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 .;
How Is Dementia Diagnosed
No single test can determine if your loved one has dementia. A physician will examine several factors to come up with a diagnosis, including a full medical history, physical exam, laboratory tests, and recognizing a pattern of loss of function and skills. With a high-level of certainty, doctors can diagnose a person with dementia, but its more challenging to define the exact type of dementia. Biomarkers can help make an accurate diagnosis of Alzheimers disease, which is included under the umbrella of dementia.
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.
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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.
Causes Of Vascular Dementia
Vascular dementia is caused by reduced blood flow to the brain, which damages and eventually kills brain cells.;
This can;happen as a result of:
- narrowing and blockage of;the small blood vessels inside the brain
- a single;stroke, where the blood supply to part of the brain is suddenly cut off
- lots of “mini strokes” that cause tiny but widespread damage to the brain
In many cases, these problems are linked to underlying conditions, such as;high blood pressure and;diabetes,;and;lifestyle factors, such as smoking and being overweight.
Tackling these might reduce your risk of vascular dementia in later life, although;it’s not yet clear exactly how much your risk of dementia can be reduced.
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What Affects Life Expectancy In Dementia
The life expectancy of someone living with dementia depends on many factors. The type of dementia, the severity of dementia at the time of diagnosis, and the individual’s age, sex, and their general health and wellbeing can all impact on the time they can live with the disease. The key things that affect life expectancy include:
What Are The 7 Stages Of Dementia
Dementia does not affect every person in the same way. It presents itself differently in each individual and progresses at different rates. Some people will stay in a state of mild decline for an extended period, while others may develop multiple symptoms quickly. Understanding the seven stages of dementia can make these transitions a little easier for your loved one and you as their caregiver.
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What Causes Vascular Dementia
Vascular dementia occurs when vessels that supply blood to the brain become blocked or narrowed. Strokes take place when the supply of blood carrying oxygen to the brain is suddenly cut off. However, not all people with stroke will develop vascular dementia.
Vascular dementia can occur over time as “silent” strokes pile up. Quite often, vascular dementia draws attention to itself only when the impact of so many strokes adds up to significant disability. Avoiding and controlling risk factors such as diabetes, high blood pressure, smoking, and high cholesterol can help curb the risk of vascular dementia.
Catching the condition early also helps limit the impact and severity of vascular dementia. Early detection requires an awareness of risk factors and, more importantly, efforts to keep them under control. Anyone who suspects vascular dementia should talk with their doctor.
Caregiving In The Late Stages
According to the Alzheimers Association, the later stages will be the most difficult, as your loved one is now very frail and relies on you for most of their daily care. At this late stage, encouraging your loved one to eat and sleep will grow increasingly difficult. During this time, they may lose the ability to walk steadily, so an occupational therapist may help them stay mobile without falling. Gather a team of experts to help you, like a speech therapist to help with communication and a nutritionist to recommend the best food and alternative food options, like blended meals, smoothies, and finger foods, that boost the immunity and are packed with nutrition. Incontinence, severe memory loss and disorientation, immune system problems, repetitive movements, and strange or unusual behavior must all be managed during this stage as well.
Watching a loved one live with dementia is never easy. With the proper tools, you can help them navigate their symptoms to live an enriching life. Staying on top of the latest research with Google alerts and attending seminars from expert speakers and medical professionals will keep you up-to-date on new treatments and care techniques. Most importantly, find a supportive community. There are many support groups for caregivers where you can share your successes, frustrations, fears, and joys with other caregivers. Remember, you are not alone!
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What Are The Symptoms Of Vascular Dementia
The first noticeable symptoms of vascular dementia tend to be the neurological ones: problems with motor reflexes, movement, and muscle weakness are usually the first sign that something is wrong. This is different to the other main form of dementia, Alzheimers disease, in which the earliest symptoms are usually problems with memory loss and behavioral changes. By contrast, memory loss usually occurs much later in patients suffering from vascular dementia.
Unlike Alzheimers disease, the symptoms in patients with vascular dementia tend to alternate between plateaus of relative stability, followed by a sudden deterioration in function, whereas Alzheimers patients usually show a much more gradual worsening of symptoms as the disease progresses.
Stage : Mid Stage Semi Severe Vascular Dementia
Another one on the list of the vascular dementia stages that I would like to reveal in this article today and want you and my other readers to know if you are considering whether they get this disorder or not.
Loss of mobility: Many people gradually lose the ability of walking and performing everyday tasks. One of the first signs is that they walk unsteadily. They can also seem slower, bump into things and fall objects. Some people even become confined to a chair or bed. People who are caring for people with vascular dementia should ask for an advice from a community nurse or a therapist to aid mobility.
Memory loss: This symptom is very severe in the stages of vascular dementia. Patients may not be able to recognize other people who are close to them and even their own reflection. Also, they may not be able to find their way home around familiar surroundings or identify objects they use every day. However, occasionally, they may experience sudden flashes of recognition. They may believe that they are in a time from their past and may look for something or somebody from that time. For those around them, it may be helpful to try talking with them about the past. Even when they have severe memory loss, they still can appreciate or respond to music, touch and scent. Thus, continue to talk to them, even when they cannot respond.
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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 ;.
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.
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Subcortical Vascular Dementia Also Called Binswangers Disease
The symptoms of Binswangers disease are related to the disruption of subcortical neural circuits involving short-term memory, organization, mood, attention, decision making, and appropriate behavior. A characteristic feature of this disease is psychomotor slowness, such as an increase in the time it takes for a person to think of a letter and then write it on a piece of paper.
Treatment of Binswangers disease
There is no specific course of treatment for Binswangers disease. Treatment is symptomatic. People with depression or anxiety may require antidepressant medications such as the serotonin-specific reuptake inhibitors sertraline or citalopram. Atypical antipsychotic drugs, such as risperidone and olanzapine, can be useful in individuals with agitation and disruptive behavior. Recent drug trials with the drug memantine have shown improved cognition and stabilization of global functioning and behavior. The successful management of hypertension and diabetes can slow the progression of atherosclerosis, and subsequently slow the progress of Binswangers disease. Because there is no cure, the best treatment is preventive, early in the adult years, by controlling risk factors such as hypertension, diabetes, and smoking.
Prognosis for Binswangers disease
Figure 1. Brain Blood Supply looking through a brain sliced in the center
Figure 2. Brain Blood Supply ; looking from the base of the brain up
Research Into The Cause Of Vascular Dementia
Vascular dementia is the second most commonly diagnosed type of dementia, and may account for 15 – 20% of all cases. Vascular dementia is caused by chronic reduced blood flow to the brain, usually as a result of a stroke or series of strokes. It can often coexist with Alzheimer’s disease.
Stroke, small vessel disease, or a mixture of the two can cause vascular dementia. Most commonly there is a blockage of small blood vessels somewhere in the network of arteries that feeds the brain. Blockages may be caused by plaque build up on the inside of the artery wall, or by blood clots which have broken loose. Clots can form as a result of abnormal heart rhythms, or other heart abnormalities. Also, a weak patch on an artery wall can balloon outward and form an aneurysm, which can burst and deprive brain cells of oxygen.
It is estimated that about 50% of cases of vascular dementia result from high blood pressure, which can lead to a major stroke or a series of strokes and a build up of brain damage over time. Less common causes of vascular dementia are associated with autoimmune inflammatory diseases of the arteries such as lupus and temporal arteritis, which are treatable with drugs that suppress the immune system.
An inherited form of vascular dementia known as CADASIL is caused by a mutation on the Notch3 gene. This is a very rare form of dementia and only affects families carrying the Notch3 gene mutation.
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Symptoms Of Vascular Dementia
Symptoms pointing to Vascular Dementia are usually pretty clear, constant confusion, disorientation, and vision loss some of the symptoms that attach to Vascular Dementia. The condition is available to be diagnosed through both testing and screening options, methods that can narrow down the condition from other possibilities. Specific treatments are unavailable at this time, however test treatments have been performed to moderate successful results. These treatments however, have not been fully evaluated by the FDA, Food and Drug Administration. Preventing cases of Vascular Dementia is possible, maintaining a healthy weight, quitting smoking, and regular doctor checkups a few options to keep Dementia at bay. These actions wont completely remove the risk, however they will make the risk a lot lower of a chance of happening.
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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Life Expectancy And Vascular Dementia
Repeated small strokes can damage the brain and cause vascular dementia. Its the second most common cause of the disease. The pattern of disease progression is different from the gradual deterioration of Alzheimers disease. The symptoms may be steady for a while, then suddenly get worse followed by a further period of stability. This reflects times when blood clots interrupt the blood supply to the brain, causing damage.
Because people with vascular dementia is linked to strokes, people affected often have other illnesses and may have worse general health. Research suggests that the average life expectancy is around four years. However, sudden or severe deterioration can happen when there is a further stroke.
Stage : Early Stage Moderate Vascular Dementia
This is also one of the most important vascular dementia stages that everyone should not look down but watch out carefully for good! This stage is the only one wherein the signs and symptoms are clear for the first time. This is because the condition has advanced to the 4th stage and is very clear and evident. People suffering from vascular dementia in this stage tend to stay away from their family and friends. They find it hard to frame sentences and maintain a conversation.
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This stage will last for 2-3 years before everything gets more serious if there is no treatment. The most effective way to treat this condition is to stimulate the individual who are suffering from this disorder to join a community workshop. At this place, he or she will be instructed to play games, which have effect on sharpening the motor and memory skills. In this stage, individual will be diagnosed with moderate vascular dementia.
This is actually also one out of the vascular dementia stages that a lot of people in the world have been diagnosed and have been trying to minimize the damages.
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