Recognizing End-Stage Dementia
Conversations about “the future” seemed a lot more fun when we were younger, didn’t they? Something about hurtling toward said future at increasing speed takes some of the joy out of it. And in few places is that as evident as when it’s time to have conversations about a loved one reaching the end of that very journey.
Unfortunately, when looking after someone with end-stage dementia, those conversations have a way of forcing themselves into our lives.
It’s painful, but it’s better both for our loved one and for ourselves to be prepared for eventualities. After all, there’s no firm time table with a diagnosis like this, so “the future” might be a lot closer than we expect.
What Is End-Stage Dementia?
Like many diseases, conditions, illnesses, etc., dementia is progressive, degenerative, and ultimately terminal. And like other terminal or life-limiting conditions, there is a final stage where symptoms worsen, support needs increase, and it becomes clear that the patient is approaching their remaining few days with their loved ones.
You’re likely already aware that dementia is an umbrella term that covers a number of related memory loss and cognitive decline conditions (such as Alzheimer’s disease). In spite of this, the warning signs are remarkably similar across the entire category of illnesses. That means that while some of the finer details for your family’s situation may differ, you can still use these descriptions to help determine if someone you care for is nearing the end.
Common Signs and Symptoms of Late-Stage Dementia
If you’ve been caring for someone with memory loss already, then some of these symptoms will sound familiar, or will come as no surprise. Many of the struggles that dementia patients and their caregivers face tend to encroach into their lives gradually, and end-stage dementia simply represents the most severe versions that you’ll have to face.
Others might be a bit unexpected though, or may be more dramatic than you were anticipating.
As patients reach late-stage dementia, you’re likely to see changes such as the following:
- Decreased appetite, increased difficulty with eating and swallowing, or possibly both.
- Increased support needs even with basic, everyday activities, like toileting, bathing, and getting dressed.
- Reduced mobility, such as going from decent walking speed to an unsteady shuffle, or from limited movement to becoming fully bed-bound.
In addition to physical dementia symptoms, there are some clear social and cognitive decline signs as well:
- Even speaking will become a struggle, often limited to single words or very short phrases.
- When they speak, it’s likely to be random or incoherent.
- Dementia patients also tend to lose awareness of the surrounding environment, or be unable to effectively process nearby stimuli.
- Mood and emotional responses may become irregular and unpredictable, possibly including outbursts of anger.
The sum total of these changes (or even just an appreciable number of them) will most likely mean that they require direct supervision around the clock, and it may be time to look into hospice care if you haven’t already.
Oddly, late-stage dementia also leads to increased risk of infection, so you’ll need to take care to help them avoid injury or exposure to infectious diseases.
How to Know When a Loved One is Nearing the Very End
The warning signs of late-stage dementia will help you know when to start expecting the worst. There’s still one more step beyond that, though, and it’s at this point that you’ll want to start saying your goodbyes.
You’re likely to notice any ongoing dementia symptoms advancing more rapidly, and an increase in restlessness. At that point, watch for changes like cold hands and feet, becoming completely bed-bound (if they haven’t already), and possibly a complete loss of consciousness. Eventually, they may lose the ability to swallow, and their breathing may become labored, irregular, and “rattly.”
By this point, your loved one has likely become unaware even of what they’re currently experiencing, and you should expect them to pass anywhere from within a few hours, up to a few days at most.
Dementia Care Needs and Support for Patients in End-Stages
It goes without saying, but the end stage will be the most demanding period of caregiving for those looking after a dementia patient. They will be their most dependent, require the most supervision, and experience the greatest amount of struggle.
If you’ve had difficulty meeting your loved one’s dementia care needs prior to this, you may need to look for external support once you reach this stage. Enlist the help of other loved ones to provide care, if you can. Otherwise, it might be necessary to look into memory care facilities or services.
When to Seek Professional Help and What to Expect
You may be reluctant to “outsource” the medical care of your loved one, when they’re so close to the end. But if we can be frank for a moment, there are two realities you should keep in mind:
- It’s difficult to provide adequate comfort and care if you’re already at your physical, emotional, or temporal limit.
- While easing their passing is both important and praiseworthy, it’s the caregiver who will be left behind to process and recover after all the goodbyes have concluded.
So if you find yourself stretched thin, unable to keep all the metaphorical balls in the air, or otherwise falling short of the quality of care you believe your loved one needs, there’s no shame in asking for help. As a matter of fact, it may even be the most prudent decision, both for them and for you.
Learn more and find available help for you and your loved ones at inhomecare.com today to start towards safety and peace of mind.
