For those of you who read this regularly, you understand that my mother has not been bathing, has incontinence issues, and has recently stopped eating, but for approximately one meal per day. She is also spending a great deal of time in her room, between her recliner, the bed, and the bathroom. After speaking with her doctor, this is a typical sign that she is, most likely, in the late stages of her dementia (Lewy Body Dementia), and is nearing what will be the end stage.
Two weeks ago, Mom was doing well, eating most of her meals, going to activities (although they were becoming more difficult for her to follow), and scanning the pages of the paper for the headlines (as her reading perception was waning). She could engage in a bit of conversation although what her responses were was anyone’s guess, but she was involved.
However, we began to see that she was beginning to spend more time in her room - her bed particularly. Last week, we realized she was suffering from impacted bowels, and we were able to rectify that situation, but the incontinence began - and then ceased. She was going to the loo more often, which seemed to account for her tiredness during the day, and she wasn’t able to present a more vigorous front anymore.
Knowing we have a meeting with her doctor this week, which will, undoubtedly, lead to hospice care, I thought it might be a good investment to investigate these signs and how they relate to dementia in the late stages. I was a little dumbfounded at how much information was written on the subject, and I will be able to relate what I found to you.
In the publication, A Caregiver’s Guide to Advanced Dementia, I found that bathing is one of the first Activities of Daily Living (ADL’s) that is the first to go. Now, Mom used to bathe nearly every day until May, when they would prompt her and she would usually comply. However, last Thursday was the first time she had bathed since early August/late July! And she had to be taken by two attendants as she protested, but once in she loved it. We thought this might be a turnaround. Wrong!
Incontinence is another function that will begin to falter. Should there be instances of Urinary Tract Infections, and incontinence (as these may become more frequent), the caregiver should become more aware and understand that the body is beginning to break down. (Alzheimer's disease and end-of-life issues)
One does not die from dementia, but rather from infections caused because of dementia. Pneumonia, fevers, other infections, and the like, are caused because the patient is no longer able to stave them off - due to lack of nutrition (not eating), lack of fluids (not drinking water or anything else). This causes a great weakness which keeps the patient from being able to ambulate or even move much as the body deteriorates from the lack of nutrients.
While there is information as to how to encourage eating, there are several conditions which may cause the patient to decline - being overly tired, troubles swallowing (a typical LBD trait), pain - which can be caused by constipation and other disorders, not recognizing the food, having changes in taste buds, and the list continues. While encouraging the patient to eat helps, also changing the diet may also be beneficial - for instance, if the patient suffers constipation, then a higher fiber diet may come into play. (Eating and drinking)
For Mom, it was thought that, perhaps, the constipation was limiting her desire for food. But that has been solved, insofar as we know. She also has back pain which is alleviated from exercise, but she has been walking around the gardens and the facility (with help, of course), but none of these seems to be working. Also, she has been receiving massage, which she enjoys, but this, too, seems not to encourage her to want to engage in a gastronomic activity.
So, what then?
What this could mean is that we may be nearing the final stages. Today she refused to go to a program she loves as she stated she wouldn’t be able to stand and walk the little distance to the event. I am also encouraging her friends to come visit her now, rather than wait while she still has some strength - as this may be regained to an extent, it doesn’t seem likely.
So we wait, discuss with the doctor, provide hospice - hopefully - and begin to realize that life isn’t forever, but a natural occurrence of events, whether we appreciate them or not.
Two weeks ago, Mom was doing well, eating most of her meals, going to activities (although they were becoming more difficult for her to follow), and scanning the pages of the paper for the headlines (as her reading perception was waning). She could engage in a bit of conversation although what her responses were was anyone’s guess, but she was involved.
However, we began to see that she was beginning to spend more time in her room - her bed particularly. Last week, we realized she was suffering from impacted bowels, and we were able to rectify that situation, but the incontinence began - and then ceased. She was going to the loo more often, which seemed to account for her tiredness during the day, and she wasn’t able to present a more vigorous front anymore.
Knowing we have a meeting with her doctor this week, which will, undoubtedly, lead to hospice care, I thought it might be a good investment to investigate these signs and how they relate to dementia in the late stages. I was a little dumbfounded at how much information was written on the subject, and I will be able to relate what I found to you.
In the publication, A Caregiver’s Guide to Advanced Dementia, I found that bathing is one of the first Activities of Daily Living (ADL’s) that is the first to go. Now, Mom used to bathe nearly every day until May, when they would prompt her and she would usually comply. However, last Thursday was the first time she had bathed since early August/late July! And she had to be taken by two attendants as she protested, but once in she loved it. We thought this might be a turnaround. Wrong!
Incontinence is another function that will begin to falter. Should there be instances of Urinary Tract Infections, and incontinence (as these may become more frequent), the caregiver should become more aware and understand that the body is beginning to break down. (Alzheimer's disease and end-of-life issues)
One does not die from dementia, but rather from infections caused because of dementia. Pneumonia, fevers, other infections, and the like, are caused because the patient is no longer able to stave them off - due to lack of nutrition (not eating), lack of fluids (not drinking water or anything else). This causes a great weakness which keeps the patient from being able to ambulate or even move much as the body deteriorates from the lack of nutrients.
While there is information as to how to encourage eating, there are several conditions which may cause the patient to decline - being overly tired, troubles swallowing (a typical LBD trait), pain - which can be caused by constipation and other disorders, not recognizing the food, having changes in taste buds, and the list continues. While encouraging the patient to eat helps, also changing the diet may also be beneficial - for instance, if the patient suffers constipation, then a higher fiber diet may come into play. (Eating and drinking)
For Mom, it was thought that, perhaps, the constipation was limiting her desire for food. But that has been solved, insofar as we know. She also has back pain which is alleviated from exercise, but she has been walking around the gardens and the facility (with help, of course), but none of these seems to be working. Also, she has been receiving massage, which she enjoys, but this, too, seems not to encourage her to want to engage in a gastronomic activity.
So, what then?
What this could mean is that we may be nearing the final stages. Today she refused to go to a program she loves as she stated she wouldn’t be able to stand and walk the little distance to the event. I am also encouraging her friends to come visit her now, rather than wait while she still has some strength - as this may be regained to an extent, it doesn’t seem likely.
So we wait, discuss with the doctor, provide hospice - hopefully - and begin to realize that life isn’t forever, but a natural occurrence of events, whether we appreciate them or not.
No comments:
Post a Comment