First.
“When we took everything into account, the big predictors of how long people survive remain sex, age, and functional ability,” University of Cambridge professor of epidemiology Carol Brayne tells WebMD. “Functional ability was a much better marker of how close someone was to death than cognitive decline.”
What Are The Signs And Symptoms Of Rapid Onset Dementia
Signs and symptoms of dementia can vary depending on the underlying cause. However, the most common signs include cognitive change, memory loss, difficulty with problem-solving or completing complex tasks, and confusion or disorientation. Many people with dementia will also experience psychological changes such as depression, anxiety, personality changes, paranoia, hallucinations, agitation, and inappropriate behavior. Some causes of rapid onset dementia can be treated and possibly reversed if a diagnosis can be found quickly enough. For other people with this disease, there is no cure and a progression of symptoms is unavoidable.
Where To Live With Dementia
Eventually, caregiving for someone with dementia wont be appropriate anymore. The needs of a person with progressive dementia become overwhelming, and moving into a full-time residence with trained staff becomes necessary. You should plan for this well before it becomes necessary, by visiting communities and asking the right questions.
Depending on your loved ones stage of illness, different living options are available:
Assisted Living in Early StagesAssisted living residences combine room and board with medical and personal care, and are often sufficient for someone in the early stages of Alzheimers disease or related dementia. Full-time supervision means residents are safe, with living units like private studios or apartments so someone with mild dementia can still feel a sense of independence.
Services offered in assisted living include meals, help with activities of daily living , social activities, and transportation to and from doctors appointments. Before moving in, the residence will assess your loved one to make sure its a good fit.
Memory care residences have physical designs that are appropriate for people with dementia. Someone with Alzheimers, for instance, may become upset when encountering a wall, so memory care buildings have circular hallways. Because people with dementia are prone to wander, memory care residences have increased security and supervision, and special locks on doors.
Did You Know?