Red sky at night, sailors’ delight Red sky in the morning, sailors take warning.
The adage has been in documented use for at least two millennia and even appears in William Shakespeare’s poetry. Reading the sky is an ancient method of reading the signs of the sky for the sake of planning – whether that’s travel by sea or managing the fields. As it turns out, the method is relatively accurate.
Red skies indicate the presence of storms in the region, either incoming or outgoing. For a pre-Doppler radar weather report, it’s helpful on the whole! Science has advanced beyond the need for poetic weather forecasts alone. Whether trying to interpret signs in the sky for ecological information or signs on the human body for a health forecast, good scientific history and discussion has helped us read signs around us for a sense of what the future holds.
Dementia: The Forecast
So it is with a dementia diagnosis. Patients who have received a dementia diagnosis typically move through stages, including mild, moderate, and severe/late-stage dementia. The symptoms that you read on the body of your loved one can help you know which stage you’re approaching, which will give you information about how you and your loved one’s care team can make the best, most up-to-date plan of care.
One of the clearest signs that your loved one has reached late-dementia is near-total dependence on others for their daily care and needs. Frailty is the term that covers this constellation of signs and symptoms you will observe at this stage. It’s important to note that categorizing a person in “late-stage dementia” is observing a group of symptoms clustered together. Some of the symptoms listed here may be evident in earlier stages of disease progression, but they may not be coupled with other signs.
The Signs
First and most notable, is memory loss. Your loved one experiencing late-stage dementia has likely already diminished in his or her ability to recognize date, time, and location, but now he or she is losing the ability to recognize close relationships. Sudden flashes of memory may return as your loved one occasionally recognizes a spouse or grandchild, but on the whole, his or her ability to recall relationships with quality begins to fail dramatically. This is associated with a loss of time, in which you might observe the person pursuing an active belief that he or she is living at a time in the past, even talking with people who have been long deceased.
It may also become increasingly difficult for the person with dementia to communicate information about their thoughts and feelings. Late-stage dementia patients are often confused to the point of losing the ability to speak with coherent words or sentences. Your loved one might use sounds and other non-verbal gestures instead, to communicate their needs, desires, or feelings.
Loss of Mobility and Disinterest
Your loved one has also generally experienced loss of mobility by late-stage dementia. He or she cannot walk or perform daily tasks without significant assistance. Eventually, your loved one may be confined alternately to their bed or to a chair. The care team helping you might bring in equipment along with physical therapists and other professionals to teach you how to help your loved one to move or be moved with safety and dignity.
It may also become difficult or disinteresting to eat and drink toward the end of the disease, as the motions may have become difficult. Along with mobility concerns, late-stage dementia often causes decreased motor skills, which makes the very act of eating, drinking, and other minor tasks significantly more difficult.
The Forecast Calls for…
As your loved one becomes more forgetful and confused, rather than correcting him or her, build on their statements, requests or concerns. Is she asking for her long-deceased mother? Respond with questions about what her mother did to make her feel better when she was sick. Does he believe that it’s Christmas rather than the Fourth of July? Talk about what you enjoy at Christmas and find out about his favorite memories. There is no harm, only help, in taking a trip into the preferences and memories of your loved one.
If your loved one has difficulty using words to express themselves, you can talk about your thoughts and feelings. Pay attention to their body language and gestures as an insight into their response. Even if your loved one can’t respond, he or she can hear you and perhaps even understand you.
Progression of the Patient
As the patient with dementia moves further into the later stages and has difficulty with mobility and motion, find ways to aid the person with care and dignity. In many ways, consider the needs of your loved one as you would a baby – a person who requires the same kind of gentle, caring touch toward the end of life as he or she enjoyed at the beginning of life. While the person has had many more life experiences than a baby, people don’t change much in their needs and wants.
Whether you are assisting the person in using the toilet, eating or drinking, or finding a comfortable position in bed, determine ways to incorporate good scents, safe and gentle touches, and positive, honest communication into your loved one’s routine care.
Hospice for Dementia/Alzheimer’s Patients
You can forecast the signs of late stage dementia in order to provide the best care possible. Dementia/Alzheimer’s is a disease that requires unique care. Hospice care for dementia/Alzheimer’s patients can provide specialized care for patients afflicted with dementia/Alzheimer’s during end-of-life. For more information about identifying symptoms of late-stage dementia and providing care for their special needs, please contact Harbor Light Hospice online or call us today.