Dementia in advanced stages
In the advanced stages of all diseases that cause dementia , the person will experience changes that signal that they are in the very advanced stages of their life and may even be approaching its end. No one likes to think about the end of life and most do not wish for it to end. However, the painful reality is that in the final stage, the person with dementia will gradually lose their abilities and functioning and their dependence will increase considerably until they reach a terminal state.
This stage may last for several years, during which the person will need help with all daily activities, including bathing, dressing, mobility, eating, and using the bathroom. However, this stage raises many ethical and practical dilemmas regarding the goals of treatment, the various interventions, and their feasibility. Knowing what to expect may ease concerns and fears during this period and allow family members and professionals to receive tools that will make this period easier.
What are the most common medical complications that occur in a person with advanced dementia ? Eating problems and infections are the most common problems in advanced dementia. Nearly 90% of people with advanced dementia will develop eating problems. When eating problems begin, it often indicates that the end of life is near. About half of people with advanced dementia experience fevers and infections. The most common type of infection is pneumonia.
Patients typically focus on “comfort” or “life extension” as the primary goal of treatment at this stage of the disease. “Comfort as the primary goal of treatment” means that the focus is on maintaining the patient’s comfort as much as possible, even if it means not giving them medical treatments that could help prolong their life. People who choose comfort as a goal of treatment do not want to be fed through a tube or put on a ventilator. They do not want medical staff to perform CPR on them if their heart stops beating or if they stop breathing. Comfort-focused treatment implies that they do not want CPR. Most people also do not want to be hospitalized unless the hospital is the only place that can provide the care needed for their comfort. Comfort-focused treatment includes many types of treatments that are designed to maximize the patient’s physical, emotional, and spiritual well-being. When treatment is focused on comfort, it does not mean that medical care is stopped.
