Part 3 | Stages of Dementia: 6 & 7

[Music] everyone welcome back to our channel my name is Brianna Wilson I am a certified to mention prep Tichenor and the founder of bamboo care so today's video is part three of our three-part series on the stages of dementia in part one we discussed stages one through three in part two we discussed stages four and five and today will be six and seven if you have not seen part one or two I will link them in the eye in the sky as well as in the description box below but I will go ahead and do a quick recap for those who haven't seen the videos as well as those who have so this is gonna be real quick we're just gonna breeze through it so that we can focus on stages six and seven okay so stage one is none so there is no impairment the brain is healthy and it's functioning normally Stage two is you meaning that the memory and thinking changes are evident to you but those around you can't really tell anything significant okay Stage three is me so me your friend your family your co-workers we can notice some of these changes in your memory and thinking that are happening and if you were to take some type of clinical test the test would likely show that there is some type of mild cognitive impairment as well okay so stages one through three are kind of like the pre dementia stages stages four and five are mild okay and moderate dementia so on Stage four you're going to start noticing that breakdown in the complex ADL's or those complex activities of daily living so think finances no prep grocery shopping taking care of pets managing your medications driving all those sorts of things you're gonna notice a breakdown in okay Stage five you're going to notice more of a breakdown in those basic activities of daily living okay but not so much in the physical sense of being able to put on your clothes or go to the bathroom it's more and remembering whether or not you've done it or you need to do it so oftentimes in stage 5 there needs to be a lot of cueing and reminders for the person to complete the task okay also this is where time the concept of time kind of starts to diminish okay and that's part of the issue is because they can't remember when something has been done how much time has passed okay that dwindles away okay so that leaves us two stage six and stage seven so let's go ahead and start with stage six so Stage six is moderately severe dementia or a severe cognitive impairment or cognitive decline okay this is where you're really really going to notice a breakdown in those basic activities of living so dressing bathing going to the bathroom feeding themselves those sorts of things and this is now beyond just needing a reminder or cue to do it okay this is having a really hard time physically doing it and it can be for a number of reasons okay it could be due to decreased contrast sensitivity decrease depth perception it can be decreased ability to sequence things um they have a harder time initiating tasks motor planning meaning I know what I want to do but I can't figure out how to sequence my movements to be able to do that thing okay so they are going to need a lot more help and a lot more support so you're going to notice that maybe they can't dress themselves properly maybe they put their shirts on backwards maybe when they're trying to put their pants on they put their leg through the wrong hole if you put a light-colored shirt on a light-colored bedding they have a hard time figuring out where their clothing items are sometimes as it progresses in stage six they even have a hard time trying to figure out what something is used for so something like a fork we know that it's a utensil that we use to eat certain foods with but to them they might see the fork and not understand what to do with it okay so that's where these issues start to become really evident okay this also extends over and to remembering to flush the toilet and also wondering how to flush the toilet okay this also extends to washing their hands understanding how to sequence that like okay I gotta turn the water on I gotta get soap I gotta wash my hands the way that I washed my hands is like this I got to get all parts okay I need to turn it off need to dry my hands those sorts of things and if you think about it we all kind of sequence it differently some people put soap in their hands first turn on the faucet wash some people dry their hands before turning it off so this can look a little bit different for every person but there's a breakdown in sequencing that being able to put all those things together sometimes what you notice is maybe they can brush their teeth if you set it for them they can brush their teeth right but they might just stay in one place and not move on they'll just stay there and then you have to say oh don't forget to get the other side of your mouth and then they'll go and then you might have to cue them until they complete their home mouth but then after that they might not remember what to do with the toothpaste in their mouth so some will swallow okay and others you have to cue okay make sure you spit it out you know so it's that kind of breakdown this is also where you start noticing more incontinent episodes of the urine and the boughs okay usually when somebody becomes incontinent it's gonna be urine incontinence first and then eventually bowel incontinence okay so you'll start noticing this more you'll also start noticing more episodes of them urinating or defecating and odd places like for example maybe they'll urinate in a trash can or in a plant or you might notice that they're having a hard time just making it to the bathroom in gym you may also start noticing changes in things like their sleep patterns or in their personality and behaviors so maybe you know they're becoming increasingly more agitated or aggressive or maybe this is where they start having more delusions or hallucinations or maybe they start wandering more which can become problematic as well okay another thing we have to think about is time so in stage 5 I told you that there was kind of this breakdown in the concept of time so that concept of time is more so 20 minutes filling like two hours or two hours filling like 20 minutes or one day filling like 30 minutes you know this concept of time is kind of fluid but in stage six which you start noticing is that it's almost as if they're on a whole separate timeline and then there still is this diminished concept of time within the timeline so for example say your name is Amy you're the daughter okay you are 52 years old sometimes what happens is it's not necessarily that they don't remember that they have a daughter and that their daughter's name is Amy but the Amy that they remember is on a separate timeline so maybe the Amy that they remember is eight-year-old Amy not 52 year old Amy so if they ask you where's Amy have you seen Amy and you're thinking I'm right here what do you mean I'm right here usually it's because the Amy that they're remembering is on a separate timeline so it's not necessarily that they don't remember you it's just that the 52 year old you and the eight year old you is not you does that make sense so in stage six you really start noticing that they're kind of on this separate timeline in a sense and this timeline can change so one day they can be here okay and then another day or a few days later they can be here it just kind of depends okay another thing that kind of throws people off is that there can be these fluctuating of confusion and lucidity where some days they're just like really really confused and they're really somewhere else okay and then there's other days where it seems like they kind of have a better feel for what's going on and who you are and things like that so that kind of throws people off because they don't understand why that's happening and it's just the brain the brain is a very amazing thing it's very complex and we know very little about it is the easiest way to explain it ok another thing you'll start noticing is increased difficulty with speech as well as decreased inability to like be able to count backwards from say like 10 being able to say 10 nine eight seven six five four three two one that diminishes okay also they might occasionally forget the names of their spouse or their children or things like that again it might fluctuate but usually not always it kind of just depends where they're at in their timeline but usually they can recognize familiar faces in the sense like oh you look familiar I recognize you you don't because I've had quite a few patients where they can't remember my name but they could remember that they've seen me before okay they don't remember what I was there for why what you know but they just remember that's a recognizable face okay so but that varies so it kind of just depends so Stage six can be incredibly difficult for care partners because not only is your partner now needing more assist but now you're getting these increased episodes of incontinence which makes things difficult plus you may notice changes in their sleep patterns right you may notice changes in their personality or behavior right and so all this together can create some especially unique challenges that you are faced with and what I want to tell you is that Stage five it was super important to have a routine Stage six it's going to be even more important to have a routine people with dementia and usually just people in general for the most part tend to fare better with some kind of routine and by routine I don't mean at this time you have to do a certain thing at this time you have to do a certain thing at this time you have to do a certain thing that's more of like a schedule which does work for some people but it's better if you have something that's more time fluid which is a routine meaning that you do things in the same order that helps because it doesn't matter what time the person wakes up okay you kind of have this routine that you have first we do this once we do that we do this we do this we do this that tends to work a lot better than if you don't have a routine okay you also want to try not to over help when a person is having all these difficulties it becomes very easy to want to just step in and do it for the person but I want to encourage you to try to let them do as much as they can for themselves whether that means setting up environmental supports so making the environment more friendly whether that means just cueing them maybe giving them a visual demonstration or physically cueing them or walking through the tasks with them step by step you really want to encourage them to be active participants in their care and honestly the longer you can get them to actively participate in a task the longer they'll be able to do it it's one of those things if you don't do it you lose it okay and so it's important that you try to keep them involved and refrain from just doing everything for them especially especially especially at Stage six where it becomes so easy to just do it for them because it's quicker it's more convenient and there's just less fuss right so that's kind of like my tip suggestion advice okay for Stage six now stage seven is severe dementia or very severe cognitive decline or impairment this is where the body is slowly starting to kind of shut down and they're slowly beginning to lose their function so their speech will become limited and for some speech may become non-existent all together you may start noticing impairments in their swallowing okay so you might have to change the food consistency and even then they may still have issues which puts them at an increased risk for aspiration so you have to really watch that and it could eventually advance to the point where they're refusing food and water altogether okay another thing that starts happening is they begin to lose the ability to walk and the ability to control their movements also they might exhibit like abnormal reflexes or rigidity as they kind of progress through stage 7 okay so that's important to know because eventually they will become bedridden or wheelchair-bound but even in a wheelchair you may notice that they have a hard time keeping themselves upright okay so usually they end up becoming bed bound but because they become bed bound or chair bound it puts them at increased risk for bed sores so you really have to make sure that you're changing their positions frequently even every two hours if you can I know for some caregivers it's really hard to do that I say four hours max but two hours ideally you want to change their position okay even if it's just shifting them around in bed just think like for example when you sleep there's very few of us who stay in that same static position all night most of us shift at least a little bit in our sleep okay so it's really important that you move them out of that position so that they do not get bedsores okay because bedsores once you get them they're super hard to get okay so if you can just avoid them all together that's ideal another thing that you have to watch out for is in stage seven they're more prone to repeated infections this can be pneumonia from the aspiration this could be something like a UTI or urinary tract infection so you just want to be mindful that these things can occur more frequently in stage seven now something that really throws caregivers off in stage seven is just like stage six they may have these moments of complete confusion and lucidity where it's kind of like for a brief moment they kind of have some idea of what's going on and who you are and things like that and it's very intriguing for caregivers and for myself as well and it's very hard to understand but it is something that happens that I want you to be aware of is completely normal in stage seven okay so when we think about stage seven what is most important and honestly the answer to that is comfort and quality of life you want to keep them as comfortable as possible and that extends down to the mattress that you're using the mattress pad chair cushions pillows right you want to make sure that they're comfortable the temperature of the room pay you and make sure that they're comfortable things like that not too bright of lights if they're light sensitive right not to a lot of noise if they're auditory sensitive those types of things so things you can do because sometimes I know a lot of people have a hard time at Stage seven trying to figure out you know what can I do okay some people really like just to have their hand stroke or their head and hair stroke or their cheek stroked okay you can sing to them you can you know put lotion on their body and kind of just make sure that their skin is not all dry and flaky and especially the feet because I feel like the feet are often time's neglected you want to keep the feet clean dry but moisturized okay feet are important another thing you can do is play soft music in the background sometimes like instrumental type music there's better than words but it kind of just depends on the person you can open the windows let some fresh air in you can open the blinds let some daylight in okay another thing you can do is things to kind of stimulate the vision so for some people they'll start sleeping a lot and stage seven and this is more because the body is shutting down whereas in other stages they might be sleeping more because they're just not being stimulated so just for example if you were in a room with nothing to do you might go to sleep right but at stage seven they begin sleeping more because the body is slowly starting to shut down in most cases okay so visual stimuli if they are keeping their eyes open could be like if they have a window putting like a bird feeder outside the window so they can see birds and squirrels that might come small fish tanks so they can watch the fishies some even like looking at the little Mobile's kind of like you would put over like a baby's crib but they have different ones and you can put you know you know different Mobile's above their bed that they can look at umm maybe a nice pleasant picture of something so there are still some things that you can do to keep the person comfortable but also kind of ensure that they still have a good quality of life as their dementia is slowly progressing and as they're slowly starting to lose their functioning okay so those are the last two final stages 6 & 7 which is moderately severe dementia and severe dementia and 6 & 7 are important stages as are the others but are especially important stages because I think it really brings to light that dementia is terminal and it is progressive and the unfortunate thing about dementia if the person does not away from something else like a heart attack a stroke complications due to diabetes like pneumonia or some type of infection they ultimately will pass away due to their dementia because the brain is dying and the body is shutting down okay and again like I always say I don't say this to scare you I simply say this to inform you this is why when a person gets the diagnosis of dementia it's important that you start planning and preparing because as the dementia progresses which the timeline looks a little bit different for everybody as far as how they progress through these stages what that looks like though that differs the end result is fairly the same okay for most people no matter what type of dementia they may have stages 6 & 7 look very very similar okay so I just want you to keep that in mind I really do hope that this video was helpful and informative as well as the other two parts of this series if you have any questions about any of the stages whether it be 1 2 3 4 5 6 7 please leave a comment down in the comment section or if you feel more comfortable you can email us you can find that in the description box below also remember you can find our website as well as all of our social media links in the description box as well and until next time [Music]

Channel: Bambu Care

Views: 57,071

Keywords: dementia, dementia care, dementia tips, dementia strategies, caregiving, challenging dementia behaviors, alzheimer's disease, dementia consultant, what is dementia, alzheimer's, dementia facts, dementia myths, how to tell my loved one they have dementia, stages of dementia

Id: 1x_1NjAs2Q0

Length: 21min 54sec (1314 seconds)

Published: Wed Mar 18 2020