Alzheimers Late Stage What Should You Expect?
Alzheimers Late Stage is the last stage of the disease and it can last from 1 to 3 years. It is the most physically demanding stage of the disease on the family. During the late stage, they become completely dependent on others for all of their needs. Their personality will fade and you will see rare glimpses of the person they were.
Communication skills are almost completely gone. They can no longer find the words to speak, if they do speak it is often nonsense or unable to be understood. They will reach a point where they can no longer recognize anyone.
Behaviors are fading. They are being replaced by the inability to function. They will lose the ability to walk. During the transition from middle stage to late stage is when they are at the highest risk for falls. They will need physical assistance to transfer from bed to chair.
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Eating Patterns Will Change
Nutrition intake declines and it becomes increasingly difficult to get any food in to them. The appetite fades along with the memory of how to eat. I have found that the sweet tooth is often the last to go. You will need to find what works for your family member and stick with it. There are several types of health drinks on the market now, try to find one they like and keep it on hand (they usually taste better cold). You should keep track of how much they eat and their weight.
It is at this point some doctors may talk about a feeding tube. This is a decision that should made long before you reach this point. It is so important to know the end of life wishes for the person with Alzheimers while they are still able to make their own decisions. Most people are adamant they do not want to be kept alive by any artificial means. Please complete Advanced Directives and make sure you have a copy and so does your doctor and the hospital you usually go to.
They will reach the point when they become completely incontinent. All of their hygiene needs will have to be completed by someone else. They will become chair or bedridden and bathing in water will become a thing of the past. Sponge baths will become a part of your daily routine and it is best if you have a daily routine. Keeping them on a routine from the beginning will help them hold onto their memory for daily activities as long as possible
Alzheimers Late Stage Progression
Sleep will overtake more of their day as the disease progresses. At this point you will need to begin to reposition them while they are sleeping. They will lose the ability to reposition themselves in bed or a chair.
If they lay or sit for long periods of time their skin will break down. This will lead to what we used to refer to as bed sores. They are now called pressure injuries because they are caused by continuous pressure in one area. I recommend repositioning them every 2-3 hours to maintain blood flow to those areas.
Often in the Alzheimer’s late stage caregivers are at home alone with their family member all of the time. This should not be your situation! You need what is referred to as respite time. You need to take time away several times a week. If you don’t you will wear down and become sick.
Most caregivers feel guilty about leaving their family member at home and going out for social activities. This is a very important part of your life that you should make time for. Failure to take time out for yourself can lead to caregiver burnout.
What help is available for caregivers?
Each state and county has programs to help caregivers in the home. Check your local senior office to find what programs are available in your area.
Alzheimers Late stage will transition to End stage dementia. It is often difficult for family members to recognize this transition since they are with them everyday. These patients usually qualify for Hospice benefits under medicaid, medicare, and private insurances. Hospice can provide care to patients in the home or long term care facility. Hospice can help with direct patient care, medication management, and emotional support for the caregiver.They have a team of people to help. The team usually consists of a nurse, a nurses aide who gives baths, a social worker, and a chaplain.
They also provide medical equipment and cover medicines. Hospice can evaluate your loved one to determine if the meet the Medicare guidelines.
They will need proof of the decline over the last couple of years. They look at weight loss, decreased movement, how much they eat, how much they sleep, how much they talk, and what other medical problems they have. I worked in hospice for several years. Part of my job was to evaluate Alzheimers patients to determine if they met the hospice criteria. I created the Alzheimers progress tracking form to help families identify when it is time to call hospice and to make it easier for the hospice nurse to determine if they met the criteria
The main hospice criteria is, the patient should have less than 6 months to live without any aggressive treatment. Please check with the hospice providers in your area to determine if you are eligible for these benefits!
It is a good idea to keep track of this information so that when it is time for hospice you will be able to show them the information they need to approve the admission. The Caregiver Notebook is designed to track all of the information hospice is looking for
