Monitor New And Worsening Behavioral Symptoms
Too often family caregivers get caught up in trying to determine what is normal for their loved ones. Normalcy can be used to describe a seniors mood, behavior, appetite, sleep schedule, symptoms and much more. Establishing a baseline for a loved ones mental and physical health is very useful for quickly identifying changes, but trying to make comparisons with other patients and textbook definitions can be an exercise in futility. This is especially true when it comes to caring for seniors with Alzheimers disease and other forms of dementia. Normal becomes an ever-changing state that is different for every single patient. In some cases, accepting certain behaviors as normal can actually cause us to overlook important red flags.
Because these behaviors may be caused by the disease itself and/or exacerbated by additional contributing factors, it is important to carefully document any new or changing symptoms and discuss them with a doctor as soon as possible. Certain environmental factors, dehydration, lack of sleep, changes in or reactions to medication, and even infection can contribute to hallucinations and delusions.
How Can Hallucinations Be Treated
Drug treatments are often not that helpful for people with dementia. However hallucinations, particularly in people with dementia with Lewy bodies, may respond to anti-dementia drugs.
Antipsychotic medication can sometimes help to reduce severe or distressing hallucinations. They should only be used when other treatments have not worked, as they can cause unpleasant or dangerous side-effects. This medication should be regularly reviewed.
People with dementia with Lewy bodies are at particular risk of severe harmful reactions to antipsychotic medication. For more information see Drugs for behavioural and psychological symptoms in dementia.
How Do You Know When Someone Is Beginning Their Dying Process
There are certain signs when illness or old age has tipped into a preparation for death.
The dying may feel compelled to resolve unfinishedbusiness End-of-life research studies show that the dying are often called by an almost organic process to confront and resolve unfinished issues from their past, particularly with estranged family members.
Special requests Sometimes people may want to do something special such as visit a particular site, or be surrounded by their favourite flowers, or to hear certain music, or to have family photographs near, or to make contact again with someone who has been important in their lives.
Their external world begins to diminish The draw of the world at large no longer appeals and even engaging with family matters no longer seems important. Rather the dying person prefers to remain in a safe, quiet place, often in bed.
Physical changes These changes are part of the dying process. The skin can become paper-thin and pale, with dark liver spots appearing on hands, feet and face. Hair can also thin and the person may shrink in stature. Teeth can discolour or develop dark stains.
Appetite reduces the body knows it no longer needs fuel to keep it going, and those who are dying often lose their desire to eat or drink. They can begin to lose weight, sometimes quite rapidly. Its important not to force food or drink onto someone who no longer wants it. But do take guidance from medical staff and end of life carers.
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How Dementia Causes Death
A person in the late stage of dementia is at risk for many medical complications, like a urinary tract infection and pneumonia . They’re at an even higher risk of certain conditions because they’re unable to move.
Trouble swallowing, eating, and drinking leads to weight loss, dehydration, and malnutrition. This further increases their risk of infection.
In the end, most people with late-stage dementia die of a medical complication related to their underlying dementia.
For example, a person may die from an infection like aspiration pneumonia. This type of pneumonia usually happens because of swallowing problems.
A person may also die from a blood clot in the lung because they are bedbound and not mobile.
It’s important to know that late-stage dementia is a terminal illness. This means that dementia itself can lead to death. Sometimes this is appropriately listed as the cause of death on a death certificate.
Loved One Having Hallucinations See The Doctor
First , if your loved one is experiencing hallucinations, it’s important you communicate this to their physician. It’s critical the medical professional conduct an evaluation and rule out other potential causes and to determine whether medication is needed. For example, some caregivers believe their loved one is experiencing hallucinations, but it’s actually vision problems.
Because of this, it’s always important to arrange a vision test with a dementia-friendly optician to rule out vision problems as the source. In addition, certain medications, a bladder infection, and kidney infections may cause confusion as well as hallucinations. For all of the reasons mentioned above, it’s best to speak with your loved one’s physician first.
General Guidelines For Dealing With Dementia And Hallucinations
Seeing things that are not there can be unnerving and even frightening even if what you’re loved one is seeing isn’t scary. As a result, it’s important to reassure your loved one their hallucinations aren’t unusual and may stop over time. You can also explain the visions may be controlled and there is nothing to be frightened of.
However, you shouldn’t argue with a loved one who insists what they’re hearing or seeing is real. From their perspective, it is real…very real. And if you attempt to convince them otherwise, it can lead to feelings of anxiety, frustration, and other negative emotions. Here are a few general guidelines caregivers can use to soothe a loved one with dementia experiencing hallucinations.
Alma And Silvias Story
Alma had been forgetful for years, but even after her family knew that Alzheimers disease was the cause of her forgetfulness, they never talked about what the future would bring. As time passed and the disease eroded Almas memory and ability to think and speak, she became less and less able to share her concerns and wishes with those close to her.
This made it hard for her daughter Silvia to know what Alma needed or wanted. When the doctors asked about feeding tubes or antibiotics to treat pneumonia, Silvia didnt know how to best reflect her mothers wishes. Her decisions had to be based on what she knew about her moms values, rather than on what Alma actually said she wanted.
Quality of life is an important issue when making healthcare decisions for people with dementia. For example, medicines are available that may delay or keep symptoms from becoming worse for a little while. Medicines also may help control some behavioral symptoms in people with mild-to-moderate Alzheimers disease.
However, some caregivers might not want drugs prescribed for people in the later stages of Alzheimers. They may believe that the persons quality of life is already so poor that the medicine is unlikely to make a difference. If the drug has serious side effects, they may be even more likely to decide against it.
What I Wish I Knew Before My Mothers Alzheimers Death
As with many Alzheimers patients, it was the family who suggested my mother get her memory tested. She was 68 years old, repeating herself, losing things and occasionally paranoid and combative with my father, something we had never seen from her before. We thought she might be depressed, but the notion that she might have dementia crossed our minds. She was diagnosed with mild cognitive impairment, the earliest stage of forgetfulness, in 2008, but was not officially given the diagnosis of Alzheimers until 2010, when she had an epileptic seizure. After that, her memory and cognitive faculties deteriorated sharply.
This is not the story of an Alzheimers patient swinging between the ignorance of their forgetfulness and the panic of watching their own ongoing decline come into focus, nor the story of the fear, the bouts of irritability, and the deep sorrow felt by family members watching their loved one slowly disappear before their eyes. We went through all that, yes. But this is the story of the last three excruciating months of my mothers life. She died in her familys arms at the age of 76, having battled Alzheimers bravely for more than eight years.
Signs Of Death In Elderly With Dementia: End Stage
Dementia is a term used to describe the persistent or chronic decline in ones mental processes and this include personality changes, impaired reasoning, and memory loss. The most common form is Alzheimers disease and it accounts for over 70 percent of all the dementia cases.
It is one of the greatest causes of death in the United States with over five million people living with the disease in the country alone. One of the age groups affected by dementia is the seniors. If you are a caregiver, it is important to know the signs of death in elderly with dementia.
Most progressive dementias and Alzheimers disease do not have any cure. The diseases get worse with the passage of time, but the timeline can be very different from one person to the next.
Caring for persons with the diseases can be stressful and very challenging, especially when their personality begins to change and their cognitive function starts to decline. It is possible that the individual will not even recognize the people who are closest and dearest to them.
As the disease progresses, the person needs more and more support from the caregiver and the family. If the person is elderly, the caregiver needs to know about all the signs that the patient may be dying.
You may need to put the patient on hospice so as that he or she can get the appropriate care during such moments. This offers the family and the patient spiritual, physical, and emotional care.
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Telling About A Death
Here are some hints for telling a person with dementia about a death:
- Tell the news as soon as possible. They will sense that something is wrong and need information to understand, even if just for that period of time.
- If you are too emotional to talk to them, find someone else maybe a friend or healthcare professional.
- Choose a time to talk when the person with dementia is well rested.
- Use short, simple sentences. Dont give too many details this may overwhelm them.
- Answer questions as honestly as possible.
- Use clear words like died instead of passed away or at peace now.
- Try not to protect the person from the truth by suggesting that the person who has died is away and will return later. This can cause worry and agitation later when the person does not return.
- You can support them with physical touch, such as a hug or holding hands.
- Consider involving the person with dementia in funeral planning, assigning a simple task. This will help the death be more real for them. They may recognize the rituals around death and act appropriately.
- Plan for someone to be with the person during services who can also take them out if they become agitated.
Watch Our Talk The Last Stage Of Alzheimers: What You Need To Know With Jasja Kotterman And Dr Liz Sampson Of University College London:
And then one day, the spell broke. She was hungry and thirsty, and drank and even ate and chewed, slowly, but with relish. And we gave her as much as we dared without causing her to choke. The doctor told us we would have many more months with her if she kept eating. It was a relief to hear this, and we had a few good daysso good that I planned to go back home, my sister made plans to head back to work, and my father planned to visit friends in France. We would keep in touch and be ready to come back as soon as things got worse again.
But worse came the following day. The doctor called saying my mother had developed a lung infection. She must have choked on something on one of the good days, some water, some food had entered her lungs and triggered a lung infection.
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The Seven Stages Of Dementia
One of the most difficult things to hear about dementia is that, in most cases, dementia is irreversible and incurable. However, with an early diagnosis and proper care, the progression of some forms of dementia can be managed and slowed down. The cognitive decline that accompanies dementia conditions does not happen all at once – the progression of dementia can be divided into seven distinct, identifiable stages.
Learning about the stages of dementia can help with identifying signs and symptoms early on, as well as assisting sufferers and caretakers in knowing what to expect in further stages. The earlier dementia is diagnosed, the sooner treatment can start.
How Can You Tell If Someone Is Hallucinating
Sometimes the person may appear to be hallucinating, but there is another cause . The following tips can help to identify hallucinations:
- Hallucinations differ from misperceptions or misidentifications. Listen to what the person is describing, and check if anything could be causing what they are experiencing. For example, if they describe a swarm of insects, and there is a busy pattern on a carpet, it may be a misperception. By changing or covering the carpet, the misperception may stop.
- If the person seems to be having auditory hallucinations , arrange to have their hearing checked. If the person wears a hearing aid, check that it is working properly at the right setting, and encourage them to wear it. The person may be having problems with their hearing, rather than hallucinating.
- If the person seems to be having gustatory hallucinations , make sure they are getting regular dental check-ups to rule out other causes such as tooth decay or denture cream. For more information see Dental care and oral health.
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Risk Factors For Psychosis
Not everyone with Parkinsons will develop hallucinations or delusions, but there are several things can increase your risk:
- Dementia or impaired memory
- Depression: Individuals suffering from depression and PD are at a greater risk. In addition, severe depression alone can cause psychosis.
- Sleep disorders, such as vivid dreaming. Individuals commonly report vivid dreaming prior to the onset of psychosis. Other associated sleep disturbances include REM sleep disorder and general insomnia.
- Impaired vision
- Use of PD medications
Can You Die From Dementia
Dementia is usually considered a disorder affecting memory and is associated with aging. In the initial stages, this could be true. Loss of memory is one of the earliest signs of the disease.
However, according to experts, dementia is a fatal brain failure that needs to be taken seriously like other terminal diseases that kill a patient slowly. It is not just an ailment that is associated with the elderly.
Even though the distinction is not really known in the medical field and to the general public, it is something that needs to be considered when one has to be treated at the very end stage of the condition.
It is believed that the fact that people are misinformed and misguided about dementia, the end stage treatment is usually made very aggressive.
The disease progresses quite slowly and the fact that it affects so many people means that it should be taken seriously. Dementia is a collection or a consequence of different diseases like Alzheimers disease, vascular dementia, and Parkinsons disease. In later stages, you can tell the type of dementia that is affecting a certain patient.
The patient can have eating problems, pneumonia, fever, pain, and difficulty breathing, which are all caused by the failure of the brain. In the end, dementia involves so many other parts of the body.
It is important to appreciate that the brain is the engine of our bodies. It controls everything, including metabolism, gastrointestinal tract, the lungs, and even the heart.
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Telling The Truth To People With Dementia
Get advice on how to deal with difficult situations around telling the truth to people with dementia.
Making decisions and managing difficult situations
Situations may arise where a person with dementia asks questions that leave carers feeling unsure about whether to answer honestly. This could be because the answer would be distressing to the person for example, reminding them that a relative or partner has died. In cases such as these, carers can look for different ways of handling the situation.
If the person says something that you know is not true or possible, try to see past what they are saying, and instead look at the emotions behind it. For example, if they are asking for their mother, who is no longer alive, it may be that they are feeling scared or need comforting. By meeting the needs behind what is being said, it can be possible to offer emotional support while avoiding a direct confrontation over the facts.
In some situations you may decide that not telling the truth is in the persons best interests. If you do decide that the truth would be too distressing for the person, there are other options available.
Each case should be judged individually and the course of action should be chosen to suit the specific time and situation. An ideal solution is one that you feel comfortable with and also considers the persons interests.
At The End Of Her Life My Mother Started Seeing Ghosts And It Freaked Me Out
Last summer, six months before my mother died, I walked into her bedroom, and she greeted me with tinny hello and a big smile. She then resumed a conversation with her mother – who had died in 1973.
“Where are you?” Mom asked, as though Grandma, a onetime Fifth Avenue milliner, was on one of her many European hat-buying junkets. As I stood there dumbstruck, Mom continued chatting – in a young girl’s voice, no less – for several more minutes. Was this a reaction to medication, a sign of advancing dementia? Or was she preparing to “transition” to wherever she was going next?
Regardless, Mom was freaking me out – as well as my brother, sister and father.
As it turned out, my mother’s chat with a ghost was a signal that the end was inching closer. Those who work with the terminally ill, such as social workers and hospice caregivers, call these episodes or visions a manifestation of what is called Nearing Death Awareness.
“They are very common among dying patients in hospice situations,” Rebecca Valla, a psychiatrist in Winston-Salem, N.C., who specializes in treating terminally ill patients, wrote in an email. “Those who are dying and seem to be in and out of this world and the ‘next’ one often find their deceased loved ones present, and they communicate with them. In many cases, the predeceased loved ones seem to be aiding them in their ‘transition’ to the next world.”
She was beaming. Six weeks later, she passed – and pasta and salad were on the menu at her service.
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