Understanding The Dementia Journey: Planning for The Fourth Stage of Dementia

During the fourth stage of Alzheimer’s disease or related dementia, individuals and families are well into the effects of dementia and have endured a lot of changes and frustrations.

At this stage of dementia, the focus shifts to living well, preparing for end-of-life, and dying with dignity. Having reliable resources, information, and a support team is essential during this stage.

This includes staying engaged with your healthcare team, managing financial matters, arranging living arrangements, and implementing established plans into action.

What to Expect During the Fourth Stage of Dementia

During the fourth stage of dementia, your loved one will need 24/7 care. Expect to provide total care for almost everything, including eating, toileting, bathing, and grooming.

Life expectancy will vary from person to person and can be influenced by various factors such as environment or if an individual has chronic health conditions such as uncontrolled diabetes, heart disease, or hypertension.

During the later stage of dementia, individuals are more likely to live a sedentary lifestyle, making them more prone to urinary tract infections, respiratory infections, and pneumonia.

Individuals during the fourth stage of dementia have no safety awareness. They may suffer from limited vision, balance issues, and frailty, making them more susceptible to falls, fractures, and injuries.

In addition, your loved one may have difficulty swallowing, which can lead to a severe lack of nutrition.

Now is the time to have an open discussion with your physician and healthcare team. They can suggest helpful resources, provide valuable insight on what to expect and how long this late stage may last, and advise you when your loved one is near the end of life.

End-of-life Planning

It’s essential to be prepared to make decisions for end-of-life care for your loved one. You should already be aware of your loved one’s wishes.

Hopefully, you prepared a plan with a financial planner or elder law attorney during the early stages of diagnosis.

At this stage, you should have a do-not-resuscitate (DNR), a healthcare surrogate, trust, asset management matters, funeral arrangements, and a living will in place. These items are essential to successful end-of-life planning.

If you don’t have plans in place, now is the time to get essential details on order.

Caregiving During the Fourth Stage of Dementia

In this stage, individuals experience additional memory loss, such as forgetting who they are, family members, the year, and surroundings.

Delusions, confusion, and other behavior changes are more common at this stage and can be difficult for families to manage without professional support.

Professional caregiving and support are a must in the last stage of dementia. Knowing your options and speaking with your physician and family are essential to choosing appropriate care. Speak with your family about what you can handle and who can help.

In-home Care

Caring for a loved one in the last stage of dementia at home can be difficult but not impossible. Before deciding, speak with your healthcare provider and family to ensure you know what’s required to properly care for a loved one at this stage of the dementia journey.

Individuals in the last stage need 24/7 care and cannot be left alone due to safety concerns. If you decide to care for your loved one at home, you’ll need help from committed family, friends, and professional in-home caregivers and nurses.

Hospice

Hospice services are an excellent option for families looking for services and support during the fourth stage of dementia.

Hospice care primarily focuses on enhancing the comfort and dignity of individuals at the end of life. Services include pain management and symptom relief for patients and compassionate emotional support for their families.

Care can be provided either at home or in a nursing community. A team of trained professionals, including doctors, nurses, home health aides, social workers, and counselors, work together to provide personalized expert care.

In addition, hospice professionals can partner with your physician or memory care community.

Memory Care Communities

Memory care communities can be pivotal for individuals with Alzheimer’s and other dementias and their families during this last stage.

These communities provide specialized care designed to meet the unique needs of individuals with Alzheimer’s disease, related dementias, or other types of cognitive changes.

Coping Techniques

Watching a loved one go through the last stages of dementia is emotionally devastating. Going through the four stages of dementia with a loved one can take a toll on families. Seeing someone you love become a person you barely recognize can lead to stress, anxiety, and depression. And sometimes you need help!

It’s important for families to get help to cope with the challenges of caring for a loved one with dementia. Grief counselors, dementia support groups, pastors, and priests are all excellent options to help families manage their emotions.

Wrap-up

Dementia is a progressive, complex, and devastating disease with no cure. The fourth stage of dementia can be extremely challenging for individuals and their families.

Having resources, being informed, and end-of-life planning is vital. During this stage, families need to focus on ensuring that their loved one lives with compassion and dies with dignity.