Are there any treatments? How might dementia affect people towards the end of life? What are the signs that someone with dementia is dying?
How can I support someone with dementia towards the end of life? When should I ask for support? Useful resources. Key points. Dementia is not a disease in itself. The symptoms that people experience may include memory loss and difficulties with thinking, perception, problem-solving and language. The symptoms will depend on which areas of the brain are affected by the diseases.
While dementia mainly affects older people, younger people under the age of 65 can also develop dementia. Alzheimer's Research UK has a quick guide to dementia. Vascular dementia is another common form, while dementia with Lewy bodies and frontotemporal dementia are less common. It is possible to have more than one type of dementia at the same time.
The symptoms of dementia vary depending on the disease, or diseases, causing it. 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 problems with thinking or memory. They will often have problems with some of the following:. 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. Dementia is progressive, which means it gets worse over time.
The speed at which someone will get worse will depend on the type of dementia they have and who they are as an individual. 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. It is difficult to know when a person with dementia is coming to the end of their life. However, there are some symptoms that may indicate the person is at the end of their life including:. If the person has another life limiting condition eg cancer , their condition is likely to worsen in a more predictable way.
When a person gets to within a few days or hours of dying, further changes are common. These include:. For more information, see our page , Signs that someone is in their last days or hours. Knowing the person will make it easier to provide person-centred care that is focused on what they need and want.
It can help to know about their likes, dislikes and their wishes for how they want to be cared for. They may have these details recorded in their care plan. People with dementia are at risk of receiving poor care because they are not able to say what they want. For example, a person with dementia may be in pain but unable to verbalise it — they may cry out or become restless instead.
This is an attempt to communicate a need but can often be dismissed because they have dementia. People with dementia often communicate their needs and feelings through non-verbal means — body language, gestures and facial expressions. The following tips may help:. The most important thing is to engage with the person — talk to them, make use of the senses touch, music, smells and use what you know about them.
People with dementia are at risk of pain but they may not be able to tell you they are in pain. Untreated pain can leave the person very distressed and uncomfortable. If you think the person is in pain there are things you can do that may help. For more information, see pain management at the end of life , including how to assess pain in people who are non-communicative.
Without nourishment, individuals can become frail and weak and at risk of falls, fractures and infections, which could lead to death. The brain controls our ability to co-ordinate swallowing and breathing. In end-stage dementia, this skill is lost. Your loved one may become dehydrated, or they may inhale food or fluids which can lead to choking and chest infections called aspiration pneumonias. These can be life-threatening. Many people living with dementia also have other chronic conditions like heart disease, hypertension, diabetes and chronic respiratory disease.
Toileting and managing personal hygiene become more difficult as dementia develops. In the late stages, many people lose control of their bladder and their bowels. This increases the risk of urine infections which can cause delirium, increased confusion and falls.
They can be deadly, especially in the frail elderly. The muscles become stiff and your loved one will need help to move and manage all aspects of daily living. This can increase the risk of pressure sores and ulcers, which can become infected, putting the individual in danger. The brain damage leads to the failure of body systems including the lungs, heart and digestion. Towards the end, people often need around-the-clock care to stay comfortable. If a loved one has been diagnosed with dementia, this blog may seem upsetting, even overwhelming.
But there can still be joy. Studying death and dementia is difficult because dementia is not always listed as the cause of death. The remainder are a collection of many miscellaneous causes, ranging from digestive diseases to cancer. Then how do people die from dementia when complications are not directly responsible?
Even if medical complications can be avoided, the deterioration of the brain never stops. As dementia progresses, communication between the brain and body will eventually cease.
Essential organs stop functioning, and even breathing independently may become impossible. The progression of the disease can be slowed with regular exercise.
And with preparation, caregivers can learn to reduce the risk of many health problems associated with dementia. Exploring the link between dementia and depression in seniors may be a good place to begin. In any case, there are always ways to be proactive.
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