Dementia is a progressive neurological condition. It doesn’t just cause memory loss, but also damage to other parts of the brain, which are responsible for controlling our vital organ-systems This is why, eventually, it causes death.
Common causes of dementia include Alzheimer’s disease, Lewy body dementia, vascular dementia, Huntington’s disease, etc.
Late stage of Dementia:
Dementia is divided into three main stages based on its clinical progression: early, middle and late stages. We are going to focus the late stage that culminates in death.
There are four symptoms of late-stage dementia:
- Increased frailty (typically brought on by comorbidities, such as arthritis or a stroke)
- Severe memory loss
- Total reliance on others
- Severely limited communication
Causes of Death in dementia patients:
As our aging population grows, it means that more people are living longer, more likely to develop dementia, and with improved understanding and awareness, more are getting diagnosed with it.
Patients with dementia often die of a medical complication, such as pneumonia. But dementia itself can be fatal as the aforementioned late-stage symptoms can lead to death. As these patients become increasingly frail, their immune system is weaker, their appetite and diet poorer, their gait worsened, healing impeded, and their muscles and bones weaker, making them prone to serious infections (pneumonia, wound infections) and injuries (related to fall).
When dementia patients are near death, they encounter irregular breathing, inability to swallow, cold hands and feet, agitation or restlessness, and frequent bouts of unconsciousness.
Support for Late-stage dementia:
Caring for people with dementia at home can be demanding and stressful for the caregiver. They commonly encounter fatigue and depression while having to dedicate more time and energy to their loved ones. Hospice and other support systems provide caregivers the needed support near the end of life of the dementia patients.
Caregivers need to decide whether they can manage their loved one’s condition at home or require skilled care facility or hospice. There are home care services, palliative care, and home hospice care services that provide the needed equipment, assistance, therapy, and medications.
A special focus should be placed on preventing infections, as they are the leading cause of death in this group. This includes keeping the person’s mouth and teeth clean, treating cuts immediately, checking for pressure sores, and keeping them warm and comfortable. Patients should get a flu vaccine each year and a pneumococcal vaccine every five years. Regular visits from the GP and nurse skilled in palliative care are required.
A physical therapist can help educate caregivers on how to transfer the person safely, change position in bed, and do range-of-motion exercises to prevent stiffness and pressure sores. Accessories such as lifts, transfer belts, wedge-shaped cushions and special mattresses that help prevent pressure sores can all be very useful in these settings.