The last stage of Alzheimer’s disease can be the most difficult due to the unique physical challenges as well as the grief associated with imminent loss. Late stage Alzheimer’s is characterized by the almost complete loss of executive functioning and significant difficulty with the physical aspects of daily living.
The brain has deteriorated so much that a person will frequently lose the ability to move, talk, and interact with their environment. Seemingly automatic mundane functions such as chewing and swallowing are tasks that are now difficult. Those who have entered into the late stage of Alzheimer’s disease require intensive care because of this dramatic degradation in both the mind and body on the ability to perform daily activities.
As mentioned, those in the late stage of Alzheimer’s disease suffer from several common struggles.
One of these struggles is problems with skin integrity. These skin problems include:
Bed sores are a major problem because of the loss of mobility and ability to walk (ambulate). The loss of mobility for those in the late stages of Alzheimer’s disease leads to extended periods either sitting or laying in bed. This, coupled with urinary incontinence can quickly lead to bed or pressure sores, which are difficult to cure.
Our advice to help prevent bed-sores is to use items like pillows, and to carefully reposition them every hour.
Another struggle that results from the lack of mobility are problems with the feet and the lower legs. Limited blood flow and fluid retention require careful maintenance of both the lower legs and feet to prevent issues such as dryness, cracking and wounds.
Our advice to help prevent feet and legs issues is to schedule Regular baths, nail trimming, foot rubs, and lotion prevent some of these issues.
The basic tasks of eating and drinking also becomes precarious. Drinking liquids become a problem because people with Alzheimer’s disease have difficulty swallowing thin liquids and foods. The result can be that they ingest the food particles or liquids into their lungs, which leads to aspiration pneumonia. Working with a speech therapist, and following their guidance, can sometimes be effective.
Our advice to help swallowing issues and risk of dehydration is to use simple reminders: by telling seniors to use their tongue while swallowing or gently rubbing their throat.
Furthermore, preparing foods and liquids in different ways by using liquid thickeners or pureeing food can help reduce the probability of aspiration. Discontinuing the usage of straws is important because they increase the difficulty of swallowing. Furthermore, people in the later stages of Alzheimer’s disease tend to consume less food either out of disinterest or lack of comprehension, which can lead to signs of malnourishment or dehydration. Keeping a structured and consistent eating schedule can help ease the difficulty at meal times. If you’re interested in learning more, you can find more information on healthy living and eating for seniors, in a handy resource list we created a few weeks back.
Every case is different, as it depends on the speed at which the disease progresses. Managing all of the difficulties in the late stages of Alzheimer’s disease requires a lot of preparation, understanding, and resilience. Care needs are extensive, and knowing the correct decision on which care options to choose is difficult. Decisions made during this stage of the disease could be some of the most difficult decisions a family faces. There are many options and many quality forms of care, such as in-home hospice. One must evaluate all the options and make the most informed decision. Furthermore, considering the desires of the person with dementia is very important. If they gave end-of-care instruction in the form of a Living Will, then these instructions are invaluable to help satisfy their final wishes.