How do I determine if mom is now entering into last stage Dementia?

@Pineapple...the drugs probably won't help her at this point as fas as slowing down the process. But for her UTi give her sugar free cranberry juice...make it a staple. Also, if she has trouble eating solids either put her dinner in a blender or buy baby food. As the progress they have trouble swallowing don't let her eat ice cream so much....she may want it as her main dish like kids. Give it to her as a treat and sugar free at that. Edys Vanilla by Splenda is very good. The blue container. (My mom is in a nursing home for Intermidiate Dementia.) My mom talks about her mom all the time I have to change the subject or go along with it and make her mom seem very busy. My grandma died about 20 yrs ago. Mom thinks she is alive, I made the mistake of reminding her last year and I will never do that again. It hurts them too much, it will be reoccuring pain. Good Luck.

My mother sounds like yellow's mom...in the lsat few months she went from peeing wherever to rarely going on the toilet and mostly soaking her pullups. There are pads I can put on the bed that are washable - which I am going to get soon. It will be easier than changing pullups to just change the pads - but I will not let her just lie around.
She can no longer walk - sometimes with assistance, but that is near impossible now. She care barely stand on her own. I try to get her to do what she can, but she is small anyway. She complains of pain when she stands - but I really really try to get her to take a few steps - but that is going to have to stop soon. She will sit in the transport wheelchair and move herself around - "walk" while sitting.
She does not have good verbal skills - has not had for some time, but there is significant decline recently.
She also is having more and more difficulty with feeding herself - even finger food. I have found her able to eat ice cream bars - so she eats them frequently and I feed her a lot of the time. I think part of the problem is increasing difficulty with swallowing - her appetite is rapidly decreasing, but I give her things I can easily spoon feed her like applesauce. I am not sure she can take Ensure / Boost - some of those things really mess with the diabetes - something else I have to find out about. Eating / appetite/ feeding self skills have taken a major downhill turn in just two weeks.
She also has diabetes which compicates everything. She has another UTI right now.
And like others I hope that she does not have to suffer from this for a long time. She does have the living will that prohibits DNR, feeding tubes, etc. It also says antibiotics.
I plan to keep her home - I live in her home with her.
She is talking more about deceased family and has told me that my brother (who died 8 years ago) is coming to get her this summer.
I have not given her Aricept, Namenda, etc (that was Dad's decision while he was still living) - but she does well with diet and exercise.

Hello yellowfever, my mother was diagnosed in 2006. but for the first year she thought I was the one that was doing stupid things. We had a few rows I ended up in hospital having an operation a severed nerve where both exasperated she threw a dish cloth at me and said I have had enough of you and I was wiping the dishes and slammed my hand down with a saucer in my hand and cut the nerve twice to my index finger had to have operation, I suffered depression after her being sectioned while at the day centre, because every day I visited her and she wanted me to take her home, I couldn't so used to cry all the way home, then I had Bells Palsy after that got better I had her back home for my last attempt to care for her. But I couldn't get any sleep because she was making such loud noises it was impossible. I slept in the lounge near the front door in case she wandered but would wake up to her shining a torch in my face at 5 am.
To me her dementia quickened at an alarming pace after they stopped her warfarin because she was having falls, the doc said she could bleed into the brain. So he put her on aspirin he commented quietly but she will have more mini strokes that was November by the following April she was quite violent at home and in the hospital where she was taken, I was called out 1am to come to subdue her, no body could get a sedative down her she was waving her walking stick at the nurses and security. When she raised her stick to strike a nurse I was behind her, I caught hold of it and the nurse did and we still couldn't bring the stick down, her strength was unbelievable. Then suddenly she let go and fell backwards into my arms with such speed I only just managed to stop her hitting the ground by the time I got her weight. Then I said to the nurse while she is down give her an injection and so she gradually was coaxed back to her side room. All this happened in the main ward she was going to attack other patients who were in the assessment ward next to the A&E. She was in a secure ward after that and I was there till 4:30am every night from 7pm. When she came home she was only home for a few weeks before the sectioning, then again she came home in the September just before her birthday and by the February the following year the Social Worker said enough is enough, if we don't put her in a home then they are going to have two people on their hands so he took the decision from me which I was relieved at because by then I was crying every day down the phone to my friend or in the kitchen crying while making food.
I found a nice home overlooking the sea but she was only in there 10 days before being admitted to hospital with a fracture to her lower leg, they said '' your mother threw herself to the floor'' or ''banged her leg against the wall while in bed'' and minus her wedding ring and eternity ring, they said she didn't come into the home with them on, but I did her nails for her the morning she went in and thought shall I take them off and keep for safety, but decided they weren't mine to take so let her wear them in there. I wouldn't let her go back to that home from the hospital so found another who then used lap restraint to keep her sat down till I made a complaint and threatened to put it in the papers. she was moved from that section of the home to where ''they can roam'' hmmm I actually saw the staff press on other patients shoulders to make them sit down. If they got up when staff weren't looking they were soon brought back to sit. I wanted my mother removed from there but the Social Services were happy with her care there and refused to let me move her. On looking originally a few refused to take her because of the noises she was making ''It would disturb others'' She stopped making the noises for a while in the home and slept so guess the sleep was induced because now in the hospital she is making them again and so as much as I would like to have her back home could I get any rest or would I be driven mad with the noises. its like alyha alyha alyha all the time. Then a bit of her talking more like rambling because she can't talk but she must know what she is trying to say. I don't know. And if she can't eat and has to be tube fed???? I don't think I could do it and would prefer for her to stay in hospital than go back to the home...

There comes a time that you have to respect the patient's wishes even thought it may not seem the right one for the caregiver. Alzheimer patients are still human beings even though they can't think for themselves at later stages. But if it gets to the point that the patient does not want to take anything oraly, it is the person and the body telling you, it wants to finish. You can't force anyone to live against their will if their body is giving in and is ready. You even said it yourself, "there is no quality of life". Isn't quality of life more important than quantity? I know there is a fine line between love and greed. There are books out there that will help you understand that when its time to go, let go. I would never take it to the extreme of making mom live against her will. If she is yearning to pass, and I am the one forcing stuff down her throat to keep her alive, I am not being respectful of who they are and what they want. You have to give these people respect. Once an Alzheimer's patient refuses to eat, yes it is very close to the end if not the end. It would be time to take her to a hospice at that point so she can die with no pain.

Dear Yellow Fever,
I know what you are going through. It is difficult having the responsibility of your mom's life in your hands. When I told the docs to feed her with a feeding tube, it was out of guilt that all of a sudden I would give up on saving mom. I had worked so hard to keep her safe and in her own home. I couldn't not feed her.
But,looking back, it did nothing to improve her life. I have had many quality moments with my mom these eight months that I would not have had, but, looking back I would not do that again. Still today, I will be in the same situation of deciding to intervene if she gets sick, feeding tube comes out, whatever. I did get a DNR in place now. Somehow you have to talk to your friends and family and feel you are doing the best you can with mom, and prolonging her life just for you to have more quality time, if that, would not be in her best interest. You and I will always feel guilt and question if we are doing the right thing, feeding her artifically, or whatever. In the long run, it is God's decision when he calls for them, and we really have to accept that when it is her time to let her go.
I hope you stay strong and know that many of us are experiencing the same gut wrenching decisions. Take care, Helen

Helen and Lilly, I am so sorry to here of your mothers. Placing mom in a home is my worst fear that she will be treated less than human. I don't care what an elder's condition is, No place should treat them as non-exsistent and non-important people. For a brief period in my life I worked in a nursing home. That place was HELL on earth for those patients. I wouldn't put my worst enemy there!! I morally couldn't work in a place like that so I quit within 2 months. I have seen those that could walk forced to sit all day, or giving medication for sediation. ones walking around in soaked diapers and soiled clothes. Its so sad that these places go on to exist!!
I have wore depends on my mom for over a year or so now. Just as precaution, she occasionally had accidents. A while back ago she had the need for adult diapers at nite. But I guess now her sensation of "when" to go is fading away. I don't mind changing her depends. But I feel so bad for her, especially when she realizes why I am changing her. She looks at me so sad. I have given my mother ensure and what not. I am concerned of weight loss. She has always been a petite woman normally weight 90-100lbs. So I know any weight loss can mean trouble. She has been taking Namenda and Aricept for 2 yrs now. I have noticed her decline is more slight than a friend of her's who also has dementia and not taking anything. Which I feel for this woman, her family don't see no sense to give it to her. Isn't that sad??? I have spent the last 2 yrs taking mom to different dr's and trying to get a right combo of meds for her. I finally got a good dr who got mom good meds to help with her anxiety along with the dementia. But I feel that maybe I took to long to find this doctor. Which makes me feel guilty, like I should have tried harder. I just want mom to have the best quality of life till the end. There is many times that I wish mom would decease before the Dementia completely takes over. That she may go in peace with no suffering, without tubes and bed-ridden. She told me a while ago that she told God she was ready, when he was. However, she has no living will and is not able to understand what that means. So, since I am POA when that time comes I know she would want DNR. But, that means I will have her life in my hands, and have to verbally say DNR, I know I will feel some sense of guilt if I did right thing and how am I going to live with that???
I tend to worry about mom on a day to day basis. However, with this new transition phase I need to focus more on whats coming in the future.Whether its months or years that day is going to come and I need to be prepared!!
thanks for your comments!!

This is very hard, and very sad. I can't help but comment that no one who can walk should be required to just sit and no one who does not need diapers should be required to have them. It sounds like a real "cookie-cutter" type of program they had going, and is far from best practice! Some places don't seem to think it matters, and if there is any choice (I know sometimes there isn't) its best to find soemwhere that does things differently, focusing on maxiizing everyone's quality of life and activity level as much as possible.

And...this is even harder...but in most cases, long-term tube feeding is non-recommended for advanced dementia. For acute stroke, for some other swallowing problems, yes, its a great thing, but overall the impact on quality and even quantity of life in most studies for people with dementia has been either nil or negative. This may be because restraints are more often required, and the more time spent restrained or in bed the more risk of sores, pneumonia, and sepsis. Though I also think the doc is right about DNR for someone who is so frail and ill like Lily's mum, but also, it should be a family decision and not implied that they would not respect your wishes if you requested otherwise. God bless...

Lily that is heart breaking how long has your mother suffered from vascular dementia, my aunt is 85 and I suspect she is beggining to show signs. Id love to hear about your experience with the vascular dementia.

My mum has been in a home for nearly 3 years, she lost the ablitiy to walk because they are made to sit down all the time. yet she used to wander when she went in, They put her in 'pads' large nappy or diaper to 'keep her dignity' yet she wasn't wetting herself but you could try these on your mother, it is no different to changing a child but you do it with them standing up.
You the carer are telling her what she can and can't do so she is going to turn against you. Been there myself.
My mother is now in the last stages of Vascular Dementia, I don't know how she is hanging on. Last week she was admitted to hospital because she had vomitted and some had gone into her lungs as she couldn't clear her throat, she has been having her food pureed for some time now.
My mum has been put on a sugar and salt drip for the past 5 days and tomorrow they are going to try to put a tube down her nose to her stomach to give her some form of nutrition. As she now cannot swallow properly without liquid going into her lungs. Yesterday I went into the hospital to find she had conjunctivitis in her eyes. Thrush in her mouth and inside her nose is white? from the oxygen she is having all the time. I have to face facts I don't think my mother is going to come out of hospital alive. In fact yesterday after seeing her I came home and cried but today she seems brighter.To me this is the final stage of Vascular dementia when she can't swallow and has to rely on a drip. When she was admitted last week the doctor told me. ''What ever you say I will not change my decision, Should your mother stop breathing we will not resuscitate her as it would mean needles in her neck and groin, heart massage or pumping on her chest and it would only prolong her agony for maybe it to happen again shortly afterwards'' So I agreed my mother is 85 I love her dearly and have been there at the hospital twice a day, There is only my son and myself to visit her so we do have to come home to rest or I would be there all the time.

I have watched my mom's gradual decline for the last 3 .5 years after having a TIA. I suspect she had beginnings of dementia earlier than that, but she seemed to be functioning fairly well. Is your mom on any medications for Alzheimers, such as Aricept and Namenda or Excelon? One of these or both of these meds can possibly slow down her decline. You should decide if you want to treat her with these meds. If she is unable to eat and know what to do with the food in her mouth, she may not be getting enough calories which could be leading to more sleep, lethargy and speed up her decline. This IS the normal process of later stage dementia. You can choose to supplement her food intake with Ensure plus, Boost Plus (350 calories day), 4 x day if she isn't able to take in solid food. The longer you prolong her nutritional needs, the longer she will survive, but to what end. You have some decisions to make concerning how much you are going to supplement her food intake. Also, please, please think about whether you would insert a feeding tube in her PEG line if she refuses to eat. I was not prepared for this decision when the time came for my mom. I did not accept or recognize that she was at the end of her life, even though she was frail, totally dependent on a caregiver for everything, walked with walker with great assistance. One day she just refused taking anything orally. I was so afraid that by not taking in water, and her medication, she would die. I did not recognize that it was her way, and the disease process of shutting down. I put a feeding tube in mom, she had no living will. She is still alive 8 months later. She has no quality of life, has 24 hour care in her own home, recognizes me, she is not happy and wants to die. So, your mom can stay in her home. She may refuse to walk, and become very heavy to transport or even move to a wheelchair without two people. You cannot predict how long your mom has to live. You have to make decisions as to what interventions You are going to do to prolong her life. This forum can be of help and research for yourself on internet last stages of dying, and get info. God Bless.