Topic: Family Life

Dementia – Coping with the Later Stages

In the third and final part in our Dementia webinar series, we discuss what to expect in the later stages of Dementia, including:

  • How to care for someone who cannot look after themselves
  • What support and care is available
  • What to look for in a care home

If you missed the webinar, you can watch the full video at the following link, but we have also included a few highlights below. Click here

What to expect in the later stages of Dementia

Dementia can take many different forms and there are different types too, which can cause a variety of experiences for those with the syndrome.

In the later stages, Dementia is most likely to cause the following symptoms:

  • Memory loss – often our own reflection, everyday objects and people
  • Communication – forgetting words or not understanding what someone is saying
  • Mobility – becoming clumsy, stiff or awkward when moving
  • Weight loss – often through a lack of appetite, diet and muscle loss
  • Continence – needing reminders to visit the bathroom
  • Unusual behaviours – such as aggression, agitation or ‘sundowning’. Sundowning is a symptom of dementia and can be noticed as confusion and agitation, which worsens in the late afternoon and evening, or as the sun goes down.

What might help?

Memory Loss. Try to be reassuring and go with the flow of your loved one.

Communication. Although it may be challenging at times and disjointed, continue normal communication with your loved one. Music, scents, touch and emotion are all helpful to build and improve communication, while also relieving stress.

Mobility. There are many different forms of support available to help a loved one with mobility, including Carers Centres for information, and physiotherapists and occupational therapists for support, aids and adaptions.

Weight Loss. Speak to your GP or community nurse and nutritionist if you require additional support with weight loss. Weight loss may also be related to speech, so it is helpful to work with a speech and language therapist if your loved one is struggling to communicate their needs.

Continence. It can be one of the most challenging symptoms of Dementia, especially for both you and your loved one. It is important to rule out any underlying medical conditions which might be causing continence issues and if continence is still a challenge, a GP can refer you to a continence service for specialist information, support and help.

Unusual Behaviour. Spotting and knowing how to respond to unusual behaviour can be particularly challenging however, the most common causes of unusual behaviour are eyesight, hearing, comfort (including being too hot/cold or hungry/thirsty) and stimulation.

Caring for someone who can’t look after themselves

If you are caring for someone with Dementia who is struggling to take care of themselves, here are a few ideas to help ease the situation and provide additional support to you and your loved one.

Home

Supporting your loved one while at home can provide a great comfort, especially if their home holds memories.  They might find it comforting to have retro-decorating, and lighting and heating features that are easily accessible. If you do not live there too, community aids and adaptations are particularly supportive to help your loved one remain mobile.

Domestic Support

Domestic support may include shopping for your loved one or cooking meals which then simply require heating.  This removes any stress from preparing and cooking a meal and reminds your loved one to eat and stay hydrated.

Food and Drink

Maintaining weight and hydration is very important. Finger foods, prepared meals and bottled drinks provide simple and easily accessible sources. You may find visual cues helpful to remind your loved one to eat and drink regularly.

Personal Care and Hygiene

Maintaining personal care and hygiene can be a difficult and highly sensitive topic for those with Dementia, and a very important element too. It’s important to provide comfort, privacy and choice for those with Dementia who are facing challenges with personal care and hygiene. A few simple additions, such as bath seats and handheld showers, can offer an immediate support. For those requiring additional help, home care agencies, personal care assistants and Admiral Nurses are a few options.

Going out – Coming home

A GPS or Key Safe are great aids if your loved one wishes to venture outside and is able to. GPS and Key Safes are great, providing secure access to the home without the added worry of looking after keys, and additional location support should they become lost or confused outside.

When staying at home is no longer an option

As challenging as it may be, sometimes staying at home is no longer an option for our loved one and may impact their safety, care and wellbeing. Finding alternative care can be a very difficult decision however, there are a few options available, including:

Abbeyfield Society

Shared Lives

Extra care sheltered housing (to rent)

Assisted Living (leasehold)

Care homes

Nursing homes

Finding Housing and Care Options

For national advice and information on housing and cate options:

FirstStop

Age UK

Alzheimer’s Society

Dementia UK

For national standards and opinions:

Care Quality Commission (CQC) www.carehome.co.uk

For a national database of care and housing options:

www.housingcare.org.uk

What to look for in a care home

If you decide to choose a care home, here are a few suggestions for what to look for:

Location and Environment

Accessibility, atmosphere and size, choice, visiting hours

Daily Life

Privacy and control, routines and restrictions, interests and fun, language and culture, food and drink

Care Needs

How many other residents are there? What if my loved one’s care needs change? Are there additional facilities? What is the staff training levels and turnover? What are the facilities like, such as toilets and baths?

Fees and Contract

What does the fee cover? How often are the fees paid? What happens if there are absences? Can valuables be secured? Is there NHS funding? What happens if money runs out?

 

Paying for a Care or Nursing Home

For those with extremely high needs, the NHS will support with funding. For all others, funding is means-tested and administrated by local councils.

For further information on paying for care, the following websites are filled with lots of information and contact details:

www.nidirect.gov.uk/paying-your-residential-care-or-nursing-home-fees

www.ageuk.org.uk

www.alzheimers.org.uk

www.carehome.co.uk