Advanced Stages of Dementia
Dementia is a progressive condition which results in the deterioration of memory, cognitive function and, eventually, may impair speech, co-ordination, hearing, mobility and continence. In the advanced stages of dementia you, your partner or loved one will require full-time care.
Despite these challenges it is perfectly possible for a person in the advanced stages of dementia and their family to maintain a calm and stress-free daily life if they have benefited from a person-centric dementia care plan, established soon after diagnosis.
Planning for the advanced and final stages of dementia at an early stage, with the full involvement and understanding of the individual who has received the diagnosis, is essential if their personal wellbeing is to be preserved into the final stages of the condition.
Symptoms associated with the advanced stages of dementia
No two instances of dementia will follow the same course and symptoms can appear at any stage of the condition’s progression depending upon the type of dementia sustained and the area or areas of the brain affected. The following symptoms, however, are almost always evident in the advanced stages of dementia.
Severe loss of memory
Forgetfulness and lapses of memory are among the earliest indicators of dementia but as the condition progresses and cognitive abilities deteriorate a person’s memory becomes increasingly impaired. People in the advanced stages of dementia may fail to recognise their surroundings, the people closest to them or everyday objects.
Whilst the loss of memory and recognition can be frustrating and dispiriting for the family of a person with dementia it is still important to find ways of connecting with them. Sometimes glimpses of memory may surface, and the person with dementia might also respond to memory-jogging stimuli such as a favourite piece of music.
Reduced mobility and dexterity
As the condition progresses a person with dementia may appear to become increasingly uncoordinated, perhaps dropping items, bumping into furniture or walking unsteadily. This may eventually lead to an inability to perform simple motor tasks such as tying shoelaces or buttoning up a shirt and, if mobility is seriously affected, the person with dementia may become bed-ridden.
Difficulty with communication
In its advanced stages dementia can adversely impact both an individual’s ability to speak clearly and to understand what is being said to them. Eventually a person with dementia may lose the ability to speak altogether or may be limited to brief incoherent utterings or noises. However, speech is only one method of communicating and for family and carers an individual’s facial expressions, gestures and body language may provide reliable cues as to what a person with dementia needs or is feeling.
Whether or not you believe that a family member, partner or someone you are caring for can understand you or not it is important that you continue to talk to them as this helps to maintain their dignity and potentially their sense of wellbeing. Body language, tone of voice and gesture become increasingly important. Feelings matter more than facts – it is not what you say, but the way that you say it which will be remembered.
Whilst loss of muscle control is symptomatic of the advanced stages of dementia it does not automatically follow that bladder or bowel problems arise in every case without exception. Where incontinence does occur this may be attributable to a cognitive impairment such as the failure to recognise and act upon the urge to go to the toilet or forgetting the location of the toilet. Incontinence may also be a side-effect of any medication that the person with dementia is taking or it may point to an unrelated health issue such as an infection or other illness.
Loss of appetite and weight
For some people in the advanced stages of dementia the simple acts of chewing and swallowing become difficult, whilst others may simply experience a reduced appetite. In either eventuality weight loss is commonly observed in such people and it is therefore important to ensure that they are cared for during mealtimes in order to ensure that they are eating and drinking sufficiently.
Mood changes and ‘irrational’ behaviour
A decline in brain function may be characterised by behaviour which, to the observer, seems irrational or curious. Such behaviour may include rocking back and forth, showing agitation or aggression, sitting perfectly still and staring as though focused on a particular spot or making repetitive movements or utterances.
It is important for the carer of a person in the advanced stages of dementia to ensure as far as possible that irrational behaviour is not the result of discomfort or distress. Other possible causes may include hallucinations or other sensory distortions, the side-effects of medication or external disturbances such as bright lights or noise or simply boredom.
Professional care is best both for people with advanced dementia and their families
In the early stages it is not uncommon for a partner or family member to become the primary carer for a person with dementia. As the condition progresses, however, providing care – particularly for those with no formal training or experience – can become increasingly demanding and stressful. Someone in the advanced stages of dementia requires constant care and supervision, and partners or family members attempting to provide this unaided may succumb to fatigue, frustration and depression.
Obtaining assistance from professional carers not only benefits the person with dementia but also provides relief, emotional support and peace of mind for their loved ones.
The Good Care Group is a leading and multi-award-winning provider of personalised live-in home care for people with dementia. Our high-quality care services enable people with dementia to continue to live a dignified, independent and fulfilled life from the time they are diagnosed through to the final stages of the condition. You can find out more about our one-to-one dementia care services here. Alternatively, to speak to someone about your dementia care requirements please call 0203 728 7577.