How To Cope With The Late Stages Of Alzheimer’s Disease
However, in late-stage Alzheimer’s disease, the disease begins to considerably affect parts of the brain that control bodily systems, such as motor coordination, bowel, and bladder function, and even breathing. The late stage of Alzheimer’s usually requires rigorous, around-the-clock care, and it can last from several weeks to several years.
The symptoms of late-stage Alzheimer’s disease often include:
- Increased susceptibility to infections, including skin infections
- Difficulty walking and moving, eventually resulting in the person becoming chair-bound or bed-bound
- Loss of the ability to communicate through words
- Groaning, grunting, moaning
- Total incontinence of bowel and bladder, requiring full-time assistance with toileting and hygiene
- Increased sleeping
- Eventual inability to sit up or hold up one’s head
- Loss of facial expressions, including the ability to smile
Individuals with Alzheimer’s disease often die of a medical complication, such as pneumonia or the flu. However, Alzheimer’s itself can be fatal even if there are no other complications, these late-stage symptoms can lead to death when patients can no longer be fed or breathe safely.
Moderate Dementia Or Moderately Severe Decline
Stage 5 lasts about 1 1/2 years and requires a lot of support. Those who dont have enough support often experience feelings of anger and suspicion.
People in this stage will remember their own names and close family members, but major events, weather conditions, or their current address can be difficult to recall. Theyll also show some confusion regarding time or place and have difficulty counting backward.
Caregiver support: People will need assistance with daily tasks and can no longer live independently. Personal hygiene and eating wont be an issue yet, but they may have trouble picking the right clothing for the weather or taking care of finances.
Moving Around: Not Or A Lot
Some people with advanced dementia are unable to walk, to stand up or to hold their weight . They may need help to make the most basic of movements such as shifting position on a chair or in bed.
Others in the later stages of the illness may move around a lot, perhaps even walking for large amounts of the day. This is often seen in care homes where more mobile individuals with advanced dementia may seem to spend their whole day walking up and down corridors and in and out of rooms. The person may or may not appear to be ill at ease while walking its important we spend time trying to establish this. Perhaps the person is trying to find something or someone. They may simply enjoy the sense of doing something purposeful like walking. This sort of constant walking can be stressful for care staff, family members and other residents, and there may or may not be risks associated with it. The key as ever is to establish the persons needs and work out how best to meet those needs.
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What Are The Warning Signs That Life Is Nearing An End
When an elderly person with dementia is almost bearing their end, it can be very traumatic especially for the loved ones. It is important to have an idea of what signs one needs to expect when the end comes as this can give you some sort of comfort.
When you think of a condition such as Alzheimers disease, a person can live for over 10 years with it. It is possible to make the person happy over those years. Since we are not immortals, at some point life does come to an end when you have dementia and it is something that one needs to be prepared for especially if they are caregivers.
Handling the final stage of dementia is much easier, especially when you are aware of the things that you should expect. It is important to give the person the kind of care that will award him or her dignified and peaceful death.
Usually, when a person is about to reach the end, the dementia symptoms usually get worse and this can be quite upsetting. Some of the things that you may notice include:
- Limited mobility so they may have to be bed bound
- Limited speech or no speech at all
- Double incontinence
- Difficulties swallowing and eating
It is important to note that the above symptoms do not really mean that the person will just die. There are people who can have such symptoms for quite some time. You should also remember that about two-thirds of dementia patients succumb to other ailments such as pneumonia.
Some of the other signs that can indicate that death is indeed close include:
Consider The Time Of Day And Frequency
Think about how often these unusual behaviors occur, the time of day they occur, and what the consequences of them are. These patterns can help caregivers prepare for episodes before they begin and prevent negative effects. Examples could be:
- Behavior occurs daily at 3:00 p.m. for two hours and results in the person attempting to escape the premises.
- Behavior occurs once a month in the middle of the night and results in the person turning on all the lights in the house and waking up family members.
- Behavior starts daily at 8:00 a.m. and lasts for 10 hours, non-stop. The result is the person fell three times this week and lost 10 pounds over the last month.
- Behavior occurred once while on vacation at 10:00 a.m. and resulted in the person being lost outside for two hours.
- Behavior occurs about twice a week at 7:00 p.m. and results in the person pacing around the home.
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Introduction To Advanced Dementia
The later stages of dementia are usually referred to advanced or severe dementia but giving a clear definition of advanced dementia is not straightforward.
A large number of measurement scales are now available in dementia care. Some of these do try to establish the overall severity for a particular individual, for example the Clinical Dementia Rating Scale or the Global Deterioration Scale . However, these scales vary and may still include quite a wide range of people with dementia those who have some speech and may be able to walk and eat independently, as well as those who are unable to walk, talk or eat without assistance.
People with advanced dementia need social interaction as much as anyone else.
Senior social worker
Added to this, there are a lot of differences among those living with advanced dementia. One person may have almost no speech left, but can move around a little on their own. Another may spend their time mainly in bed, needing help to move around, but be able to use single words or convey their meaning clearly in words.
What Causes Alzheimers Wandering
There are many reasons why someone with Alzheimers might wander, including:
- Fear or stress they might not recognize where they are, the environment is overstimulating, or a loud noise or confusing situation could upset them
- Basic needs they might be looking for food, a bathroom, or just want to get some fresh air
- Searching they might get lost while looking for someone or something
- Boredom they could be looking for something to do
- Old routines they might be trying to go to work, do chores, or run errands like they used to
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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.
Ways To Work With Your Loved One
Once you think youâve figured out the cause, make a plan and see if it helps. You can try a few simple things right away that might make a difference:
- Try to distract them. You might go for a walk or have a snack. Once theyâve calmed down, try the activity again.
- Make sure they arenât uncomfortable or in need of the bathroom.
- Speak as softly and as calmly as you can, even if you feel frustrated, angry, or sad. Step away for a few minutes if you can, and take some deep breaths. Your loved one can tell by your voice and body when you feel stressed.
- If theyâre upset, give them space and try again later. Donât force them to do something they donât want to do.
- Give them simple choices if possible.
- Use short, simple sentences to tell them what they should do and why. Donât tell them what not to do.
- Break tasks into simple steps and give instructions that are 1 or 2 steps only. Go slowly and don’t rush them. Tell them what youâll do before you do it, especially before you touch them.
- Talk to them like an adult, not as if they were a child.
You may need to try several of these things. If none of them seem to help, talk with a doctor.
If your loved one thinks somethingâs happening that isnât, donât argue with them. You might:
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Lauren Mahakian: Reasons Why A Person With Dementia Might Stop Walking
Many people ask me why their loved one has stopped walking. Caring for someone with a cognitive impairment is a challenge. When they won’t or cant walk, the challenge is all that much greater.
Before we address this issue, lets be clear
That said, its important to understand that Alzheimers disease and other dementia affect the brain, and the brain has an incredibly complex interaction with the body. We know this, of course, but we cant see it.
Most of us focus on cognitive issues and memory, as well as behaviors that can result. Its easy to forget that the brain also controls our mobility. Just as memory is affected, so too can all aspects of walking be affected, including balance, gait and muscle control.
Dementia care practitioners and researchers continue to explore the physical effects of Alzheimers disease . They tend to focus on two specific areas: gait and executive function. Our hope is to understand physical aspects of the disease so we can offer better treatment and care as the disease progresses.
Gait is effectively the way we walk, our stride and motion, so to speak. As cognitive functions decline, so can gait, leading to shuffling, slow walking or feet dragging. This seems particularly true of those with Parkinsons disease, but it can affect anyone experiencing decline from dementia.
For The First Time Walking Patterns Identify Specific Types Of Dementia
- Newcastle University
- Walking may be a key clinical tool in helping medics accurately identify the specific type of dementia a patient has, pioneering research has revealed.
Walking may be a key clinical tool in helping medics accurately identify the specific type of dementia a patient has, pioneering research has revealed.
For the first time, scientists at Newcastle University have shown that people with Alzheimer’s disease or Lewy body dementia have unique walking patterns that signal subtle differences between the two conditions.
The research, published today in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, shows that people with Lewy body dementia change their walking steps more — varying step time and length — and are asymmetric when they move, in comparison to those with Alzheimer’s disease.
It is a first significant step towards establishing gait as a clinical biomarker for various subtypes of the disease and could lead to improved treatment plans for patients.
Useful diagnostic tool
Dr Ríona McArdle, Post-Doctoral Researcher at Newcastle University’s Faculty of Medical Sciences, led the Alzheimer’s Society-funded research.
She said: “The way we walk can reflect changes in thinking and memory that highlight problems in our brain, such as dementia.
“The results from this study are exciting as they suggest that walking could be a useful tool to add to the diagnostic toolbox for dementia.
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Understanding Why Dementia Patients Wander
To prevent a loved one from wandering and promote safe walking, you first need to define what they are trying to achieve or where they want to go. It may seem directionless and irrational to outsiders who still have their faculties, but dont assume a wanderer is literally just wandering. This behavior is very individualized and a full description of their actions is essential.
Of course, thats easier said than done. I know family caregivers and the staff at elder care settings are very busy, but it is important to take the time to observe the nuances of a wandering dementia patients behavior. Sometimes it is as simple as asking your loved one what they are doing, but often you will need to step back and closely watch what is happening to discover the purpose behind their behavior. This may take time and require multiple observations. Just remember that, if you cannot define, measure and explain these behaviors, how can you or dementia care experts develop wandering interventions?
Wandering is complex, and there is no one-size-fits-all solution for this symptom of dementia. In my line of work, I use the following three-step approach when troubleshooting these behaviors.
Finding The Right Solution To Walking About
Help in finding a better, ie less restrictive, solution to walking about may be available. An assessment from social services can be requested and may provide some alternative options. One solution could be accompanying the person when walking for some of the way, and then moving their attention to something else so that you can both return. If walking is caused by boredom, providing meaningful activities for the person may help. If the person does walk alone and gets lost, they could carry identification to help ensure their safe return.
Alzheimers Society Helpcards can be filled in with important details about the person with dementia, and can help if someone finds them when they are lost.
Some carers consider using assistive technology products, such as a tracking device, to help find the person. There is also a panic button they can press if they get lost. Tracking devices are beneficial as they provide people with dementia and their carers with a better sense of independence and reassurance. However, they do raise ethical concerns if the person is unable to consent to carrying the device. If tracking devices are used then the person must be consulted about this. Risks and benefits must be carefully weighed up, and any decision taken must be in the persons best interests and be the least restrictive option available.
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Understanding Balance And Gait
One of the first signs of loss of mobility, is walking unsteadily and shuffling. Your loved one may seem slow or clumsy, causing more accidents and bumping into things. This slowing is typically associated with a syndrome called parkinsonism. Other signs of Parkinsonism include the shortening of steps, stooped posture, and the narrowing of the space between feet. Turning can become more difficult, because the person no longer pivots on their heels, but instead turn in a series of short steps. During the turns, their balance can become unstable, increasing the changes that they fall backward.
When The Person With Alzheimers Can’t Move
During the later stages of Alzheimers disease, a person may lose the ability to move and spend much of his or her time in a bed or chair. This lack of movement can cause problems such as pressure sores or bedsores, and stiffness of the arms, hands, and legs.
If the person with Alzheimers cannot move around on his or her own, contact a home health aide, physical therapist, or nurse for help. These professionals can show you how to move the person safely, such as changing positions in bed or in a chair.
A physical therapist can also show you how to move the person’s body joints using range-of-motion exercises. During these exercises, you hold the person’s arms or legs, one at a time, and move and bend it several times a day. Movement prevents stiffness of the arms, hands, and legs. It also prevents pressure sores or bedsores.
To make the person more comfortable:
To keep from hurting yourself when moving someone with Alzheimer’s disease:
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