How does dementia lead to death. What are the signs that a person with dementia is nearing the end of life. Can dementia be considered a terminal illness. How long can someone live with end-stage dementia. What are the most common causes of death in dementia patients.

The Progressive Nature of Dementia: More Than Memory Loss

Dementia, particularly Alzheimer’s disease, is often misunderstood as a condition that solely affects memory and cognitive function. However, its impact is far more extensive and ultimately fatal. As the leading cause of death in England and Wales, surpassing heart disease, dementia’s progression through the brain has devastating consequences on the entire body.

How exactly does dementia cause death? The disease’s primary mechanism involves the gradual destruction of brain cells. This damage initially manifests as memory problems and communication difficulties. As the condition advances, it affects the brain’s ability to control vital bodily functions, including breathing, circulation, and digestion. This comprehensive impact on the body’s systems ultimately leads to death through various pathways.

Increased Risk of Accidents and Incidents in Dementia Patients

One of the significant dangers faced by individuals with dementia is an elevated risk of accidents and incidents. As cognitive abilities decline, maintaining safety in daily life becomes increasingly challenging. Why does this occur?

• Memory loss impairs the ability to remember safety protocols
• Difficulties with planning and complex tasks increase the likelihood of errors
• Impaired mobility and spatial awareness lead to falls and fractures
• Decreased judgment may result in dangerous situations

These factors combine to create a hazardous environment for dementia patients, both at home and in public spaces. The resulting injuries from falls or accidents can be severe, potentially leading to complications that hasten the progression towards end-of-life stages.

Nutritional Challenges and Physical Decline in Late-Stage Dementia

As dementia progresses to its later stages, maintaining proper nutrition becomes a significant challenge. This difficulty arises from several factors:

1. Inability to plan and prepare meals independently
2. Loss of appetite or changes in food preferences
3. Difficulties with the physical act of eating
4. Impaired ability to recognize hunger or thirst

How does malnutrition affect dementia patients? The consequences of poor nutrition are far-reaching. Weight loss and muscle wasting lead to increased frailty, making patients more susceptible to falls and fractures. The weakened state also compromises the immune system, leaving individuals more vulnerable to infections that can be life-threatening in the context of advanced dementia.

The Critical Role of Swallowing in End-Stage Dementia

In the final stages of dementia, the loss of muscle control extends to the ability to chew and swallow effectively. This impairment is not just a matter of discomfort or inconvenience; it poses a severe risk to the patient’s health and survival. The brain’s diminished capacity to coordinate swallowing and breathing can result in two primary dangers:

• Dehydration due to insufficient fluid intake
• Aspiration of food or liquids into the lungs

Aspiration, in particular, can lead to a type of pneumonia known as aspiration pneumonia. This condition is a common cause of death in late-stage dementia patients, as their weakened state makes fighting off such infections extremely difficult.

Respiratory Complications: A Major Threat in Advanced Dementia

Respiratory issues become increasingly prevalent and dangerous as dementia progresses. Why are dementia patients particularly susceptible to respiratory problems? The answer lies in the combination of physical decline and cognitive impairment:

• Weakened immune system due to overall health decline
• Increased time spent in bed, leading to fluid accumulation in the lungs
• Difficulty in clearing secretions through coughing
• Impaired swallowing reflex increasing the risk of aspiration

These factors create an environment where pneumonia and other respiratory infections can easily take hold. In the context of advanced dementia, where the body’s natural defenses are severely compromised, such infections can quickly become life-threatening.

The Danger of Silent Aspiration

Silent aspiration, where food or liquid enters the lungs without triggering a cough reflex, is a particularly insidious threat. This phenomenon occurs more frequently in dementia patients due to the neurological impairment of protective reflexes. The lack of obvious choking or coughing means that caregivers may not immediately recognize when aspiration has occurred, allowing damage to the lungs to progress unnoticed.

Cardiovascular Complications in Dementia Patients

While dementia itself primarily affects the brain, its progression can have significant implications for cardiovascular health. How does dementia impact the heart and circulatory system?

• Reduced physical activity leads to weakening of the heart muscle
• Changes in eating habits may result in nutritional imbalances affecting heart health
• Stress and anxiety associated with the condition can strain the cardiovascular system
• Medications used to manage dementia symptoms may have cardiovascular side effects

These factors contribute to an increased risk of heart disease, stroke, and other cardiovascular events in dementia patients. As the condition progresses and overall health declines, the ability to recover from such events diminishes, potentially leading to fatal outcomes.

The Impact of Comorbidities on Dementia Progression

Many individuals with dementia, particularly those in older age groups, have pre-existing health conditions. These comorbidities can significantly complicate the course of dementia and accelerate the decline towards end-of-life stages. Common comorbidities include:

• Diabetes
• Hypertension
• Chronic obstructive pulmonary disease (COPD)
• Arthritis

The management of these conditions becomes increasingly challenging as cognitive function declines, potentially leading to exacerbations that further compromise overall health and hasten the progression of dementia.

Recognizing End-of-Life Signs in Dementia Patients

Identifying when a person with dementia is approaching the end of their life is crucial for providing appropriate care and support. What are the key indicators that suggest a dementia patient may be nearing their final days or weeks?

• Increased sleeping or difficulty waking
• Loss of appetite and refusal of food and fluids
• Changes in breathing patterns, including periods of rapid breathing followed by pauses
• Decrease in body temperature and cold extremities
• Changes in skin color, often appearing pale or bluish
• Increased agitation or restlessness
• Loss of bladder and bowel control

It’s important to note that the progression of dementia can vary significantly between individuals, and not all patients will exhibit all these signs. However, the presence of multiple indicators, particularly when they represent a marked change from the person’s usual state, suggests that end-of-life care considerations may be appropriate.

The Importance of Advance Care Planning

Given the progressive and ultimately fatal nature of dementia, advance care planning becomes an essential aspect of managing the condition. This process involves discussions about preferences for care, treatment options, and end-of-life decisions while the individual still has the capacity to participate in such conversations. Key elements of advance care planning include:

• Designating a healthcare proxy or power of attorney
• Discussing preferences for life-sustaining treatments
• Considering hospice care options
• Addressing spiritual or cultural needs at the end of life

By engaging in these discussions early, families and healthcare providers can ensure that the person’s wishes are respected and that appropriate care is provided as the condition progresses to its final stages.

The Role of Palliative Care in End-Stage Dementia

As dementia reaches its advanced stages, the focus of care often shifts from curative or life-prolonging treatments to comfort and quality of life. This is where palliative care plays a crucial role. But what exactly is palliative care, and how does it benefit dementia patients?

Palliative care is a specialized medical approach that focuses on providing relief from the symptoms and stress of a serious illness. For dementia patients, this can include:

• Management of pain and other physical symptoms
• Emotional and psychological support for both the patient and family
• Assistance with decision-making regarding treatment options
• Coordination of care among various healthcare providers

The goal of palliative care is not to hasten death, but rather to ensure that the person’s final days or weeks are as comfortable and peaceful as possible. This approach recognizes that while dementia itself may not be curable, much can be done to alleviate suffering and maintain dignity at the end of life.

The Ethical Considerations in End-Stage Dementia Care

Caring for individuals with end-stage dementia often involves complex ethical considerations. These may include decisions about:

• Artificial nutrition and hydration
• Use of antibiotics for infections
• Cardiopulmonary resuscitation (CPR) in the event of cardiac arrest
• Management of behavioral symptoms with medications

These decisions can be challenging, particularly when the person’s wishes are not known or when family members disagree on the best course of action. Healthcare providers, ethicists, and palliative care specialists can offer guidance in navigating these difficult choices, always with the goal of respecting the individual’s dignity and values.

Supporting Families Through the End-of-Life Journey

The end-of-life process for a person with dementia can be emotionally taxing for family members and caregivers. How can healthcare providers and support systems best assist families during this challenging time?

• Providing clear and honest communication about the person’s condition and prognosis
• Offering emotional support and counseling services
• Educating families about what to expect during the dying process
• Assisting with practical matters such as funeral planning and legal considerations
• Connecting families with bereavement support services

It’s crucial to recognize that each family’s experience is unique, and support should be tailored to their specific needs and cultural background. By providing comprehensive support, healthcare providers can help families navigate this difficult transition with greater ease and find meaning in their final moments with their loved one.

The Importance of Self-Care for Caregivers

Caring for a person with end-stage dementia can be physically and emotionally exhausting. Caregivers often neglect their own needs in their dedication to their loved one. However, maintaining caregiver well-being is essential for providing the best possible care. Some strategies for caregiver self-care include:

• Seeking respite care to allow for rest and recuperation
• Joining support groups to share experiences and coping strategies
• Maintaining personal health through regular check-ups and healthy lifestyle choices
• Engaging in stress-reduction techniques such as meditation or exercise
• Accepting help from friends, family, or professional services

By prioritizing their own well-being, caregivers can maintain the strength and resilience needed to support their loved one through the final stages of dementia.

How to know when a person with dementia is nearing the end of their life

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Advice

Talking Point members share their advice for someone who is at the point of understanding and accepting that a relative or friend with dementia is at the end of life. 

Talking Point members share their advice for someone who is at the point of understanding and accepting that a relative or friend with dementia is at the end of life. 

…

30 September 2022

Real stories

After the passing of her nan, Eileen, Mandy reflects on the lack of professional support her family received following Eileen’s diagnosis. Mandy explains why her experiences have made her more determined to raise awareness of dementia, and why she’s taking part in Memory Walk.

After the passing of her nan, Eileen, Mandy reflects on the lack of professional support her family received following Eileen’s diagnosis. Mandy explains why her experiences have made her more determined to raise awareness of dementia, and why she’s taking part in Memory Walk.

…

15 August 2022

Real stories

Conversations about end of life care for a person with dementia can be difficult, but people living with the condition have been encouraging dialogue.

Conversations about end of life care for a person with dementia can be difficult, but people living with the condition have been encouraging dialogue.

…

30 July 2021

News
Tag: News.

Dementia is again the leading cause of death in the UK, ONS numbers show

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Research
Tag: Research.

Research project: Advance care planning in dementia: Improving GP consultations and development of a support programme for general practitioners (Consult-GP)

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Real stories

End of life doulas support people with dementia to complete their lives in peace and contentment.

End of life doulas support people with dementia to complete their lives in peace and contentment.

…

31 March 2021

News
Tag: News.

The charity responds to findings that DNARs were applied without consent or discussion with families.

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How does a person die from dementia?

Can dementia kill? Alzheimer’s disease doesn’t just make you forgetful. It’s a serious, progressive condition which is, eventually, terminal. Alzheimer’s and other forms of dementia have now overtaken heart disease to become the leading cause of death in England and Wales.

The brain is responsible for more than thought, memory and understanding. It controls our bodily systems including breathing, circulation and digestion. Alzheimer’s kills cells in the brain. This damage initially leads to problems remembering things and communicating effectively. However, with time the brain damage affects the whole body, leading to death. This can be from a number of causes:

Accidents and incidents

Dementia can affect people’s ability to live safely and independently. Memory loss and problems with planning and performing complex tasks can increase the risk of accidents in the home and when out and about. Mobility, stability and spatial awareness can all be impaired, leading to an increased danger of falls and dangerous fractures.

Food and frailty

In the later stages of dementia, people struggle to eat well and stay healthy. They may find buying and preparing meals a challenge, go off their food and lose weight. Towards the end of the illness, they lose muscle control and may be unable to chew and swallow. Without nourishment, individuals can become frail and weak and at risk of falls, fractures and infections, which could lead to death.

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Aspiration and infections

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.

Co-existing illnesses

Many people living with dementia also have other chronic conditions like heart disease, hypertension, diabetes and chronic respiratory disease. With Alzheimer’s, it can be more challenging to look after your general health and wellbeing, so that complications associated with these conditions can become more likely.

Continence and self-care

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.

Skin ulcers

Alzheimer’s leads to a progressive decline in physical as well as mental function. 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.

In the late stages of Alzheimer’s, individuals lose their ability to communicate and respond to the environment. 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.

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If a loved one has been diagnosed with dementia, this blog may seem upsetting, even overwhelming. Alzheimer’s is a challenging condition from first diagnosis to the last days of life. But there can still be joy. With the right support and care in place you can help your loved one live well with dementia and to die with dignity. Find out more about our specialist dementia care.

Dr Jane Gilbert

Jane has over 20 years’ experience as a health writer and TV presenter. Jane writes on a wide variety of clinical and care topics – from explaining the latest studies and research to unpacking conditions and discussing treatment options. Jane holds a MBBS degree from Imperial College, London and spent seven years working in the NHS.

90,000 signs and forecasts. Treatment of dementia in Moscow

Contents↓[show]

Dementia is a serious and widespread disease caused by organic damage to the brain and leading to intellectual dysfunction and personality disorders. The danger of the disease lies in its irreversible nature, clinical signs, inappropriate behavior of patients, which affects the life expectancy of patients, so the prognosis of the disease is disappointing.

An experienced team of specialists at the Yusupov Hospital, thanks to their professionalism, can recognize pathology at any stage, determine the possible causes of the disease and draw up an individual treatment plan that prevents further development of the disease and improves the quality of life. Thanks to high-quality and rational treatment, it is possible to stop the progression of the disease and exclude the transition to a severe stage. Of course, it is impossible to fully restore the lost functions and cure the patient, since the pathology is irreversible, but social adaptation and improvement in the quality of life are possible.

Symptoms of end-stage dementia

There are many conditions and causes that can lead to dementia. They affect the general condition of patients and the appearance of clinical signs. The following symptoms are distinguished, which are characteristic of different types of dementia:

• memory impairment;
• speech problems;
• thinking disorders;
• disorientation in space;
• change in character;
• difficulty doing daily tasks;
• apathetic attitude towards the environment.

The development of the disease is divided into mild, moderate and severe stages. The duration of the transition from one stage to another depends on the timely treatment, the cause of the pathology, the general condition of the patient and his individual characteristics. The initial stage can move into the final stage for more than 10 years, and sometimes the process takes less than 1 year. The intensity of manifestations and features of symptoms depend on the age of the patient, the level of intelligence, moral and physical health, the level of social activity, quality of life, nutrition, living conditions, genetic predisposition and other factors.

Signs of the last stage of dementia

The following signs are characteristic of the last stage of dementia:

• complete disintegration of personality;
• loss of self-care skills;
• severe depression, apathy, mania;
• hallucinations and delusions;
• impossibility of speech;
• disorientation in space and time;
• complete loss of memory (the patient does not recognize relatives, home, does not recognize the reflection in the mirror).

In the final stages of dementia, patients are unable to care for themselves and require constant care and supervision. At the last stage of the development of the disease, the patient is rapidly dying. This period is characterized by impaired coordination and gait, abrupt and slurred speech, lack of hygiene, inability to control defecation and urination, stagnant processes, inadequate response to infections and other diseases.

Patients at the final stage of the development of the disease need constant care, as they cannot perform everyday activities on their own, often just lie down, do not show any reaction to others. Caring for people with dementia is hard work and requires mental preparation. After all, such patients will not express gratitude to you in connection with the peculiarities of the pathology, and besides, they will show a hostile attitude. The rate of transition of dementia from the initial stage to the severe one depends on many factors, in particular, on the timeliness and rationality of therapy.

Predictions for the final stage of dementia

According to statistics, the number of patients with dementia is increasing every year, only in Russia there are, according to official data, more than 1.8 million patients. This figure is a significant underestimate, as most patients show mild signs of cognitive impairment. Elderly patients and their relatives often perceive these disorders as a natural aging process.

Life expectancy in dementia depends on external factors, the cause of the disease, the severity, the general condition of the patient. The life expectancy of patients is strongly influenced by the behavior of patients. Often they are dangerous to themselves and others, because they do not understand what they are doing and why. They can leave the gas on, get hurt, leave home, and get lost. On average, patients after confirmation of the diagnosis live for about 4-5 years, but with rational therapy and careful care, this period can be increased to 15 years or more. It should be noted that dementia is rarely indicated as a cause of death, since the death of patients is most often caused by the consequences of the disease. The main cause of death are strokes, heart attacks, associated infection (sepsis, pneumonia, etc.). You can get detailed advice, learn about the manifestations of the disease, its prognosis and treatment features, by making an appointment with a neurologist by phone.

Dementia is becoming one of the leading causes of death – Science

• The science

Dementia has become one of the leading causes of death in Americans – twice as many people are now dying from it than twenty years ago.

Photo: Alexander Petrosyan, Kommersant / buy photo

According to the World Health Organization, dementia is a syndrome, usually chronic or progressive, in which cognitive function (that is, the ability to think) deteriorates to a greater extent than is expected during normal aging . There is a degradation of memory, thinking, understanding, speech and the ability to navigate, count, learn and reason. Dementia does not affect consciousness. Cognitive impairment is often accompanied, and sometimes preceded, by deterioration in emotional control, as well as degradation of social behavior or motivation.

Dementia is caused by a variety of illnesses and injuries that primarily or secondarily cause brain damage, such as Alzheimer’s disease or stroke.

Researchers from the US Centers for Disease Prevention and Control (CDC) state that in 2000, 30.5 people per 100,000 died of dementia, and last year – 66.7 people.

In absolute terms, it looks like this: in 2017, according to death certificates, about 262,000 Americans died from dementia, and 46% of these deaths were from Alzheimer’s disease. In 2000, there were only about 84,000 deaths from dementia.

“It’s already a big problem,” says Keith Fargo, director of the Alzheimer’s Association’s science program, “and it’s getting worse. ” America is aging, and this fact increases the number of deaths caused by dementia, says CDC statistician Ellen Kramarov: “Part of the problem, of course, is that people live longer, and the older a person is, the more likely he is to have dementia. He did not die of cancer or a heart attack, he lived a long time – the risk of dying from dementia becomes very high.

Dr. Fargo believes part of the dramatic increase in dementia deaths is simply due to the fact that dementia has become better diagnosed and more frequently recorded on death certificates.

But it should be noted right away, continues Dr. Fargo, that even now, apparently, not all deaths associated with dementia are correctly attributed: for example, more people actually die from Alzheimer’s disease than the statistics record.

CDC in the study points to almost 130,000 more deaths in 2017, in the causes of which dementia is listed as one of the factors, not the main one, Kramarov reports. In general, according to her data, women die from dementia more often than men (73 cases per 100 thousand versus 56.