Barbara, Can you finish the portion on dementia and dying that was not finished on your The Art of Manliness podcast?
There are just two ways to die, fast (sudden death) or gradual (old age or disease). Fast death just happens, without warning. Gradual death has a process to it. If it didn’t it would be fast death.
The process of a gradual death from disease takes two to four months (old age with no disease takes longer). Three things are the sign posts that say the dying process has begun: decreased eating, increased sleeping, and withdrawal. These three things are on a continuum, gradually beginning in months before death and going right up to the moment of death.
Weeks before a gradual death there are signs we look for that come in addition to decreased eating, increased sleeping, and withdrawal. On this continuum, in the months before death a person looks frail and sick but does not necessarily look like they are dying. In the weeks before death the person now looks like they are dying. (See Gone From My Sight for a description of all the signs of approaching death).
Dementia doesn’t play by these rules. Someone with dementia does not follow the process of a gradual death; they do not show us the signs that death is approaching. Someone with dementia can withdraw from this world’s activities for years, by being not interested, non-interactive, uncomprehending, unfocused. Someone with dementia can begin sleeping more, or even sleep all the time, and not have entered the dying process. Again, they don’t play by the rules.
Their food intake can decrease but it isn’t until they begin forgetting how to swallow or have difficulty swallowing without choking that dying actually begins. If we don’t eat we can’t live. If the decision not to use a feeding tube is made then the dying process starts. ALWAYS, ALWAYS offer food. You don’t just one day stop feeding someone. Generally, at this point the person is struggling against eating. We are the ones that are concerned. The person’s body has already begun to shut down and is probably disliking food. Offer, but don’t plead. Also beware of choking.
When the decision to not use a feeding tube has been made, depending upon the person’s weight and how much they are eating and drinking, death will probably come within weeks. Now you will see all the signs of approaching death that occur from other diseases and old age. Those signs will fit into the normal timeline that affects others as death approaches.
Something more... about Signs of Approaching Death with Dementia
I suggest my booklet How Do I Know You? Dementia At End Of Life to families with a loved one who is dying with dementia.
188 comments
Hi Tiffany, dementia so doesn’t play by any rules. I have no idea what is happening with your grandmother. She certainly has an interesting other reality. I would just talk with her and see if she would answer any questions about what she is seeing and experiencing. I see dementia as a window into another reality—the person’s reality for the moment. No harm is done by asking her about what she is seeing and doing. I don’t think this behavior means she is dying right now. Watch her eating for directions to her entering the drying process. You might find my booklet on dementia, How Do I Know You, helpful. https://bkbooks.com/collections/all-products/products/how-do-i-know-you-dementia-at-the-end-of-life
Blessings to you and your family. Barbara
My grandmother is 95 yrs old. She’s had dementia for a while. She’s up moving around. She can’t tell her days from nights sometimes. The other night she was sleeping. Around 3:30am to 9:00am she was talking g her normal voice, then it was like a man’s deep voice was talking too. I had to get conformation from my aunt. She said she could hear the same thing. Then she started singing Christian songs she knew. And praying and saying scriptures like she remembered. I need to find out what’s going on. Is she dying or What? Help!?!?!
My Mother was diagnosed with vascular dementia approx 7 years ago. She has been in a nursing home for 3 to 4 years, bedridden for nearly 2, she’s 90. I am a Brit Expat in the USA and try to get over the pond as often as I can to see her. My siblings keep me updated on Mum, and the last report was today. Her intake of food has decreased considerably, maybe a spoonful or two throughout the day, she now weighs 70lbs. Mum just sleeps.
Her nursing home, siblings and I believe her passing is not too far away.
This disease is so cruel, and as much as we don’t want our oh so brave and beautiful Mum to slip away, we don’t want to see her suffer, we want her to have peace and be free.
We love you Mum, thank you for everything you sacrificed for your family, you are our strength and anyways will be. God bless you.
Hi to everyone who is connected to this page, My Mother was Diagnosed With Dementia 10 years ago, She has lose so much weight it’s mind blowing, and for years we had to put in the shower to wash her, now we are at this point where she is not eating,she will hold the food in her mouth for hours, it’s like her brain is not working like it use to, and we are telling her what to do and she still can’t get it,but after so many times of telling her, then with our help she does what we ask her to do,now we are at this point where she is sleeping all the time and her conversations are very hard to understand at times, she just stares at you with a blank look, our Mother is still here but not here if you know what I mean …just the other day I held her in my arms and said a prayer for her and told her how much I love her,…crying, crying,and crying, but before I end this, I want to thank my sisters for doing a fantastic job in taking care of our Mother’s needs while working, if it had not been for my sister April who opened her home and is still taking care of our Mother’s needs every day even when we can’t make it, I want to say, Thank you April for your heart of Gold.
Hi Karla, caring for someone with dementia is such a long, unsure ride. There are just no structured patterns that the person follows. Each is its own individual path. The individuality of this disease symptom makes caring for someone we care about all the more burdensome. Your question of how long just can’t be answered. It all is based on food unless something unexpected happens like a severe injury from a fall. Offer her food but if she doesn’t want it or doesn’t chew it don’t push. She will lose weight to the point her body can’t sustain itself. How long that will take depends on how big her body is now, My booklets Gone from My Sight, How Do I Know You and The Eleventh Hour will help guide you through this time.
Blessings! Barbara
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