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The final stage of Alzheimer's

Deborah Kan

Created on August 9, 2024

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Transcript

The guide to

The final stage of Alzheimer's

End-stage Alzheimer's

End-of-life care

Common causes of death from Alzheimer's

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The seven stages of Alzheimer’s

Late stage refers to stage 6 or stage 7 Alzheimer's, when brain and bodily functions experience severe or very severe decline.

Mild decline

STAGE 3

No impairment

STAGE 1

Moderately severe decline

STAGE 5

Very severe decline

STAGE 7

Severe decline

STAGE 6

Moderate decline

STAGE 4

Very mild decline

STAGE 2

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End-of-life treatments

Neuronal death

In end-of-life care, treatments are focused on providing comfort and pain relief, with less emphasis on curative measures or long-term effects.

Aggressive pain management

Terminal lucidity

The death of neurons and loss of neural connections can severely affecting brain function, affecting critical areas that control essential bodily functions.

Those receiving end-of-life care may experience terminal lucidity, where they regain clarity and awareness for a short period of time.

Opioids such as morphine may be prescribed by doctors to relieve pain and ease breathing difficulties.

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"Silver lining to the disease"

Being Patient interviewed Jasja Kotterman, whose mother passed away due to Alzheimer's. She shares her feelings and what she wishes she knew.

Caregiver's perspective

"Even though I researched what I could about how the disease would ultimately end, I was still surprised by what happened. I learned that it is a disease, one that kills; it isn’t old age that kills, it is the disease shriveling the brain and the important parts of the body that keep it functioning. I learned that there is a silver lining to the disease. By the end, the patient is unaware of their condition, unaware that they will die from it. Not like a cancer patient that is fully aware of the terminal nature of their disease until the end. An Alzheimer’s patient isn’t aware and that is a blessing."

Jasja KottermanDaughter and caregiver of Alzheimer's patient

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Bodily functions in late stage Alzheimer's

Alzheimer's disease leads to neuronal death, which harms the brain's ability to regulate bodily functions. This ultimately leads to death through various mechanisms:

Neuronal death

Swallowing difficulties

Damage to the brain's regions responsible for swallowing can lead to aspiration pneumonia, in which food or liquids enter the lungs and cause infections.

Breathing issues

The brainstem controls breathing. When it is impaired, breathing problems can lead to respiratory failure.

The death of neurons and loss of neural connections can severely affecting brain function, affecting critical areas that control essential bodily functions.

Motor function decline

The loss of motor neurons can result in the inability to move or maintain muscle tone, increasing the risk of falls and accidents.

Heart and blood pressure control

Decline in the autonomic nervous system, which controls heart rate and blood pressure, can cause heart attacks.

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How Alzheimer's affects one's life

Being Patient interviewed Dr. Liz Sampson about how Alzheimer's the daily lives of those living with it across different stages of the disease.

Doctor's perspective

"Alzheimer’s affects parts of the brain that control our more basic functions. For example, in the early stages of dementia, people have memory problems, and in moderate stages, they might have difficulty with relating to other people, relationships, and perhaps their behavior and distress becomes an issue. Then as the brain cells die off more quickly, more fundamental parts of the brain become affected—the parts of the brain that coordinate movement. That may mean that someone is unable to move around and they may need to be in bed all day."

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Dr. Liz Sampson

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Types of care

There is a range of services designed to address individual needs:

Care homes and in-home care

In late and final stages of dementia, people with disease rely on others even for basic needs. This may change the caregiver's ability to provide care.

Palliative care

Palliative care can be provided at any stage of disease, regardless of severity. Comfort and wellbeing are prioritized, while pain is treated aggressively.

Hospice care

Hospice care is compassionate end-of-life care provided by healthcare professionals and volunteers with expertise, at home, in a facility, or at a hospital.

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Read more about adv. dementia care

Palliative care vs hospice care

Being Patient interviewed Maribeth Gallagher, director of Arizona’s Hospice of the Valley dementia program, and she talked about common misconceptions when dicussing palliative care and hospice care.

Caregiver's Perspective

"First of all, people tend to think that palliative care is hospice care, and that’s a myth. Palliative care is specialty care that focuses on symptom management and comfort in its many forms: body, mind, and spirit. [It’s] also helping people who have stress. This palliative care is for people with serious illnesses; we not only care for the person with the condition, but also their care partners, their families, and friends, to help everybody be their best. Palliative care is for any stage."

Maribeth GallagherDirector of Arizona’s Hospice of the Valley dementia program

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Caregiving in late-stage dementia

Palliative care physician Dr. Lynn Hallarman shares her own family’s journey caring for her late mother who had dementia.

Caregiver's Perspective

“[Just] Because you can’t remember doesn’t mean you’re not who you are. You’re still who you are and you’re a person, and these times that I had with my mother I cherish completely because she was still wonderful.”

Dr. Lynn HallarmanPalliative care physician

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Want to keep learning?

Visit

beingpatient.com

for the latest news and information on brain health and Alzheimer's disease

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