How does dementia lead to death. What are the signs that a person with dementia is nearing the end of life. How can caregivers provide appropriate end-of-life care for individuals with dementia.

The Progressive Nature of Dementia and Its Impact on Survival

Dementia is a complex neurological condition that affects millions of people worldwide. As the disease progresses, it not only impairs cognitive function but also impacts various bodily systems, ultimately leading to death. Understanding how dementia becomes fatal is crucial for patients, caregivers, and healthcare professionals to provide appropriate care and support throughout the disease’s progression.

Dementia, including Alzheimer’s disease, has surpassed heart disease as the leading cause of death in England and Wales. This sobering statistic highlights the severity and widespread impact of the condition. But how exactly does dementia lead to death?

Brain Cell Damage and Its Consequences

At its core, dementia causes progressive damage to brain cells. This damage initially manifests as memory loss and communication difficulties. However, as the disease advances, it affects critical brain functions that control essential bodily systems, including:

• Breathing
• Circulation
• Digestion

The deterioration of these vital functions can ultimately lead to a person’s death. It’s important to note that dementia itself doesn’t directly cause death, but rather the complications arising from the brain’s inability to regulate bodily functions.

Common Causes of Death in Dementia Patients

As dementia progresses, several factors can contribute to a person’s decline and eventual death. Understanding these potential causes can help caregivers and healthcare providers anticipate and address potential complications.

Accidents and Incidents

One significant risk for individuals with dementia is an increased likelihood of accidents. Why does this occur? As cognitive function declines, people with dementia may experience:

• Impaired memory
• Difficulty with planning and complex tasks
• Reduced mobility and stability
• Decreased spatial awareness

These factors combine to create a higher risk of falls, fractures, and other accidents both at home and in public spaces. Serious injuries resulting from such incidents can potentially lead to life-threatening complications.

Nutritional Challenges and Frailty

As dementia progresses to its later stages, individuals often face significant challenges related to nutrition and overall health. How do these issues manifest?

• Difficulty in buying and preparing meals
• Loss of appetite and weight loss
• Impaired ability to chew and swallow

These nutritional challenges can result in frailty, weakness, and an increased susceptibility to falls and fractures. Moreover, malnutrition can weaken the immune system, making individuals more vulnerable to infections that can become life-threatening.

Aspiration and Infections

In the end stages of dementia, the brain’s ability to coordinate swallowing and breathing becomes severely impaired. This loss of function can lead to serious complications, including:

• Dehydration
• Choking on food or liquids
• Aspiration pneumonia (lung infection caused by inhaling food or fluids)

Aspiration pneumonia, in particular, is a common and potentially fatal complication in advanced dementia. The compromised immune system of a person with late-stage dementia often struggles to fight off these infections effectively.

Recognizing End-of-Life Signs in Dementia Patients

Identifying when a person with dementia is nearing the end of their life can be challenging, but there are several signs that caregivers and healthcare professionals can look out for. Recognizing these signs can help ensure that appropriate care and support are provided during this difficult time.

Physical Changes

As dementia progresses to its final stages, several physical changes may become apparent:

• Increased drowsiness and difficulty staying awake
• Loss of appetite and reduced fluid intake
• Changes in breathing patterns, including periods of rapid breathing followed by pauses
• Decreased body temperature and cold extremities
• Changes in skin color, often becoming pale, grey, or bluish

Cognitive and Behavioral Changes

In addition to physical changes, individuals nearing the end of life may experience significant cognitive and behavioral shifts:

• Increased confusion and disorientation
• Difficulty recognizing familiar people or surroundings
• Reduced ability to communicate verbally
• Agitation or restlessness, which may be followed by periods of calmness
• Withdrawal from social interactions

It’s important to note that these signs can vary from person to person, and not all individuals will experience every symptom. However, recognizing these changes can help caregivers and healthcare providers adjust their care approach accordingly.

Providing Appropriate End-of-Life Care for Dementia Patients

When a person with dementia is nearing the end of their life, the focus of care shifts from curative treatments to comfort and quality of life. How can caregivers and healthcare professionals ensure the best possible care during this stage?

Pain Management and Comfort Measures

Ensuring the comfort of the individual is paramount. This may involve:

• Regular pain assessments and appropriate pain management
• Positioning the person comfortably to prevent pressure sores
• Keeping the mouth moist and clean
• Providing gentle personal care

Emotional and Spiritual Support

End-of-life care should address not only physical needs but also emotional and spiritual well-being:

• Creating a calm and peaceful environment
• Playing soothing music or reading aloud if it seems to bring comfort
• Facilitating visits from family, friends, or spiritual advisors if desired
• Respecting cultural and religious practices important to the individual

Communication and Decision-Making

Clear communication among caregivers, healthcare providers, and family members is crucial during this time. This may involve:

• Discussing and documenting end-of-life wishes and preferences
• Making decisions about medical interventions, such as feeding tubes or resuscitation
• Ensuring that advance directives are in place and respected

The Role of Palliative Care in End-Stage Dementia

Palliative care plays a crucial role in supporting individuals with end-stage dementia and their families. 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 individuals with advanced dementia, palliative care can significantly improve quality of life and ensure that their final days are as comfortable as possible.

Key Aspects of Palliative Care in Dementia

• Symptom management: Addressing pain, anxiety, and other distressing symptoms
• Emotional support: Providing counseling and support for both the patient and their family
• Coordination of care: Ensuring seamless communication between various healthcare providers
• Advance care planning: Assisting with decisions about future care and treatment preferences

Palliative care teams often include a range of professionals, such as doctors, nurses, social workers, and chaplains, who work together to provide comprehensive support. This multidisciplinary approach ensures that all aspects of a person’s well-being are addressed.

When to Consider Palliative Care

Palliative care can be beneficial at any stage of dementia, but it becomes particularly important as the disease progresses. Early involvement of palliative care specialists can help:

• Establish a care plan aligned with the individual’s wishes
• Manage symptoms more effectively
• Reduce unnecessary hospitalizations
• Provide support and guidance to family caregivers

It’s important to note that palliative care can be provided alongside other treatments and does not necessarily mean giving up on curative efforts. The goal is to enhance quality of life, regardless of the stage of the disease.

Supporting Family Caregivers During the End-of-Life Journey

Caring for a loved one with dementia through the end of life can be an emotionally and physically demanding experience. How can we ensure that family caregivers receive the support they need during this challenging time?

Emotional Support and Counseling

Caregivers often experience a range of complex emotions as their loved one nears the end of life. Providing access to emotional support is crucial:

• Offering counseling services or support groups specifically for dementia caregivers
• Encouraging open communication about fears, concerns, and feelings of grief
• Providing resources on coping strategies and self-care techniques

Practical Assistance and Respite Care

The physical demands of caregiving can be overwhelming, especially in the later stages of dementia. Practical support can make a significant difference:

• Arranging for respite care to give caregivers regular breaks
• Providing training on specific care tasks, such as feeding or mobility assistance
• Offering help with household chores or meal preparation

Information and Education

Equipping caregivers with knowledge about what to expect can help reduce anxiety and improve care quality:

• Providing clear information about the progression of dementia and end-of-life symptoms
• Educating caregivers on pain assessment and management techniques
• Offering guidance on when to seek additional medical help

By supporting family caregivers effectively, we can help ensure that both the person with dementia and their loved ones receive the best possible care and support during this difficult transition.

Ethical Considerations in End-of-Life Care for Dementia Patients

As dementia progresses to its final stages, several ethical considerations come into play regarding end-of-life care. These issues can be complex and emotionally charged, requiring careful thought and discussion among healthcare providers, patients (when possible), and family members.

Advance Directives and Decision-Making

One of the primary ethical challenges in end-of-life care for dementia patients is respecting their autonomy and wishes. How can we ensure that a person’s preferences are honored when they may no longer be able to communicate them?

• Encouraging early discussions about end-of-life preferences while the individual still has decision-making capacity
• Documenting advance directives and regularly reviewing them
• Appointing a healthcare proxy or power of attorney for healthcare decisions

When advance directives are in place, healthcare providers and family members must navigate the sometimes difficult task of interpreting and applying these wishes in specific situations.

Artificial Nutrition and Hydration

As swallowing difficulties emerge in late-stage dementia, decisions about artificial nutrition and hydration become necessary. This topic often raises ethical questions:

• Is it beneficial to provide artificial nutrition, or does it prolong suffering?
• How do we balance quality of life with the desire to sustain life?
• What are the cultural and religious considerations surrounding this decision?

These decisions require careful consideration of medical evidence, ethical principles, and the individual’s known preferences.

Pain Management and Palliative Sedation

Ensuring adequate pain relief is a crucial aspect of end-of-life care, but it can sometimes raise ethical concerns:

• Balancing pain relief with potential side effects, such as decreased alertness
• Addressing fears about opioid use and addiction, even in end-of-life situations
• Considering the use of palliative sedation for intractable symptoms

Healthcare providers must navigate these issues while prioritizing the comfort and dignity of the individual with dementia.

Withholding or Withdrawing Treatment

As dementia reaches its final stages, decisions about continuing or discontinuing certain treatments may arise:

• Determining when curative treatments are no longer beneficial and may be burdensome
• Deciding whether to treat acute conditions, such as infections, aggressively
• Considering the appropriateness of cardiopulmonary resuscitation (CPR) in advanced dementia

These decisions should be guided by the individual’s known wishes, quality of life considerations, and medical judgment about the potential benefits and burdens of treatment.

Navigating these ethical considerations requires open communication, empathy, and a commitment to respecting the dignity and wishes of the person with dementia. Healthcare providers, ethicists, and family members must work together to make decisions that honor the individual’s values and ensure the most compassionate care possible.

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

What kind of information would you like to read?

Use the button below to choose between help, advice and real stories.

Decide what you see

Choose one or more options

• Information
• Advice
• News
• Real stories
• Research
• Support us
• Dementia directory

We will remember your selection for future visits; you can change your choices at any time

Apply

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

Read more

Research
Tag: Research.

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

Read more

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.

Read more

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.

Get our FREE definitive home care guide now! Get your guide

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.

[xyz-ihs snippet=”Adsense-Native-Ad”]

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.

boarding houses for the elderly Guardianship in Moscow

Dementia and Alzheimer’s disease are not the same thing. Dementia is a general term used to describe symptoms that affect memory, performance in daily activities, and communication skills.

Alzheimer’s disease is the most common type of dementia. Alzheimer’s disease progresses over time and affects memory, language, and thinking.

Even young people can develop dementia or Alzheimer’s disease, but the risk increases with age. However, none of these diseases are considered a normal part of aging.

Although the symptoms of the two conditions may be similar, distinguishing them is important for treatment.

Dementia

Dementia is a syndrome, not a disease. A syndrome is a group of symptoms that do not have a definitive diagnosis. Dementia is a group of symptoms that affects mental cognitive functions such as memory and judgment. Dementia is a general term that can be part of Alzheimer’s disease. Dementia, as a syndrome, can be caused by various conditions, including Alzheimer’s disease.

People can have more than one type of dementia. This is called mixed dementia. Often people with mixed dementia suffer from various diseases (and syndromes) associated with the development of dementia. The diagnosis of mixed dementia can only be confirmed at autopsy.

As dementia progresses, the disease has a huge impact on the ability to live and function independently. This is the main cause of disability for the elderly and imposes a certain emotional and financial burden on the family and caregivers.

The World Health Organization says that 47.5 million people worldwide are living with dementia.

Symptoms of dementia

It’s easy to overlook the early symptoms of dementia, which can be mild and mild. Often it starts with simple episodes of forgetfulness. People with dementia have trouble keeping track of time and tend to forget their daily routine.

As dementia progresses, memory lapses and confusion increase. Difficulty remembering names and faces. Personal care becomes a problem. Obvious signs of dementia include repetitive questions, inadequate hygiene, and difficulty making decisions.

At its most severe stage, people with dementia become unable to care for themselves. They will struggle even more with keeping track of time and remembering people and places they are familiar with. Behavior continues to change and can lead to depression and aggression.

Causes of dementia

You are more likely to experience dementia as you age. It happens when certain brain cells are damaged. Many conditions can cause dementia, including degenerative diseases such as Alzheimer’s disease, Parkinson’s disease, and Huntington’s disease. Each cause of dementia causes damage to a specific set of brain cells.

Alzheimer’s disease is responsible for approximately 50-70% of all cases of dementia.

Other causes of dementia include :

• Infections such as HIV;

• Vascular diseases;

• Stroke;

• depression;

• Chronic drug use.

Alzheimer’s disease

Dementia is a term applied to a group of symptoms that negatively affect memory, but Alzheimer’s disease is a progressive brain disease that slowly causes memory and cognitive impairment. The exact cause is unknown and no treatment is available.

Although younger people can and do suffer from Alzheimer’s disease, symptoms usually begin after age 60. The time from diagnosis to death can be as little as three years for people over 80. However, this period may be extended if younger people are affected.

Effect of Alzheimer’s on the brain

Brain damage begins several years before symptoms appear. Abnormal protein deposits form plaques and literally “confuse” the brain – connections between cells are lost and they begin to die.

It is impossible to diagnose Alzheimer’s disease with complete accuracy while the person is alive. The diagnosis can only be confirmed when the brain is examined under a microscope during an autopsy. However, specialists can make a correct diagnosis in 90% of cases.

Symptoms of Alzheimer’s and Dementia

Symptoms of Alzheimer’s disease and dementia may overlap, but there may be some differences.

Both states can cause :

Symptoms of Alzheimer’s disease include :

• Trouble remembering recent events and conversations

• apathy;

• depression;

• Limited judgment;

• disorientation;

• confusion;

• Changes in behavior;

• Difficulty speaking, swallowing, or moving around in the later stages of the disease.

Some types of dementia will have only some of the symptoms listed, but specific types of dementia will also present with symptoms other than those listed, which may help in making a diagnosis. For example, Lewy body dementia includes most of the symptoms of Alzheimer’s disease. However, people with this condition are more likely to experience hallucinations, disturbed sleep and daily routines. People with dementia due to Parkinson’s or Huntington’s disease are more likely to experience involuntary seizures in the early stages of the disease.

Treatment of dementia and treatment of Alzheimer’s disease

Treatment for dementia will depend on the exact cause and type of dementia, but many treatments for dementia and Alzheimer’s disease are similar.

Alzheimer’s Treatment

There is no cure for Alzheimer’s disease, but the following medications may be prescribed to improve the condition:

• Antipsychotics;

• Medications for memory loss;

• Medicines that improve brain function or general health, such as coconut oil or fish oil

• Drugs to improve sleep;

• medications for depression;

• Medicines for dementia.

In some cases, treating not the dementia itself but the condition causing it may help. The most likely conditions that cause dementia in this case include:

In most cases, dementia is irreversible. However, many forms are treatable. Proper treatment can help manage dementia. Treatment for dementia will depend on the cause.

For example, doctors often treat Parkinson’s and PBD dementia with cholinesterase inhibitors, which they also often use to treat Alzheimer’s.

Treatment for vascular dementia will focus on preventing further damage to the brain’s blood vessels and preventing stroke.

People with dementia can also use the support services of nurses and nurses. As the disease progresses, a move to a nursing home may be required.

Perspectives in the treatment of dementia and Alzheimer’s disease

The outlook for people with dementia depends entirely on the immediate cause of the disease. There are drugs that can help manage the symptoms of Parkinson’s dementia, but there is currently no way to stop or even slow the condition.