Talk About One Thing At A Time
Someone with dementia may not be able to engage in the mental juggling needed to maintain a conversation with multiple threads. Its best to keep it concise and simple.
Ask open-ended, observational questions, instead of quizzing or asking too much at once. If youre looking through an old photo album, for example, you could say, This is a beautiful dress. What do you think? instead of, Do you remember your wedding day? Asking specifically about the dress keeps the conversation simple and direct.
Stage : Moderate Dementia
Patients in stage 5 need some assistance in order to carry out their daily lives. The main sign for stage 5 dementia is the inability to remember major details such as the name of a close family member or a home address. Patients may become disoriented about the time and place, have trouble making decisions, and forget basic information about themselves, such as a telephone number or address.
While moderate dementia can interfere with basic functioning, patients at this stage do not need assistance with basic functions such as using the bathroom or eating. Patients also still have the ability to remember their own names and generally the names of spouses and children.
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.
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What Are The Symptoms
Each person is unique and will experience dementia in their own way. The different types of dementia tend to affect people differently, especially in the early stages.
A person with dementia will often have cognitive symptoms . They will often have problems with some of the following:
- Day-to-day memory difficulty recalling events that happened recently.
- Repetition repeating the same question or conversation frequently in a short space of time.
- Concentrating, planning or organising difficulties making decisions, solving problems or carrying out a sequence of tasks .
- Language difficulties following a conversation or finding the right word for something.
- Visuospatial skills – problems judging distances and seeing objects in three dimensions.
- Orientation – losing track of the day or date, or becoming confused about where they are.
Some people have other symptoms including movement problems, hallucinations or behaviour changes.
Late Stage Alzheimers Care
The needs of Alzheimers patients change considerably during the final stages of the disease. Their physical and mental decline accelerates, leaving them dependent on their caregivers. Patients have to be monitored round the clock, with family members watching their own health to guard against burnout and exhaustion.
But regardless of the difficulties, there will still be bright and welcome moments. Even in late stage Alzheimers, it is possible to express your feelings and create happy memories to hold onto after the disease has reached its end.
Jose Escobar is the Hospice Executive for Parentis Health. He works with patients and families across Southern California, providing support and education, in order to alleviate the pain and suffering of chronic and terminal illness.
Lewis Jackson writes about technology and healthcare. His work provides practical insight into modern medicine and healthy living.
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How Alzheimers Disease Affects Communication
Memory loss is one of the widely known symptoms of Alzheimers disease, but many other skills and abilities become impaired as well. Persons living with dementia experience changes in the brains temporal lobe that affect their ability to process language. Even in the diseases early stages, caregivers may notice a decline in formal language , which all humans rely upon to communicate verbally. Symptoms include word loss, confusion during the conversation, not being able to follow a storyline, and decreased speech.
Are There Any Treatments
There are treatments that can help with the symptoms of some forms of dementia for a period of time, but there are currently no treatments that slow, halt or reverse the changes in the brain caused by the diseases. There are currently no treatments specifically for vascular dementia or frontotemporal dementia.
In the case of vascular dementia, a doctor may prescribe medication to treat underlying cardiovascular risk factors like high blood pressure or diabetes. Physiotherapy, speech therapy or occupational therapy may be offered to help with speech or movement problems. Non-drug treatments such as cognitive therapies may be available and can help some people with dementia to manage their symptoms.
Alzheimer’s Society has more information on treatments for dementia.
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Formula Predicts Alzheimers Longevity
That, says Gregory A. Jicha, MD, is the first question patients ask after receiving a diagnosis of Alzheimerâs disease.
Until now, the answer has largely been a guessing game. But Jicha and colleagues have developed a simple formula based on a patientâs sex, age, and cognitive skills at the time of diagnosis to more accurately predict life expectancy.
âHaving a better of idea of how long they will live will allow patients and families to better plan for the future,â says Jicha, an assistant professor of neurology at the University of Kentucky in Lexington.
He presented his findings at the annual meeting of the American Academy of Neurology.
Dont Talk Down To Them
Caregivers and/or family members should never talk down to the individual with dementia and/or Alzheimer’s, and this especially includes baby talk, which doesn’t work neurologically . The fact that the patient and/or loved one is having problems with language does not mean that talking to them like a four-year-old is going to help. The communication style should still be to a respected, older adult.
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The blisters didnt heal, and then an old bruise on her leg opened up and started bleeding and crusting over. It was due to poor blood circulation, made worse by the fact that she was having trouble eating and her protein intake was too low, exacerbating the fluid build-up in the blisters. And then she stopped being able to swallow her medicine no antibiotics to help heal the wounds on her heels and legs, no paracetamol to ease the discomfort, not even a relaxant to help her sleep at night.
I didnt know it then, but we finally encountered the real killer with Alzheimersforgetting how to swallow.
In late March I found her still sitting at the dining table two hours after the meal, staring at her bowl of fruit. The nurses said she had become a slow eater. I realized at that point that the suddenness of my mothers spiral had even surprised the staff. They didnt realize the blisters were from bedsores, thinking her shoes were too tight they didnt help her to eat, thinking she was taking her time. It was the disease, slowly shriveling the part of her brain that takes care of the physical processes and basic functions.
One day she just stopped eating and drinking completely. Not only does Alzheimers make you forget how to swallow, but it also attacks the part of the brain that sends thirst and hunger pangs. And thats when I understood what would kill hershe would slowly wither away, dry up, unable and unwilling to eat or drink.
What To Do Next After Learning What Stage Of Alzheimer’s Disease Your Loved One Is In
As mentioned, learning about the stage of Alzheimers disease that a loved one is experiencing helps provide perspective and context. This knowledge makes it easier to have conversations with doctors about the patients condition and how to approach future treatment options. Understanding the later stages of the disease also helps when planning for lifestyle changes, new equipment, and other items that may be needed. One of the other major benefits in understanding the overall progression of Alzheimers disease is preparing for future living arrangements, such a memory care community, that could become a preferred option during later stages of the disease. Because the cost of dementia care is high, families should begin planning as soon as possible following a diagnosis.
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Communication In The Later Stages Of Dementia
Is it possible to communicate with a person with advanced dementia who may not be able to talk and appears unresponsive? When you first meet someone with no language and apparently little of their personality remaining, it is easy to believe that it is not.
But there is clear evidence through the power of music, song and touch that people with advanced dementia do not lose the ability to communicate.
Even though they cant talk you can tell. Their eyes are fixed on you and theyll smile or theyll be far more relaxed when youre doing something.
Care worker being interviewed about her work.
Naomi Feil, founder of Validation Therapy, shares a breakthrough moment on film with Gladys Wilson, 87, who is virtually unable to speak. As Naomi starts singing gospel songs favourites of Gladys, who has Alzheimers disease Gladys starts tapping to the songs and begins to sing along with her.
Naomi says: When she moved I moved with her. I matched the intensity of my voice to the intensity of her movement. And pretty soon, for a split second, we became one person.
You can watch the remarkable transformation in Gladys in an extract from the film, There is a bridge.
At What Point Do Dementia Patients Need 24 Hour Care
When living at home is no longer an option There may come a time when the person living with Alzheimers disease or dementia will need more care than can be provided at home. During the middle stages of Alzheimers, it becomes necessary to provide 24-hour supervision to keep the person with dementia safe.
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When Someone You Love Has Alzheimer Disease
You might feel sad or angry or both if someone you love has Alzheimer disease. You might feel nervous around the person, especially if he or she is having trouble remembering important things or can no longer take care of himself or herself.
You might not want to go visit the person, even though your mom or dad wants you to. You are definitely not alone in these feelings. Try talking with a parent or another trusted adult. Just saying what’s on your mind might help you feel better. You also may learn that the adults in your life are having struggles of their own with the situation.
If you visit a loved one who has Alzheimer disease, try to be patient. He or she may have good days and bad days. It can be sad if you can’t have fun in the same ways together. Maybe you and your grandmother liked to go to concerts. If that’s no longer possible, maybe bring her some wonderful music and listen together. It’s a way to show her that you care and showing that love is important, even if her memory is failing.
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.
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Who Is Judy Cornish
Judy Cornish is a former eldercare lawyer and the former owner of Palouse Dementia Care, a dementia care agency that provides in-home dementia care to seniors in northern Idaho. She is the author of Dementia With Dignity and The Dementia Handbook as well as the creator of the DAWN Method of dementia care. Judy believes that with a little training, families can provide excellent dementia care at home with less stress and more companionship.
Of course, we expect that, due to memory loss, people who have dementia will have trouble recalling what they did earlier in the day, let alone whats been happening during the past week. And, we know that how much they can remember will diminish as time goes on. At first, you may find that it helps to ask leading questions by including a fact or two . In the earlier stages of dementia, memories sometimes become available when we prompt with a few facts.
What To Do When Alzheimers Patients Stop Talking
Alzheimers is a horrible disease that eats away a person bit by bit. It causes significant damage to the brain. As the disease progresses, the symptoms become worse and worse to a point where the patient cannot do anything on their own. Activities of daily living like bathing, dressing, cooking, eating, taking medication and talking become impossible to do. It is unfortunate that the condition is irreversible and progressive.
At the first, the patient will start with mild dementia and forget simple things like the date, names of people and objects, recent events and difficulties in analyzing things. It may appear to be age-related problems yet these are the onset symptoms of Alzheimers.
As the disease progresses, the dementia becomes pronounced. The daily life and relationships of the patient are adversely affected. Here, the patient cannot understand what is going on around them and they cannot pay attention easily. Learning new things becomes a challenge for them. They become delusional and lose interest in everything. They will need help in performing tasks like cooking or shopping.
Alzheimers is a life-limiting condition. It gets difficult when the patient cannot communicate or speak. This can be frustrating for a family member or a caregiver who can decide to simply ignore the patient.
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Devoted Guardians’ Response to COVID-19
Devoted Guardians is actively monitoring the progression of the coronavirus, COVID-19, to ensure that we have the most accurate and latest information on the threat of the virus. As you know, this situation continues to develop rapidly as new cases are identified in our communities and our protocols will be adjusted as needed.
While most cases of COVID-19 are mild, causing only fever and cough, a very small percentage of cases become severe and may progress particularly in the elderly and people with underlying medical conditions. Because this is the primary population that Devoted Guardians serves, we understand your concerns and want to share with you how our organization is responding to the threat of COVID-19.
We are following updates and procedures from the Centers for Disease Control State Department of Health, local and county authorities, the Home Care Association of America and other agencies and resources. Our response and plans may adjust according to the recommendations from these organizations.
Does My Loved One Have A Healthy Structured Routine At Home
People with Alzheimers benefit from a consistent, structured daily routine. They also benefit from a healthy diet, regular physical activity, and mental and social stimulation. Circumstances may make it impossible for you to offer your loved one a daily routine that supports their well-being: for instance, if you work long hours, or depend on support from family members who cannot commit to regular hours, meaning that the patients routine is frequently disrupted.
If you feel that while you would prefer to keep your loved one at home, you are not able to give them a good quality of life, it would be a good time to consider a nursing home. Nursing homes can offer a customized treatment program, a healthy diet, 24-hour support and supervision, and social activities. If you would like further advice on Alzheimers nursing homes, please contact us here.
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When Do Dementia Patients Stop Eating
When a patient stops or refuses to eat, things can be very depressing for the caregiver. Drinking and eating are complex and have to do with a control center that is within the brain, which controls the muscles in the throat and neck area.
Dementia affects this part of the brain as it progresses and things like choking, coughing, grimacing as one swallows, clearing the throat, movements that are exaggerated, especially of the tongue and mouth, refusing to swallow, and spitting the food can be seen. This usually happens in the later stages of the disease.