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Old 08-15-2011, 04:03 PM   #1
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Final stages of Alzheimer's

Hello. My mom is falling into the final stages of alzheimers. She needs assistance with everyday activity from bathing to eating. Although she still knows me and my siblings she is very verbally mean and has been hitting my dad (he is primary caregiver). I need to know if it is normal that my mom just wants to sleep most of the time and never leave the house? It is a challenge to get her to eat. We cannot get her to walk even to the mail box. What are we to do if we cant get her to eat? We are so uncertain and extremely afraid. She fights everything we do to help her. Its almost as if she has given up on life...

 
Old 08-15-2011, 08:12 PM   #2
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Re: Final stages of Alzheimer's

Middle, everything you described is typical of the later stages of dementia. It is typical for them to sleep more and mover. As their world becomes more confusing to them they tend to shut it out and would rather stay where it is quiet and familiar. Routine is good for her.

The first rule of dealing with Alzheimer's is do not argue. The more you push the more they will resist. It is not that they are intentionally being stubborn. It is because they do not understand. Presenting it in a different way might help. It is not that she had given up, she is forgetting how to do the simple things we take for granted.

Eating can be tricky. Find the foods she loves the best. Many prefer sweet or salty. Giver her what she wants to eat rather than what might be considered a "healthy diet". Encourage her to eat high calorie foods. You can also supplement with Ensure or other dietary supplements. It comes in a variety of flavors that she might enjoy. Make sure it is very cold when you serve it. I even put some ice cream in it and made a milk shake. You may also want to give her foods that are of softer consistency so she doesn't have to chew. Mom went through a stage where she didn't want to sit and eat so she ate grilled cheese sandwiches while walking. It is not necessary to sit and eat a full meal. Make high calorie snacks available at all times. Half a peanut butter and jelly sandwich, then some ice cream, perhaps some potato soup. Instead of three full meals give her 5 or 6 smaller meals during the day. Also know it does not take a large quantity of food to keep the body going. Instead of watching every bit she eats, weigh her every two weeks. If she is not losing weight then she is ok.

As for the anxiety and combativeness... there are medications that will help quiet her anxiety. This can be done without "knocking her out". Ativan and Xanax are the first meds that many doctor's try but I have found them to be relatively ineffective. But there are medications that do work. Please ask your doctor to give her something for the agitation. Her striking out is out of fear, anger, and frustration that she can not control. It is emotional pain. If she had physical pain you would treat that so please help her with the emotional pain

Welcome to our little corner of dementiaville. Hate you needed to find us but glad you did. Stick around. This is a great place to vent, find understanding, information, and lots of experiences Glad you are here!

Love, deb

 
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Old 08-16-2011, 07:58 AM   #3
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Re: Final stages of Alzheimer's

I don't know the exact stage she has, but it may be stage 6. Not stage 7. It depends on how the caregiving goes. My FIL who has stage 6/7 AD has had the same problems over the years.

First of all, regarding eating, does she choke a lot on the food or water? If she is in late stage, she will have trouble swallowing. My FIL has had this problem for 2 years so now he is having pureed food to prevent him from stopping eating completely.
You need to puree the food so she can swallow. She would not understand what to do with the food. Also, my FIL stopped knowing about food and getting cakes in the kitchen last year, so your Mom may also have stopped knowing that she needs to eat. People have to cue them. My FIL has moved to this residential home last summer and they cue him and take him to the cafe to eat with other residents. He is quite happy with that.
So try some babyfood and pureed food. Also, don't push her to drink. At this point, she could cough and get aspiration pneumonia. So watch out for that. If you feed her something that will choke her or make her cough, she will refuse it.

Secondly, it is tricky about walking. My FIL lost his balance on walking in late 2007. He had managed to walk with a cane since then until this May. Now he can no longer walk on his own and the walker is not that useful - he can no longer gets up by himself and all that. In 6 months, he may need wheelchair and become chairbound.
You need to find out from the doctor what level she is walking. If she needs a cane, get it for her, if she needs helps, be there. Walking next to her can help her balance.
Now my FIL can only walk a room's distance on the walker poorly and gets very tired and wants to sit down. If she is at this stage, don't push her to walk. Get a wheelchair so you can transport her. Get her up every 2 or 3 hours.

The thing is you cannot just make her do it without understanding the tricks with dementia. They cannot be pushed or forced. You have to be nice to her even if she is mean. You may need to say white lies to her.

It would help if you hire a home care nurse or someone who can manage the elderly's dementia and she/he can tell you what to do with her.
We hired a home care co. nurse back home and she had helped a lot. Also read some books on Alzheimer's to understand how she thinks.

Your Dad gets hit by her a lot partly due to his demand on her. Don't demand her to do things, persuade her, babytalk her... It is hard, but it is the only way. If you get upset, she gets more upset and will fight endlessly...
There are many other stuff you need to know. She is afraid of water, so don't make her take a shower on her own. Be there in the bath, draw the water for her to tell her the temp. is OK and etc. Sponge bath may help. She needs to be told to wash her hands. Her brain has been damaged so don't think she can do it on her own anymore.

If she is frustrated with everything you did, she may just want to tune out and sleep on her own. It could also be that she is in late stage closer to stage 7 like my FIL. Your Dad and the family need to change the way of approaching her. She does not understand it is "your help", so work on it from her perspective.

Take care,
Nina

Last edited by ninamarc; 08-16-2011 at 08:11 AM.

 
Old 08-16-2011, 02:21 PM   #4
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Re: Final stages of Alzheimer's

i am sorry to hear this. it sounds like you need some assistance.

 
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