Alzheimer’s and Other Dementias

Early signs of dementia may seem like normal signs of aging. Some people showing signs of dementia may not seek help. They may be in denial or embarrassed about their symptoms. As a rule, a doctor should be called if symptoms disrupt daily life. Dementia affects each person in a different way. The timeline and symptoms will vary for everyone. Some people take years to reach late stage. Others decline quickly. Those who are getting worse may seem better at times. Those who have progressed slowly may suddenly get worse. Memory loss is the most common sign of dementia. Below are signs to look for at each stage. Not everyone with dementia will have all these symptoms.

Early Stage

• Have trouble recalling names, words, or recent events.
• Be confused about time or place.
• Lose things often and for long spans of time; not be able to retrace steps to find lost items.
• Have trouble speaking or writing in a way that makes sense.
• Have trouble doing familiar tasks; show poor judgment.

Middle Stage

This stage can last for many years. Symptoms are more obvious. The person needs help with daily tasks. Many cases of dementia are not caught until this stage or later. The person might:

• Forget family members or big life events.
• Be more confused about time or place and get lost easily.
• Not be able to talk or write clearly, or at all.
• Withdraw from activities.
• Not be able to drive.
• Not be able to cook, clean, or manage other household tasks.
• Need help eating, toileting, bathing, dressing, or walking.
• Have personality changes, have mood swings, become more aggressive, or lose self-control.
• Be more anxious at night.

Late Stage

Symptoms are at the worst at this stage. The person relies on others to do daily tasks and will need full-time care. The person might:

• Not know where they are, who they are, or who the people around them are.
• Have big changes in personality; be easily upset or angered.
• No longer be able to stand, walk, speak, or swallow.
• Use gestures, reactions, or facial expressions instead of talking.
• Be very weak and frail.

Every dementia patient will need to shift to end-of-life care at some point. In order for a dementia patient to meet the hospice eligibility criteria, Medicare regulations require a physician to certify that a patient entering hospice is likely to die of his or her disease within six months.

Common signs that the disease has progressed to a point where all involved would likely benefit from hospice care for dementia is when:

• The patient can say only a few words.
• Can no longer walk and may be bed-bound.
• Is totally dependent on others for eating, dressing and grooming.
• Shows signs of severe anxiety.

The goal of hospice care for dementia patients is to treat symptoms and relieve the physical and emotional stress to help ensure the greatest level of comfort for patients and their families. Hospice services at Capital Caring can help dementia patients experience a more peaceful and natural death by:

• Providing services that include palliative care. Hospice will see to the person’s physical, emotional, social and spiritual needs.
• Managing the patient’s pain, anxiety, and other symptoms. The focus is on pain relief and comfort.
• Meeting the special needs of the patient and providing support for their caregivers.

Visit www.capitalcaring.org or call 800-869-2136 for more information or to make a referral.