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What happens towards the end of life with a Dementia patient?

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The community has responded wonderfully, bookworm54, so read all of the responses so far.

My vote at this stage is to always go for comfort. The body shuts down in last stages and people often have a hard time letting caregivers know how they feel. Watch the body language to see if anything indicates pain. Consider hospice care if hospice is not already involved. They know what to watch for to ensure comfort.

Try to take care of yourself, too.
Carol
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As the brain fails memory and cognitive skills go away. Eventually many patients begin to have trouble swallowing and lose interest in food and fluids. This is usually a sign that the end may be near. If you have a loved one getting close to this stage I would suggest you check into hospice care. Hospice can make the end of life relatively painless and keep the person comfortable.
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My husband changed again, as he had so many times during his 9 year bout with Alzheimer's disease. This time, he stopped speaking, but followed directions to get up, use the toilet (aided), he fed himself, wandered around a bit and appeared content.
Because the memory care unit was so much more active than he,I moved him to a 10 bed assisted living home. He made the change easily, he had a private room near the kitchen hub of the house.For the next 6 months, he ate less and I had a difficult time convincing the staff to let him choose what to eat. This was his only active choice during the day. I had to call in a not for profit hospice agency to evaluate him and place him on palliative care. That is care for comfort, not for rehabilitation. We weren't going to make him better. They placed him on hospice care so the agency had control of his medical decisions, not the home's physician.
Sometimes a hospice agency that is for profit, aims to keep the patients alive as long as possible, spoon feeding, force feeding, using liquid foods etc. I disagree. Let the patient have as much dignity at the end of life as before. This is about the dying person not about us loved ones. Let them decide when it is time to let go.
Seven months after the move, I was called on a Sunday morning, that my husband refused all of his breakfast. The caretaker fed him 4 spoonfuls of chicken broth(for breakfast) and he pushed her hand away. I called hospice who sent over a bed that could tilt his head upward to prevent the patient from choking. My husband never left that bed. He stopped eating and went to sleep. He slept for three days and then he stopped breathing and died peacefully.
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I agree with the hospice decision. My mom just passed a month ago. We had been having problems with her eating and taking pills for a little while, but the few weeks to a month before she passed, it was really bad. it wasn't that she forgot how to eat or swallow, she just made the decision that she didn't want it. We tried to get creative but she was stubborn. We begged her to eat or drink and she would say she would, but then when the food got there she refused it. We as a family had to make the decision for DNR/DNI and then the suggestion of hospice was made. With her not eating and we would not have wanted a feeding tube, this was the next logical decision. We were with her every moment until the end which was about a week and a few days later. Hospice knew exactly what to do and they kept her comfortable which was our main goal at this point. Of course, I'd rather have her here with me, but you have to watch and listen and try to tune into what they want, and I think my Mom decided it was time. Other decisions could have been made, but it wouldn't have been what she wanted.
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My Mom ate less and less, then could not walk or stand anymore and there were frequent UTIs, coffee colored urine. This went on and off for a year and a half and many unsuccessful rehabs. She was put on hospice and was bedridden for seven and a half months at home. I knew something was changing when she stopped eating solid foods, then no foods, only a little liquid and then refused anything about 3 days beforehand. I kept offering her foods and drinks, but she sent them back. I did not press her to eat or drink the things I put on the tray if she did not want it. I absolutely recommend hospice. If you call they will evaluate the patient and put them on hospice. I could not have gotten through this rough time without them and they were wonderful and supportive, kept Mom clean and pain free and comfortable the whole time.
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Wonderful response. My thoughts exactly. It's about letting dad go on his own terms and keeping him comfortable. As an only child, I have nobody to help with decisions, other than dads brother who has criticized everything I have done. He seems him about twice a year. Actually he came last week to the AL. Told other family members that dad didn't need to be in a home...he was fine. He commented that uncle's watch was nice! Thankfully I have a wonderful elder care attorney for dad that I go to when I question myself. It's so hard right now, but nobody ever said life would be easy. As long as dads last days are comfortable, that's all that matters.
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Here are some signs of end of life. Hands and feet very cold. Coldness even extending to lower legs and arms. Not eating. Not going to the bathroom. Hallucinations, or seeing/talking to relatives who have already passed on. If a disease like Alzheimer's is affecting the brain, the person may (or may not) become unable to swallow or walk. As for how to prepare, look at hospice organizations/hospice facilities NOW, before you really need them. Ask friends or associates for recommendations. They're not all the same. Hospice is supposed to be wonderful, but I've seen some terrible ones. Avoid that by doing the prep now. You may never need to use them, but if you do, you'll be glad you made an informed choice. Good luck and God bless. I'm in the same boat with my precious mother.
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My Mom became sick with pneumonia and Urinary tract infections more often, would refuse food and liquid for the most part, We chose Hospice care for the last month of her life. I knew in my heart that we were done, she was tired and just wanted to rest, it is not an easy choice but you will know when the time is.
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My mom ate till the very end, and actually died with a spoonful of ice cream in her mouth...(her favorite food). When she didn't swallow that, I knew she was done. My signs that she was getting there, (although I didn't know it at the time), was when she could no longer walk...even with assistance. My mom got very stubborn and mean towards the end, biting and pinching, so I thought that her refusing to take a step on her own was just her being mean and giving me a hard time. I asked for hospice help and got someone 2 days before she died. Even those 2 days were a big help...they even cleaned her up after she died, which I would never have been able to do. She died at home, which is what she wanted.
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My dad passed away on November 20, 2016, ten years after his Alzheimer's diagnosis. He had been very healthy for 16 months prior but my mom reported that he had been sleeping through dinner most nights for about 3 weeks. Then he got aspiration pneumonia which is common for patients who can no longer chew and swallow properly. His fever went through the roof and the nursing home sent him to the ER. From there he went upstairs to a room and within 2 days the staff suggested that his status be changed to hospice care. In other words, he wasn't responding to the antibiotics and the pneumonia wasn't getting better. They kept him very comfortable for another 5 days and he passed away in his sleep. The hospice setting within the hospital was wonderful. We were happy that he didn't suffer.
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