Dementia with Late-Stage Symptoms. While the inevitable death of your loved one is a difficult concept to wrap your head around and accept, knowledge about the future and what to expect may help you prepare both logistically and emotionally when your loved one has late-stage dementia.
Dementia Is a Progressive Brain Disease
A person with dementia will follow a fairly typical pattern of decline, although the pace at which this occurs will vary.
For example, a person with Alzheimer’s disease may initially experience difficulties remembering new information like names, events, or recent conversations. He may also exhibit signs of depression and apathy, as well as problems planning or completing usual tasks. As the disease progresses, a person often becomes confused and disoriented and has trouble communicating (both speaking and writing). Poor judgment and withdrawal from activities she once enjoyed are also common. It’s important to note, though, that there are different types of dementia, and each type is linked to different patterns of symptoms based on the brain changes that occur, so symptoms may vary a bit early in the disease state.
Still, in the final stage of dementia, symptoms are quite similar across all types, as a person experiences a significant decline in everyday functioning.
Eventually, your loved one will reach the late stage of dementia (also called end-stage dementia or advanced dementia) in which symptoms become severe.
Most notably, a person will have problems with normal everyday functions like bathing, dressing, eating, and going to the bathroom. At this point, your loved one will be unable to walk or even sit up without assistance, so he or she will become bedbound and require around-the-clock care.
They will also lose the ability to speak and experience a loss of facial expression, including the ability to smile. This can be particularly challenging for a loved one to witness.
How Dementia Causes Death
With the impaired ability to move, a person in the late stage of dementia is at risk for a number of medical complications like an infection of the urinary tract and pneumonia (an infection of the lungs). Difficulty in swallowing, eating and drinking leads to weight loss, dehydration, and malnutrition, which further increases her vulnerability to infection.
In the end, most people with late-stage dementia die of a medical complication related to their underlying dementia. For instance, a person may die from an infection like aspiration pneumonia, which occurs as a result of swallowing difficulties, or a person may die from a blood clot in the lung as a result of being immobile and bedbound.
However, it’s important to note that dementia itself is fatal. At times this is appropriately listed as the cause of death on a death certificate, as late-stage dementia is a terminal illness.
While a person with end-stage dementia may technically die from an infection or other medical complication, it is their severe dementia that predisposed them to that complication and made them too weak to fight it off.
While advanced dementia is incurable and will ultimately result in death, it’s important to note that you can still provide comfort to your loved ones and play an active role in their care.
With this strategy, you are proactively providing love and support and nurturing your loved one without putting them through futile medical interventions.
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- Alzheimer’s Association. “Alzheimer’s Disease Facts and Figures.”
- Alzheimer’s Society, “Symptoms and memory in the later stages of dementia.”
- Arcand M. Part 1: Goals of Care, Decision-Making Process, and Family Education. Can Fam Physician. 2015 Apr;61(4):330-34.
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