VASCULAR DEMENTIA IN THE ELDERLY: GLOBAL DETERIORATION SCALE/PART 6/STAGE 7

This is the sixth in a series of six posts based on information from the Global Deterioration Scale adaptation by Dr. Doug Drummond from Reisberg, Barry et al. This scale is for the assessment of primary degenerative dementia and Dr. Drummond includes the "Usual Care Setting" for people in this phase, which is very helpful from a pragmatic point of view.


The information from the GDS will be italicized for clarity of origin.

Stage 7   Severe dementia

               Verbal abilities will be lost over the course of this stage
               Incontinent
              Needs assistance with feeding
             Loses ability to walk

\Usual Care Setting:   Complex Care

Though we have been dealing with dementia for about ten years now, we have not reached this stage completely yet.  I have to admit that I pray we never do. 

Our mother requires assistance walking, but occasionally still "takes off" on her own, which is of course dangerous in terms of falling and resulted in a broken hip about two years ago. 

At times, she is able to feed herself, but of late she has required assistance in feeding.  She would simply not eat if no one helped her.  During the approximate two years she has been in assisted living, she has had periods where she totally fed herself with prompting and other times where she had to have total help.  Some of that has seemed to depend upon other physical issues and how her general health was at the time. 

Incontinence becomes common for most at this stage.

Her verbal abilities continue to be intact, but on a recent visit, she talked nonstop for the entire day, much of it undecipherable.  The staff said that occasionlly happened.  Other days, she is quiet, but will always respond to us when spoken to.  Sometimes she will surprise us with an insight about someone when we didn't realize she was observing at all. 

Two incidents come to mind.  One of my brother-in-laws was visiting along with my younger sister, and they had taken Mother outside to enjoy the nice weather.  Rick said, "I wonder if there's a grill around here." 

Mother then responded, "Well, I don't think I've seen a gorilla around here."

Rick teased her,, saying, "Don't you really think if you'd seen a gorilla around here you'd remember that?" and explained what he had said.

She laughed, and agreed that she would have remembered that for sure. 

Another day, a different brother-in-law took a wet wipe that had been used for some cleanup between his thumb and forefinger, barely touching it, before tossing it in the trash, and Mother remarked that she didn't know he was so "dainty", which brought a laugh. 

There have been other light moments where she made the staff laugh by some observation she made about something they did or said.  

Dementia Hint:  Music is said to reach a part of the brain that speech cannot.  When speech fails, music may provide a bridge, so sing with the person, or if you are not musically inclined, make sure that they are exposed to music through headphones or other means. 

Dementia Hint:  There are personal alarm devices that can be used to try to avoid persons getting up on their own since a fall can end up being lethal.  These can be attached to chair, wheelchair, and bed. 









Installed