It's common for dementia patients to sleep a lot, especially as the disease progresses, but letting them sleep all day isn't ideal as it disrupts sleep cycles and quality of life; instead, encourage short daytime naps and maintain routines, as excessive daytime sleep can signal worsening dementia, depression, or other issues needing medical attention, notes. Aim for a balance: support rest while promoting activity during daylight hours to help maintain nighttime sleep, manage behavioral symptoms, and prevent isolation.
Sleep changes are common in dementia and tend to become more noticeable as the condition progresses. While most older adults need seven to nine hours of sleep each night, people with dementia may sleep as much as 13 to 15 hours over a 24-hour period.
Late-stage dementia involves severe cognitive, physical, and communication decline, where individuals lose the ability to recognize people, talk, walk, or control bodily functions, requiring total assistance with all daily tasks, including eating, dressing, and toileting, often becoming bed-bound and experiencing significant weight loss and swallowing difficulties. Key symptoms include severe memory loss, limited speech (single words/phrases or none), incontinence, loss of mobility (inability to stand/walk), and needing constant care.
Never argue, correct, or overwhelm your loved one with dementia; instead, avoid telling them they are wrong, don't bring up upsetting topics like the death of loved ones, and don't treat them like a child or talk down to them, focusing instead on validation and gentle redirection to maintain their dignity and reduce anxiety.
Life expectancy after a diagnosis of dementia decreases with increasing age. For example, an average person diagnosed with Alzheimer's disease between ages 70-79 can expect to survive seven more years, while a diagnosis after age 90 is associated with an expected survival of only 2.8 additional years.
Signs of late-stage dementia
having a limited understanding of what is being said to them. needing help with most everyday activities. eating less and having difficulties swallowing.
The average life expectancy figures for the most common types of dementia are as follows:
The most common cause of death among Alzheimer's patients is aspiration pneumonia. This happens when, due to difficulty in swallowing caused by the disease, an individual inadvertently inhales food particles, liquid, or even gastric fluids.
Playing music, having objects to touch and interact with, and hand massage can all help people with dementia in the later stages. Playlist for Life is a music and dementia charity. It promotes how music with personal meaning can help people with dementia. You can find and listen to existing playlists, or make your own.
Although deciding when it is unsafe to leave someone living with dementia alone oftentimes depends on your unique situation, there are signs indicating that it is no longer safe. Warning signs include: Wandering: Disorientation or confusion often leads to attempts to leave the home.
At the end of life, patients with dementia often experience high levels of pain due to complex interplay of disease processes and numerous barriers to symptom management. In the hospice setting, informal caregivers play an essential role in pain management.
It's not always a good idea for someone with dementia to be involved in the formal part of the funeral. It can be extremely upsetting and intense if they forget that their loved one has died and then are reminded of it again at the funeral.
Biological Changes in the Brain
Dementia affects the brain's regulation of sleep-wake cycles. The degeneration of brain cells can disrupt the production of key neurotransmitters and hormones that regulate sleep, leading to increased fatigue and a greater need for sleep.
While family caregivers often provide the primary daily support for individuals with dementia, legal responsibility for decision-making and financial management can fall to spouses, adult children (depending on filial responsibility laws), or court-appointed guardians or conservators, especially in the absence of a ...
The best dementia treatment involves a mix of medications (like cholinesterase inhibitors: donepezil, galantamine, rivastigmine; and memantine) to manage cognitive symptoms, alongside non-drug approaches like cognitive stimulation, support groups, exercise, and lifestyle adjustments, with new disease-modifying drugs (like lecanemab/donanemab) emerging for early Alzheimer's, though there's no cure, treatments aim to improve quality of life.
Create a calm environment.
Remove stressors. This may involve moving the person to a safer or quieter place, or offering a security object, rest or privacy. Try soothing rituals and limiting caffeine use.
Currently, there is up to an estimated 120,000 people living alone with dementia in the UK. This number is predicted to double to around 240,000 by 2039.
Many people affected by dementia are concerned that they may inherit or pass on dementia. The majority of dementia is not inherited by children and grandchildren. In rarer types of dementia there may be a strong genetic link, but these are only a tiny proportion of overall cases of dementia.
Life expectancy with dementia varies greatly but averages a few years to over a decade, often 4 to 8 years for Alzheimer's, depending heavily on age at diagnosis (younger means longer), type (Alzheimer's generally longer than Vascular), and other health conditions, with newer research showing averages like 5.1 years for women and 4.3 for men from diagnosis, but with wide ranges from shorter for older adults to longer for some.
The term "sundowning" refers to a state of confusion that occurs in the late afternoon and lasts into the night. Sundowning can cause various behaviors, such as confusion, anxiety, aggression or ignoring directions. Sundowning also can lead to pacing or wandering. Sundowning isn't a disease.
When someone gets the diagnosis of dementia, a cure is only very rarely possible (see p2 About Reversible Dementias). In the current issue of Neurology, Sacks and Shulman1 report one of these rare cases of a reversal of dementia involving a patient on steroid medication.
Generally, urinary incontinence occurs first (stage 6d), then fecal incontinence occurs (stage 6e). The incontinence can be treated, or even initially prevented entirely in many cases, by frequent toileting.
Sleeping more and more is a common feature of later-stage dementia. As the disease progresses, the damage to a person's brain becomes more extensive and they gradually become weaker and frailer over time.
Different types of dementia move at different speeds
Frontotemporal dementia typically progresses faster than Alzheimer's disease. Meanwhile the speed of Lewy body dementia can vary greatly with some individuals only living a few years after diagnosis and others surviving 20 years.