10 Signs Death is Near Dementia: What to Expect, As my grandfather’s dementia got worse, I saw a slow but sad decline. This is a tough time for both the person with dementia and their family. Knowing the signs that death is near can help us make the most of the time we have left.
Dementia is a serious condition that limits life, making it hard to know exactly when the end is near. By learning about these signs, we can prepare better and give our loved ones the care they need at the end.
Key Takeaways
- Dementia is the 7th leading cause of death in the United States.
- Signs of dying in the final two-to-three months can include limited speech, swallowing difficulties, inability to walk without assistance, and incontinence.
- Patients with dementia are eligible for hospice care when they have a diagnosis of six months or less to live.
- Caregivers should look for signs of pain or discomfort, such as moaning, restlessness, grimacing, or sweating.
- Hospice care can assist with physical and emotional needs, medication adjustments, and providing emotional and spiritual support.
Understanding Dementia and Its Progression
Dementia is a term for a long-lasting decline in mental abilities. It includes losing memory, thinking less clearly, and changing in personality. Alzheimer’s disease is the most common type, followed by vascular dementia, Lewy body dementia, and frontotemporal dementia. Each type shows different symptoms because of unique brain changes.
What is Dementia?
Dementia is a long-term condition that affects thinking, memory, and reasoning. It can also change behavior, mood, and personality. The condition usually gets worse over time.
Types of Dementia
There are many types of dementia, each with its own traits and causes:
- Alzheimer’s Disease: This is the most common dementia type, making up 50-75% of cases. It causes memory loss, poor judgment, trouble with objects and dates, and mood changes.
- Vascular Dementia: This dementia comes from strokes or brain vascular issues. It leads to trouble understanding, emotional and personality changes, and memory issues.
- Lewy Body Dementia: This dementia has mood swings, hallucinations, sleep issues, and walking problems.
- Frontotemporal Dementia: This type doesn’t start with memory loss but shows clear changes in personality and behavior early on.
- Mixed Dementia: Some people have dementia from more than one cause, known as mixed dementia.
Dementia isn’t just for older people; it can happen to younger ones too. Giving care that focuses on the person and their wishes is key. It helps manage symptoms and improves life quality for those with dementia.
Late-Stage or End-Stage Dementia
In the final stage of dementia, symptoms become severe. People need constant care because they can’t do everyday tasks. They face a high risk of health problems like UTIs, pneumonia, and skin issues due to not moving much and trouble with eating and drinking.
Symptoms of Late-Stage Dementia
Watching someone with late-stage dementia can be tough for everyone. They might lose the ability to talk, show feelings, and know where they are. Alzheimer’s disease, a common dementia type, causes memory loss and trouble with judgment and tracking objects. It also changes mood and personality.
Lewy body dementia
Lewy body dementia brings mood swings, hallucinations, sleep issues, and walking problems. Frontotemporal dementia changes personality and behavior early on, not memory. Vascular dementia leads to trouble understanding things, emotional changes, and memory issues. Chronic Traumatic Encephalopathy (CTE) causes mood and personality changes, and memory and cognitive skill decline.
As dementia worsens, people may decline over several months. They might only say a few words, have trouble understanding, and need help with simple tasks like eating. Near the end, they could deteriorate quickly, become unconscious, have trouble swallowing, feel restless, and breathe differently.
Late-stage dementia
Late-stage dementia is a terminal illness that can lead to death and is often listed as the cause on death certificates. Pneumonia from infections is a common cause of death in dementia patients because their immune system is weak.
Memory care units and hospice care are recommended for those with advanced dementia. These services provide medical equipment, therapy, dietary advice, respite care, and spiritual support for the patient and their family.
“It is crucial for caregivers to monitor loved ones with advanced dementia for signs of pain or discomfort due to challenges in communication.”
| Dementia Type | Characteristic Symptoms |
|---|---|
| Alzheimer’s Disease | Memory loss, poor judgment, difficulty keeping track of objects and dates, mood and personality changes |
| Lewy Body Dementia | Fluctuations in arousal, hallucinations, sleep problems, and difficulty walking |
| Frontotemporal Dementia | Changes in personality and behavior rather than memory problems in the early stages |
| Vascular Dementia | Issues understanding concepts, emotional and personality changes, and memory problems |
| Chronic Traumatic Encephalopathy (CTE) | Mood changes, personality changes, decline in memory and cognitive skills |
In the final stages of dementia, people’s daily abilities drop a lot. Families may struggle when patients can’t swallow or eat well, making decisions about IV drips or feeding tubes hard to understand.
Dealing with late-stage or end-stage dementia is tough and complex. It needs caring and support for both the person and their loved ones.
10 Signs Death is Nearing Dementia
As dementia patients near the end, they may show signs that death is close. Knowing these signs helps families and caregivers support them well.
- Increased Physical Weakness: Dementia patients may lose strength and mobility. They find it hard to do simple tasks.
- Decreased Appetite and Thirst: Late-stage dementia patients often lose their appetite and thirst. This leads to weight loss and dehydration.
- More Frequent and Longer Periods of Sleep: As death nears, dementia patients sleep a lot and don’t respond much to their environment.
- Communication Difficulties: In the final stages, dementia makes it hard for patients to communicate. They struggle to say what they need and feel.
- Changes in Behavior: Dementia patients may act differently, like being agitated, restless, or avoiding people.
- Increased Infections or Susceptibility to Infections: Advanced dementia makes patients more likely to get infections. This can harm their health further.
- Incontinence: As dementia worsens, patients may lose control of their bladder and bowel. This leads to incontinence.
- Difficulty Swallowing: Swallowing gets harder for dementia patients. This makes eating and drinking tough and increases the risk of choking.
- Labored Breathing or Changes in Breathing Patterns: Near the end, dementia patients may breathe irregularly or shallowly.
- Changes in Skin Color and Temperature: As circulation slows, the skin may change color. Hands and feet may feel cold.
Knowing these signs helps families and caregivers prepare for the future. It ensures the patient stays comfortable and dignified.
Not all dementia patients show all these signs. The disease progresses differently for everyone. Getting help from healthcare experts, like palliative care or hospice, is key to understanding and caring for dementia patients at the end.
Physical Changes in the Final Stages
As dementia advances, people may see many physical changes in its final stages. These changes are part of the dying process as the body slows down. The final stage of dementia is usually short, lasting about one to two years. People with Alzheimer’s disease in this stage can live for eight to 10 years if diagnosed in their 80s or 90s.
Vascular dementia can cut life expectancy to about five years due to higher stroke or heart attack risks. Dementia with Lewy bodies can shorten life to six years because of more falls and infections.
People with the disease may lose the ability to swallow and have cold hands or feet. They might lose consciousness and breathe irregularly or with a rattling sound. Reduced appetite and weight loss are signs they’re nearing the end.
They may also have trouble swallowing, get frequent infections, and lose mobility.
Communication gets harder, and they might become restless and agitated. They could also sleep a lot and for long periods, showing they’re in the final stages of dementia. As the disease worsens, they need more help with everyday tasks.
These changes are a natural part of dying and can be hard for both the person and their loved ones to see. Palliative care and support services are key in making life comfortable for those in the final stages of dementia.
Communication and Cognitive Impairment
As dementia gets worse, people often face challenges with communication and thinking skills. Communication difficulties in dementia can make speaking, writing, and understanding hard. Cognitive impairment in dementia can cause poor judgment, getting lost, and avoiding activities they love.
In the late stages, a person might not speak or show feelings with their face anymore. This can be very hard for those close to them to see.
Difficulty Speaking and Expressing Emotions
Difficulty speaking in dementia and difficulty expressing emotions in dementia become more common as the disease advances. People may struggle to find words, share their thoughts, or understand others. This can cause frustration, loneliness, and problems with talking.
It’s important for caregivers and family to be patient and use simple language. They should also look for other ways to communicate, like gestures, pictures, or notes. With patience and support, people with dementia can still feel connected and share their needs and feelings, even if they can’t speak as well.
“Communicating with a person with dementia requires patience, creativity, and a willingness to adapt. It’s about finding new ways to connect and understand each other.”
Increased Sleep and Unconsciousness
As dementia gets worse, one sign that death is close is more sleep and being unconscious. The person may sleep a lot or be in and out of consciousness, eventually losing it all. This change in sleep habits shows the disease is almost over.
Before dying, dementia patients often eat less and sleep more. Their dying process might not show the usual signs of other illnesses or aging. Yet, those with dementia close to death may still show signs similar to those of others who are dying.
- Weeks before end of life: Signs include loss of appetite, general weakness, and increasing fatigue.
- Days before end of life: Symptoms like labored breathing, difficulty swallowing, and hallucinations may occur.
- Hours before end of life: Signs such as abnormal breathing, glassy eyes, weak pulse, and changes in consciousness may manifest.
As the disease gets worse, the person may sleep more and be unconscious more, showing death is near. It’s important to comfort and support the patient and their family during this time.
| End-of-Life Symptoms | Description |
|---|---|
| Appetite and Digestive Changes | Decreased appetite and difficulty swallowing are common. |
| Increased Sleep | The individual may spend more time sleeping or be unconscious. |
| Withdrawal from the World | The person may become less engaged with their surroundings. |
| Anxiety and Depression | The individual may experience increased emotional distress. |
Knowing about increased sleep and being unconscious helps caregivers and families support the person with dementia as they approach the end. Being aware of these signs lets families prepare and make the final days peaceful and comfortable.
Difficulty Swallowing and Eating
As dementia gets worse, many people have trouble swallowing and eating. This can cause weight loss, dehydration, and not getting enough nutrients, which raises the risk of infections and serious health issues. Trouble swallowing, or dysphagia, is common in late-stage dementia. It can lead to aspiration pneumonia, a major cause of death.
Risks of Malnutrition and Dehydration
Malnutrition and dehydration are big problems for dementia patients who have trouble eating and swallowing. Without enough food and water, these individuals get weaker and more likely to have other health issues. Caregivers need to watch how much food and water the patient gets. They should work with doctors to make sure the patient eats well, maybe with special diets, feeding tubes, or other help.
- Difficulty swallowing can lead to weight loss, dehydration, and malnutrition in dementia patients.
- Aspiration pneumonia is a leading cause of death in late-stage dementia due to the inability to swallow properly.
- Caregivers must closely monitor food and fluid intake to prevent malnutrition and dehydration.
“Maintaining proper nutrition and hydration is crucial for the health and well-being of dementia patients, as it can significantly impact their quality of life and overall prognosis.”
As the disease gets worse, caregivers might need to look into other ways to feed their loved ones, like feeding tubes or help with eating. With the right care and a team working together, the risks of not getting enough food or water can be lowered. This helps give the best care to people with advanced dementia.
Breathing Pattern Changes
As dementia gets worse, changes in how someone breathes can signal they are nearing the end. These changes might include breathing that is hard and shallow or breathing that is not regular at all.
One sign that death is close is called Cheyne-Stokes breathing. It’s when breathing goes in cycles of breaths followed by long pauses. Another sign is the “death rattle,” which happens when fluids build up in the throat.
In the last stages, breathing can become very irregular, with long pauses between breaths. Other signs that death is near include a drop in blood pressure, getting confused, having cool and blotchy hands and feet, sleeping a lot or not responding, and needing less food and water.
Families might want to stay calm and supportive, sitting quietly or talking to the person, saying prayers, or playing soft music. The signs of the end of life can differ based on the disease or illness, like cancer, COPD, dementia, or kidney failure.
Knowing about the changes in breathing patterns in the final stages of dementia helps caregivers and loved ones prepare. They can give the best care and comfort to the person during this hard time.
Increased Risk of Infections and Complications
People with late-stage dementia face a big challenge. They are more likely to get infections because their immune system is weak and they can’t move easily. They are at risk of getting urinary tract infections, pneumonia, pressure ulcers, and blood clots.19Â These problems can make their condition worse, showing how important it is to take good care of them.
Pneumonia is a big problem for people with dementia. They often can’t take care of themselves well. Sadly, many times, dementia isn’t listed as the cause of death on death certificates. Instead, something like pneumonia is listed. This shows how hard it is to manage dementia in its late stages.
Studies also show that infections can make people more likely to get dementia and have trouble thinking clearly. Things like sepsis, urinary tract infections, and pneumonia can lead to worse thinking and doing things for a long time. This shows how infections and dementia are connected.
The risk of getting infections and other health problems in late-stage dementia is very high. This makes it very important to have good, caring care. By tackling these issues early, caregivers and doctors can help reduce the bad effects of dementia. This way, people with dementia can have a better quality of life.
Palliative and Hospice Care for Dementia Patients
As dementia gets worse, special care is key to make them comfortable and manage their symptoms. It also helps support the patient and their family. Hospice care is crucial for those with late-stage dementia.
Benefits of Hospice Care
Hospice care aims to relieve pain, manage symptoms, and improve life quality for those with terminal illnesses like Alzheimer’s and dementia. It offers a wide range of services to lessen the load on patients and caregivers in the final stages.
- Access to medical equipment, physical therapy, dietary counseling, and respite care
- Spiritual and emotional support for the patient and their family21
- Improved pain management and a greater likelihood of passing away in the preferred setting
- Caregiver support, including respite care and mental health counseling
- Continued support for the family for up to a year after the loved one’s passing
Hospice care reduces the physical and emotional strain on caregivers as the disease advances. Yet, planning hospice care can be tough due to the uncertainty of when someone with advanced dementia will pass away.
Understanding hospice care’s benefits and the needs of those with late-stage dementia helps families make informed choices. This way, their loved ones get the compassionate and full care they need.
Coping with Loss and Grief
Coping with Loss and Grief Losing someone with dementia is hard and emotional. Grief is often seen as a constant, hidden part of caring for someone with dementia. In the final stages, the person may feel pain when they can’t communicate, making it harder for caregivers.
Caregivers might not feel grief right after the person with dementia has passed away because they’ve been grieving for a long time. They may feel denial, anger, guilt, sadness, or acceptance. It’s common to feel ambiguous loss when the person is still there but can’t connect mentally. This makes grieving hard because closure isn’t possible.
Caregivers need to take care of themselves to care for their loved ones well. Joining a support group helps with grief and feeling alone, and seeing a doctor or counselor is key if grief is too much. Accepting yourself and making smart choices about what you can control is important for dealing with grief and loss.
Dementia is a condition that gets worse, causing grief and loss for those close to the person. People with dementia feel loss and grief as their condition gets worse, not just at the end. The COVID-19 pandemic has made mourning harder for many, changing how we say goodbye.
Understanding the complex feelings and getting support helps caregivers and loved ones deal with loss and grief at the end of dementia.
Legal and Financial Preparations
Helping your loved one with end-stage dementia prepare for the future is a big gift. Make sure they have financial and healthcare powers of attorney. This lets you make important decisions for them when they can’t26. Also, planning for funerals ahead of time can ease the burden in a crisis.
Different states have their own rules for legal and financial planning for dementia patients. If you’re not legally married, you might face limitations in making decisions for each other if dementia strikes. Legal documents like a power of attorney help avoid confusion and unwanted decisions when someone with dementia can’t make them.
Legal plans for dementia cover healthcare, money decisions, and managing assets. Being able to make informed decisions is key in legal and financial planning for dementia sufferers. A living trust can skip the probate process and name a trustee for assets. If someone with dementia can’t take care of themselves, guardianship or conservatorship might be needed.
Here are legal and financial preparation
| Legal Preparations | Financial Preparations |
|---|---|
|
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Advance directives help people share their medical wishes before it’s too late. This ensures doctors follow these wishes when the person can’t decide for themselves. Planning for the end of life is crucial because Alzheimer’s and similar dementias get worse over time. Treatments can only help for a while before things get worse.
Lawyers can help with financial planning, like making wills and powers of attorney for finances. They ensure your wishes are followed in managing your property and money. Care managers for older people are key in planning long-term care. They help with making decisions and checking out care options, whether at home or in a facility.
Money troubles can be an early sign of Alzheimer’s or dementia. As dementia worsens, people may struggle with managing money, like counting change or understanding bank statements. Watch for signs like unopened bills, strange purchases, missing money, and new items at home.
People with dementia are at risk of being scammed, from identity theft to health scams, which can threaten their money. To prevent fraud, sign them up for fraud alerts and add their phone to the National Do Not Call Registry. The National Elder Fraud Hotline can be reached at 833-372-8311 for fraud tips, with other options available locally and federally.
Getting help from elder law attorneys or legal aid can make navigating legal and financial matters easier for those with end-stage dementia. By acting early, you can make sure your loved one’s wishes are respected and their finances are safe during this tough time.
Providing Comfort and Support
As someone with dementia gets worse, you can make a big difference by being there for them. Just sitting with them, holding their hand, and playing their favorite music can mean a lot. Making a calm place can also make them feel better in the last stages of the disease.
Creating a Peaceful Environment
Dementia is a condition that will lead to death, sadly. To make a peaceful place for someone with dementia near the end, follow these steps:
- Keep the room quiet and dim the lights to help them relax.
- Use soothing scents like essential oils or a lavender-scented diffuser.
- Give gentle touch by holding their hand, massaging their feet, or using a cool cloth on their forehead.
- Play their favorite music to bring comfort and a sense of home.
- Keep a regular schedule for meals, medicine, and daily activities.
Creating a peaceful and supportive space can make the end of life with dementia easier and more comfortable. Planning ahead, palliative care, and hospice support are also key for a dignified and caring end of life.
“The greatest gift you can give someone is your presence.” – Thich Nhat Hanh
By focusing on the patient’s comfort and supporting them, you can make their final journey meaningful and peaceful. This helps both the person and their loved ones.
Conclusion
Dementia is a terminal illness that leads to death. In its late stages, people’s daily abilities drop a lot, and they face many health issues. Knowing the signs that death is close, like more physical weakness and trouble swallowing, helps make sure they get the right care. Palliative and hospice care are key to easing symptoms and making the end of life more comfortable.
As dementia gets worse, patients may act differently, feeling angry or frustrated, and might not communicate much. They could also face physical problems, like being unable to move, having accidents, and needing more help. Moving to a care facility can be helpful, offering safety, medical supervision, and better care coordination.
Knowing the signs of end-stage dementia helps families and caregivers prepare for and support the patient. The main aim is to keep the person’s quality of life good, focusing on easing pain and keeping them emotionally well. With a caring approach and the help of palliative and hospice care, families can navigate this tough time better.
FAQ
What are the 10 signs that death is near in dementia?
Signs that death is near in dementia include getting weaker, eating less, and feeling thirstier. They also include sleeping more and having trouble talking. Other signs include acting differently, getting more infections, and having trouble controlling their bladder or swallowing.
Other signs are hard breathing, changes in how they breathe, and changes in their skin color and temperature.
What is the difference between Alzheimer’s disease and Alzheimer’s dementia?
Alzheimer’s disease is a type of dementia that causes memory loss and poor judgment. It also leads to trouble keeping track of things and mood changes. Alzheimer’s dementia is one of the dementia symptoms caused by Alzheimer’s disease.
What are the stages of dementia progression?
Dementia progresses through the early, middle, and late stages. In the late stage, people decline a lot and face a high risk of health problems.
How long can someone live with late-stage or end-stage dementia?
It’s hard to say exactly how long someone with dementia will live. It depends on many things. If they have another serious condition, it might be clearer how long they have left.
In the late stage, they may slowly get weaker over many months. They become more frail and need more care.
What are the signs that a person with dementia is actively dying?
Signs that someone with dementia is dying include getting weaker and eating less. They sleep more and have trouble swallowing. Other signs are hard breathing and changes in their skin color and temperature.
How can hospice care help someone with late-stage dementia?
Hospice care offers medical equipment, physical therapy, and dietary advice. It also provides respite care for those with late-stage dementia. Hospice focuses on easing pain, managing symptoms, and offering spiritual support to the patient and their family.
How can I help a loved one with dementia during the final stages of the disease?
Helping your loved one means being there for them, sitting, holding their hand, and playing their favorite music. Making a peaceful space can also comfort them in the final stages of dementia.
