What To Do When Dementia Gets Worse

Early Symptoms Of Dementia

Although the early signs vary, common early symptoms of dementia include:

• memory problems, particularly remembering recent events
• increasing confusion
• apathy and withdrawal or depression
• loss of ability to do everyday tasks.

Sometimes, people fail to recognise that these symptoms indicate that something is wrong. They may mistakenly assume that such behaviour is a normal part of the ageing process. Symptoms may also develop gradually and go unnoticed for a long time. Also, some people may refuse to act, even when they know something is wrong.

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.

Sudden Worsening Of Dementia Symptoms

Whether youve been diagnosed with dementia yourself or are caring for someone who has, a sudden change in symptoms, such acute confusion, memory loss, or delirium can be really worrying. In this guide we talk about some of the lesser known reasons why symptoms can get worse in a short space of time, and what to do about it.

According to Alzheimers Research UK, one in every two people will know someone affected by dementia, and you dont have to personally receive a diagnosis for it to have a big impact on your daily life. Seeing a loved one go through cognitive decline is never easy, especially if they seem to be progressing fairly quickly through the different stages of dementia.

Its important to remember that while there are three recognised stages of dementia, symptoms will vary from person to person, which can sometimes give the impression that the condition is progressing faster than it actually is. For example, some common symptoms may occur earlier than expected, while others will fail to occur at all. Some behaviours, such as emotional outbursts, or feeling depressed can come and go too.

And, while dementia is progressive, a sudden or unexpected change in behaviour, mood or memory wont always mean that its the condition itself getting worse. There are a number of other health conditions that can make symptoms worse, which well cover in this guide too.

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• What if someone has a sudden change in symptoms?

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Frontotemporal Dementia: Early Symptoms Vary

In contrast to Alzheimers, people at the early stages of frontotemporal disorders generally dont have trouble with short-term memory. But depending on the type of frontotemporal issue, early symptoms may vary.

For the type of frontotemporal disorder that initially affects the part of the brain that controls behavior, people may behave rudely or appear oblivious to social norms, seem easily distracted, or appear uncharacteristically selfish or unfeeling.

For the less-common type of frontotemporal disorder that initially affects the part of the brain that controls language skills, the early stage includes trouble attaching names to things, comprehending words, or speaking fluently.

But as dementia becomes progressively worse, people who are experiencing behavior changes will begin having language difficulty, and vice versa.

As frontotemporal disorders progress, symptoms will begin to resemble those of Alzheimers, though agitation and aggression generally develop before short-term memory loss and other symptoms of later-stage Alzheimers, such as trouble judging distance and difficulty seeing objects in three dimensions.

On average people with frontotemporal disorders live for six to eight years after the onset of symptoms.

Ways To Reduce And Manage Mean Dementia Behavior

1. Calm the situation downThe first thing to do is reduce the tension in the room.

Start by limiting the distractions in the room, like turning off the TV or asking others to leave.

And if you stay calm, theyre also more likely to calm down.

It might help you to count to 10 or even leave the room for a short time to cool down. Repeat to yourself its the disease as a reminder that theyre not intentionally doing this.

If the current activity seemed to cause the agitation, try shifting to a more pleasant, calming activity. Or, try soft music or a gentle massage.

2. Comfort and reassure while checking for causes of discomfort or fearTake a deep breath, dont argue, and use a calm, soothing voice to reassure and comfort your older adult.

It also helps to speak slowly and use short, direct sentences.

Then, check for possible causes of agitation or fear, like:

• Feeling disturbed by strange surroundings
• Being overwhelmed by complicated tasks
• Frustration because of the inability to communicate

It also helps to focus on their emotions rather than their specific words or actions. Look for the feelings behind what theyre doing as a way to identify the cause.

3. Keep track of and avoid possible triggersWhenever difficult behavior comes up, write down what happened, the time, and the date in a dedicated notebook.

Also think about what was going on just before the behavior started and write that down as a possible trigger.

Taking some time away can help both of you.

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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.

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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Caring For Someone With Dementia Towards The End Of Life

Please be aware – this information is for healthcare professionals. We also have information for the public.

You can use our My Learning form to reflect on how this page has helped with your continuing professional development.

People with dementia may experience problems with thinking, memory, behaviour and mobility. It can be difficult to recognise when someone with dementia is nearing the end of their life. You can support the person by communicating with them and helping them with any symptoms they have. If possible, its a good idea to plan the persons care in advance to help understand what they want from their care.

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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.

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A Person With Dementia Doesnt Always Fit Into One Stage

Dementia affects each person in a unique way and changes different parts of the brain at different points in the disease progression.

Plus, different types of dementia tend to have different symptoms.

For example, someone with frontotemporal dementia may first show extreme behavior and personality changes. But someone with Alzheimers disease would first experience short-term memory loss and struggle with everyday tasks.

Researchers and doctors still dont know enough about how these diseases work to predict exactly what will happen.

Another common occurrence is for someone in the middle stages of dementia to suddenly have a clear moment, hour, or day and seem like theyre back to their pre-dementia abilities. They could be sharp for a little while and later, go back to having obvious cognitive impairment.

When this happens, some families may feel like their older adult is faking their symptoms or just isnt trying hard enough.

Its important to know that this isnt true, its truly the dementia thats causing their declining abilities as well as those strange moments of clarity theyre truly not doing it on purpose.

How Quickly Does Dementia Progress

The speed at which dementia progresses varies a lot from person to person because of factors such as:

• the type of dementia for example, Alzheimers disease tends to progress more slowly than the other types
• a persons age for example, Alzheimers disease generally progresses more slowly in older people than in younger people
• other long-term health problems dementia tends to progress more quickly if the person is living with other conditions, such as heart disease, diabetes or high blood pressure, particularly if these are not well-managed
• delirium a medical condition that starts suddenly .

There is no way to be sure how quickly a persons dementia will progress. Some people with dementia will need support very soon after their diagnosis. In contrast, others will stay independent for several years.

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How Is Parkinson Disease Treated

Parkinson disease can’t be cured. But there are different therapies that can help control symptoms. Many of the medicines used to treat Parkinson disease help to offset the loss of the chemical dopamine in the brain. Most of these medicines help manage symptoms quite successfully.

A procedure called deep brain stimulation may also be used to treat Parkinson disease. It sends electrical impulses into the brain to help control tremors and twitching movements. Some people may need surgery to manage Parkinson disease symptoms. Surgery may involve destroying small areas of brain tissue responsible for the symptoms. However, these surgeries are rarely done since deep brain stimulation is now available.

What Causes Parkinson Disease

Parkinson disease arises from decreased dopamine production in the brain. The absence of dopamine makes it hard for the brain to coordinate muscle movements. Low dopamine also contributes to mood and cognitive problems later in the course of the disease. Experts don’t know what triggers the development of Parkinson disease most of the time. Early onset Parkinson disease is often inherited and is the result of certain gene defects.

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Tips For Everyday Tasks For People Living With Dementia

Alzheimers disease and related dementias get worse over time. Even simple everyday activities can become difficult to complete. To help cope with changes in memory and thinking, consider strategies that can make daily tasks easier. Try to adopt them early on so you will have more time to adjust. You can:

• Write down to-do lists, appointments, and events in a notebook or calendar.
• Set up automated bill payments and consider asking someone you trust to help manage your finances.
• Have your groceries delivered.
• Manage your medications with a weekly pillbox, a pillbox with reminders , or a medication dispenser.
• Ask your doctor to provide a care plan and write down care directions .

Do Not Shy Away From Asking For Help

No one may have all the answers especially when it comes to taking care of a person with dementia. Try doing research on how their behavior changes and what needs to be done to help them live their lives without too many complications. Hire help when it becomes too much as it also ensures that you do not become too frustrated or drained. When you have multiple family members who can help, ask everyone to pitch in and look after the patient so that you can get some personal space to breathe and re-energize when it is your time to look after the patient. When you feel like you can no longer look after your loved one at your own home, it may be time to consider assisted living. In such case, look into dementia care homes that can provide specially trained professionals.

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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.

Is Dementia Treatable

First, its important to understand the difference in the terms treatable, reversible, and curable. All or almost all forms of dementia are treatable, in that medication and supportive measures are available to help manage symptoms in patients with dementia. However, most types of dementia remain incurable or irreversible and treatment results in only modest benefits.

Some dementias disorders, however, may be successfully treated, with patient returning to normal after treatment. These dementias are ones caused by:

• Side effects of medications or illicit drugs alcohol
• Tumors that can be removed
• Subdural hematoma, a buildup of blood beneath the outer covering of the brain that is caused by a head injury
• Normal pressure hydrocephalus, a buildup of cerebral spinal fluid in the brain
• Metabolic disorders, such as a vitamin B12 deficiency
• Hypothyroidism, a condition that results from low levels of thyroid hormones
• Hypoglycemia, a condition that results from low blood sugar
• Depression

Dementias that are not reversible, but may still be at least partially responsive to medications currently available for memory loss or behavior-based problems include:

• Alzheimer’s disease
• Dementias associated with Parkinson’s disease and similar disorders
• AIDS dementia complex
• Creutzfeldt-Jakob disease

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Take Care Of Yourself

Caring for a loved one who is sundowning can make it hard for you to get restful sleep. And you need to take care of yourself in order to be there for your loved one.

Itâs normal to feel scared or overwhelmed when you care for someone with delirium and/or sundowning. Even things you do to help can upset them. It can also cause them to do things that are unsafe for you and them.

It can be hard to know if or when delirium and sundowning may cause someone to get aggressive. To keep your loved one from hurting themselves or others, take away or lock up anything in the home that could be used as a weapon. If they get physically violent, stop what youâre doing and back away. Call for help if you need to.

Remember that delirium may cause a person to say or do things that are rude or hurtful, but itâs not something they can control.

If you feel overwhelmed, you can:

• Ask a friend or relative to fill in for you at night.
• Try to nap during the day.
• Take breaks whenever you can during the day.
• Hire a home health care service for backup.

Other ways to take care of yourself are to:

• Exercise
• Eat healthy
• Spend time with friends
• Try to find time — even if itâs not a lot — for your own hobbies and interests.

Consider joining a caregiversâ support group, too. Your doctor can help you find one.

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