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. 

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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.

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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.

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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.

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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.