Definition of 'late stages of Dementia'

Miss A

Registered User
Oct 26, 2012
62
0
The South West
I've seen many posts on here of people talking about their loved ones in the 'later stages of dementia'.

How do you know it's late stages? Have you been told by medical professionals or is it a feeling? Are there certain things to look out for which determines late stage of dementia?

I'm not sure where my Dad is, to me it feels bad but I just want to know where we all are. Somedays it feels unbareable? Does that make sense?

Xx


Sent from my iPhone using Talking Point mobile app
 

margaret g

Registered User
Nov 9, 2013
48
0
I've seen many posts on here of people talking about their loved ones in the 'later stages of dementia'.

How do you know it's late stages? Have you been told by medical professionals or is it a feeling? Are there certain things to look out for which determines late stage of dementia?

I'm not sure where my Dad is, to me it feels bad but I just want to know where we all are. Somedays it feels unbareable? Does that make sense?

Xx


Sent from my iPhone using Talking Point mobile app

True, my husband had altzhers, I believe he is in middle stage, I got Mr s book, and followed symptoms! Sadly, no one can predict how slowly or fat it will go, we only know that it will, my hubby is 76 . I contest about 11 years ago. I am a nurse, but doesn't help me,, lots of help for me, tho,, I've struggled with depression, but I've had help,, I'm fine now, but, life's goes on. Sorry., seek help. Read. . Regards, Margaret

Sent from my C5303 using Talking Point mobile app
 

margaret g

Registered User
Nov 9, 2013
48
0
Sorry, my predicted text runs away with me,, I laugh and say"" it's catching! "" xx

Sent from my C5303 using Talking Point mobile app
 

tom0591

Registered User
Dec 18, 2013
59
0
The 'stages' are not fixed and the symptoms of some overlap into the others - some moderate and late stage symptoms overlap. It also depends on the type of dementia - Vascular or Alzheimers, or both together.

Vascular Dementia is more difficult, as it progresses in 'steps' - symptoms appear and then stay the same for some time and then another step down happens and more symptoms occur and stay the same and then another step down ..... The length of time between the 'steps down' can be months or years. Each step down is caused by a 'mini-stroke' - a cerebral infarction, or blockage of blood to a part of the brain - which causes further disability.

Late stage symptoms are typically :

- Being confused about the place / time they are in - they often ask to 'go home' even if they are at home. Also they often think they somewhere else, often somewhere from an earlier time in their life. They may think that someone is trying to steal from them, or someone is in the house that isn't really there.

- Confusing one member of the family with another or not recognising a family member

- Living in the past , talking about old times as though they were the present and asking about people who have died as though they were still alive.

- May be aggressive and argumentative ( this doesn't always occur ) - paranoid

- unable to speak coherent sentences

- Incontinent ( often urinary , but can also be bowel )

- Loss of ability to stand / walk ( doesn't always occur )

- Loss of wanting food and drink

- increasing periods of tiredness

- Frequent infections like Urinary Tract Infections (UTI ) and chest infections

- choking on food due to chewing and swallowing difficulties as 'gag' reflex fails - can cause aspiration pneumonia if not treated immediately

Not ALL these symptoms appear .... Dementia affect people differently.

ONE VERY IMPORTANT THING - NEVER NEVER try to bring someone with dementia into the present by correcting them about where they are or telling them that someone has been dead many years. This will cause them distress and upset . A person with dementia has probably lost the ability to reason so correcting them is useless and only causes them to be unhappy. You will NOT be able to bring them into the present if they are living in the past.
Often they slip into the past for a brief ' flashback period ' but come back to the present.

You should try to 'live in their world' for a person with dementia, even if this means telling white lies or pretending.

I have had to find all these things out for myself - I had no help whatsoever from the so-called 'caring services' . Unless you are lucky, and have good medical and social services, you won't be told much unless you ask.

Unfortunately, I found out much of this too late to help my Dad.

I am disgusted and angry about the lack of information I was given as my Dad's 24/7 carer at home . I couild have made him a lot happier if I knew what I know now.
Seems to me that you might be experiencing the same problem - 'information negligence' by the 'caring professions'
 
Last edited:

Miss A

Registered User
Oct 26, 2012
62
0
The South West
Thank you so much for your replies. It's so sad but unfortunately I found myself ticking off 80% of the list you included Tom. I couldn't agree with you more, you learn every step of the way with this illness, my dads GP gave me a leaflet and sent me on my way :0(


Sent from my iPhone using Talking Point mobile app
 

tom0591

Registered User
Dec 18, 2013
59
0
Thank you so much for your replies. It's so sad but unfortunately I found myself ticking off 80% of the list you included Tom. I couldn't agree with you more, you learn every step of the way with this illness, my dads GP gave me a leaflet and sent me on my way :0(
Sent from my iPhone using Talking Point mobile app

I am sorry , if your loved one is in late stage - but it can last some time.

Watch out for Aspiration Pneumonia (AP)- it is what killed my Dad because I didn't know about it.

Watch carefully how your Dad eats and chews , because if he swallows food or drink the 'wrong way' he can get AP and it is very serious. If something goes down the wrong way, even if he coughs it up, take him to A&E immediately.
Mucus from the throat and mouth can also go down the wrong way, even when asleep and without knowing.
Check every day.for wheezing or a little rattle in his breathing .
If in any doubt, ask GP to arrange for a SALT assessment ( speech and language and tests for swallowing functions )

The other thing to watch for is UTI's - urinary infections. These are quite common and can also be fatal if not treated straight away. A sign is that your Dad will may get the 'shakes' - rigor - and a temperature.

It sound like you have the sort of 'non-services' that I got.
Do your research online - there is good information.
Believe it or not, I was never even told that my Dad had Advanced Dementia until he was in his last week of life in hospital.

If your dad is in late stage he needs care. You will have to fight for it. Get him an assessment - your Local Authority HAS to give him an assessment by law.

The bottom line, I learned too late - TRUST NO ONE IN THE 'CARING SERVICES' TO DO THEIR JOB PROPERLY , because probably no one but you REALLY gives a damn about your Dad.
 
Last edited:

Yjess

Registered User
Dec 29, 2013
8
0
Thanks for posting this info - I cannot believe how many people have this but how little help/info there is.

I'm certain the govmt are fibbing about the numbers involved - I know FAR more people whose parents have got dementia than cancer & hear disease put together.

Tragic for our families - such hard work to get the best for our loved ones.
 

Miss A

Registered User
Oct 26, 2012
62
0
The South West
Thank you Tom0591 for sharing this, I have learnt a lot just from your posts this evening and I'm sure it will help others too. There are days when I feel lost because I don't know where the information is. I feel I have a little more knowledge now to help me thank you X


Sent from my iPhone using Talking Point mobile app
 

LadyA

Registered User
Oct 19, 2009
13,730
0
Ireland
It's so sad that for some, so little information and help is forthcoming. Have to say though, my husband's GP has always been fantastic - my husband has always had asthma, and last year he was getting repeated chest infections, so he was put on a nebuliser instead of his inhalers (because he refused to use them anymore; oddly, he loves using the nebuliser, 3 times a day!). Then when I took him in because he had had a couple of coughing fits when drinking, he was treated with antibiotics "just in case", and put on thickener (to thicken liquids) - he's still fine with food. And the GP co-ordinates with the PHN and the Occupational Therapist about what else can be done to help - it doesn't always work out to minimise delays caused by the austerity cutbacks over here, but at least you know they are being kept aware. Wm now would be in the late/moderate stages but overlapping into late stage in a lot of areas.

I would say, arm yourself with as much info as you can, and then keep in touch with GPs. After all, if regular visits to a GP can nip things in the bud before they become serious and so keep our loved ones out of hospitals, that surely will save a lot of money for the Govt. Health Budget, won't it?
 

Welshwoman

Registered User
Dec 1, 2013
47
0
South Wales
The 'stages' are not fixed and the symptoms of some overlap into the others - some moderate and late stage symptoms overlap. It also depends on the type of dementia - Vascular or Alzheimers, or both together.

Vascular Dementia is more difficult, as it progresses in 'steps' - symptoms appear and then stay the same for some time and then another step down happens and more symptoms occur and stay the same and then another step down ..... The length of time between the 'steps down' can be months or years. Each step down is caused by a 'mini-stroke' - a cerebral infarction, or blockage of blood to a part of the brain - which causes further disability.

Late stage symptoms are typically

- Being confused about the place / time they are in - they often ask to 'go home' even if they are at home. Also they often think they somewhere else, often somewhere from an earlier time in their life. They may think that someone is trying to steal from them, or someone is in the house that isn't really there.

- Confusing one member of the family with another or not recognising a family member

- Living in the past , talking about old times as though they were the present and asking about people who have died as though they were still alive.

- May be aggressive and argumentative ( this doesn't always occur ) - paranoid

- unable to speak coherent sentences

- Incontinent ( often urinary , but can also be bowel )

- Loss of ability to walk ( doesn't always occur )

- Loss of wanting food and drink

- Frequent infections like Urinary Tract Infections (UTI ) and chest infections

- choking on food due to swallowing difficulties as 'gag' reflex fails - can cause aspiration pneumonia if not treated immediately

Not ALL these symptoms appear .... Dementia affect people differently.

ONE VERY IMPORTANT THING - NEVER NEVER try to bring someone with dementia into the present by correcting them about where they are or telling them that someone has been dead many years. This will cause them distress and upset . A person with dementia has probably lost the ability to reason so correcting them is useless and only causes them to be unhappy. You will NOT be able to bring them into the present if they are living in the past.
Often they slip into the past for a brief ' flashback period ' but come back to the present.

You should try to 'live in their world' for a person with dementia, even if this means telling white lies or pretending.

I have had to find all these things out for myself - I had no help whatsoever from the so-called 'caring services' . Unless you are lucky, and have good medical and social services, you won't be told much unless you ask.

Unfortunately, I found out much of this too late to help my Dad.

I am disgusted and angry about the lack of information I was given as my Dad's 24/7 carer at home . I couild have made him a lot happier if I knew what I know now.
Seems to me that you might be experiencing the same problem - 'information negligence' by the 'caring professions'

I just want to thank you Tom for explaining some of the very symptoms we, as a Family, are completely confused about. You are right as well, unless you ask the 'Care Services' anything, they definitely won't tell you!! Again, thank you :)
 

tom0591

Registered User
Dec 18, 2013
59
0
It's so sad that for some, so little information and help is forthcoming. Have to say though, my husband's GP has always been fantastic - my husband has always had asthma, and last year he was getting repeated chest infections, so he was put on a nebuliser instead of his inhalers (because he refused to use them anymore; oddly, he loves using the nebuliser, 3 times a day!). Then when I took him in because he had had a couple of coughing fits when drinking, he was treated with antibiotics "just in case", and put on thickener (to thicken liquids) - he's still fine with food. And the GP co-ordinates with the PHN and the Occupational Therapist about what else can be done to help - it doesn't always work out to minimise delays caused by the austerity cutbacks over here, but at least you know they are being kept aware.


You are lucky to have a good GP - I suspect it's not the 'norm' in England.

If my Dad had been treated by your GP he would still be alive today because as his carer I would have got the support information about advancing dementia that I never got.

I had been left with the (incorrect) idea that my Dad had ' memory loss, which would get worse' . I just thought my Dad would have 'memory problems' , and I had no idea that there were physical manifestations which would affect his health.

As I now realise, an elderly person with dementia can't always tell you when something is wrong, so you have to keep constant vigilance for physical symptoms and behavioural changes . Sadly, when the physical symptoms show up overtly,as needing attention, it's sometimes too late because an infection has already overwhelmed the immune system.

Your doctor was ' on the ball ' by giving some antibiotics 'just in case'. He may have saved your partner from developing life-threatening pneumonia.

And yes, I am very very bitter about losing my Dad unnecessarily.
I consider that the 'caring services' are responsible for taking my Dad's life prematurely by non-information to me as a carer and leaving a gap in my life which has made me intensely depressed, lonely, and overcome with grief and guilt.
.......... completely avoidable for the sake of a 15 minute chat and explanation about advancing dementia - one life taken too soon and another one wrecked by loss.
 
Last edited:

LYN T

Registered User
Aug 30, 2012
6,958
0
Brixham Devon
Hi Tom0591

I'm so sorry you feel so hurt and bitter (I think all Carers feel that way at times.Care/info re Dementia is terrible). You should try to remember what a good caRER you were to your Dad.It's so sad to read you are feeling lonely and depressed-as you say the grief is overwhelming. I feel at a loss to say anything to ease your pain; even if you had been given more information the outcome may have been the same.Who knows? Dementia is different for everyone. Even when I asked what I thought were the 'right' questions the answers I was given were somewhat diluted.

For instance my Husband was only officially diagnosed with AD and bi-polar July 13 2012 (yes it was a Friday) even though by then he had been ill for nearly 7 years. When I asked what stage P's AD was at I was told 'moderate' by a mental health nurse. By accident this year I was told at that time (last year) Pete was already at severe stage.(the consultant told me). Did the nurse not like giving bad news? Did she think I couldn't cope?. I can cope with 'truth' and I think that there is a reluctance by some professionals to say what stage people are at.

For me information is power and I wish that when Carers insist on the truth, as I did,the truth should be given.I looked on the internet and I pretty much found out what stage P was at anyway.

As for your perfectly understandable feelings regarding your Dad's passing; please,please continue posting. Don't be a stranger as there are always people who are ready to listen.In the meantime have a big hug from me and take care of yourself

Lyn T
 

tom0591

Registered User
Dec 18, 2013
59
0
Lyn T

My Dad and I were very very close and I anticipated a few more years with him.
He wasn't ready to go - I would have known when that time came.

Yes I did my best, but I made a LOT of mistakes with his care - some physical , but mostly emotional.
And that leaves a lot of guilt, which is very hard to erase and is a sort of mental torture, which will never go away.
The more I learn about dementia, the more I realise how much I did wrong and how unhappy I must have made my Dad sometimes. It tears me apart every single day, and I cry.
A bit late now to know what I should have been saying and doing to keep him happy and save his life.

It's always easy to try to blame someone else, but I am very rational about it.
My anger isn't part of the ' grieving process ' .

I was not provided with the information that I needed, so my Dad died because I didn't know what to look for - I was never forewarned, which is a disgrace and is totally inexcusable.

For the want of a 15 minutes chat, about the perils of advanced dementia, my Dad would be probably here now, and I wouldn't be an emotional wreck.

It's so simple. So unavoidable. So disgraceful.
 
Last edited:

tom0591

Registered User
Dec 18, 2013
59
0
Hi Tom0591

For me information is power and I wish that when Carers insist on the truth, as I did,the truth should be given.I looked on the internet and I pretty much found out what stage P was at anyway.

Lyn T

You think that these medical people know 'the truth' and have diagnosed correctly ?.
You give a level of competence for them above what I would give them. But then again, I have lost any respect for them that I had once.

Maybe what matters most is to know the symptoms to watch out for as the disease progresses from it's current state.
It's important to know what is on the horizon so that you can recognise the symptom of each new disorder straight away and be prepared to deal with it as it presents itself.

The problem for my Dad was that I was always dealing with problems 'after the event' rather than recognising them early enough and being prepared or heading them off.

Proactive and Communication seem to be words that are missing from the vocabulary of the 'caring services' ,as far as dementia is concerned, at least in my experience.

Yes ' Information is Power ' - assuming that you KNOW what information to ask for - but often you don't, and you aren't told.

As I wrote before ..... trust no one in the 'caring professions' to give the love and care needed.
Assume that they don't actually give a damn behind the smiles and kind words.
If you are lucky, you may get a 'good one or two' - but don't expect it.

But then again, my experiences and loss of my lovely Dad has left me very embittered. And rightly so.
 
Last edited:

LYN T

Registered User
Aug 30, 2012
6,958
0
Brixham Devon
Hi Tom

I'm very sorry but I know (i think) a little bit of how you feel.When Pete was diagnosed I thought that the progress would be slow but it hasn't been like that at all.I don't think Pete will last for years now. He has all of the symptoms, and more,that you listed apart from swallowing, He can still walk-but only with assistance.I was very close to Pete but now he doesn't know me as his wife and hasn't done for over a year.

All Carers make mistakes, The worst one I made was in the early hours of the morning when P was incontinent over the carpets;I cleaned him, put him back to bed and cleaned the carpets for two hours. I'd just finished when P did it again and walked through his mess. The carpets were the same disgusting state again; then he put poo on the dogs ears.He wouldn't go in the shower so I swore at him to get in the bathroom. I will always feel guilty about that.It wasn't his fault. He didn't do it on purpose. I should have kept quiet, but I was so tired.

I agree with you; as I said in my previous post I wasn't told the truth entirely. I found out a lot of information on the net but mainly on this Forum. As for you being an 'emotional wreck' I can only express my heartfelt sympathy for what you are going through.

Take care

Lyn T
 
Last edited:

LYN T

Registered User
Aug 30, 2012
6,958
0
Brixham Devon
You think that these medical people know 'the truth' and have diagnosed correctly ?.
You give a level of competence for them above what I would give them. But then again, I have lost any respect for them that I had once.

Maybe what matters most is to know the symptoms to watch out for as the disease progresses from it's current state.
It's important to know what is on the horizon so that you can recognise the symptom of each new disorder straight away and be prepared to deal with it as it presents itself.

The problem for my Dad was that I was always dealing with problems 'after the event' rather than recognising them early enough and being prepared or heading them off.

Proactive and Communication seem to be words that are missing from the vocabulary of the 'caring services' ,as far as dementia is concerned, at least in my experience.

Yes ' Information is Power ' - assuming that you KNOW what information to ask for - but often you don't, and you aren't told.

As I wrote before ..... trust no one in the 'caring professions' to give the love and care needed.
Assume that they don't actually give a damn behind the smiles and kind words.
If you are lucky, you may get a 'good one or two' - but don't expect it.

But then again, my experiences and loss of my lovely Dad has left me very embittered. And rightly so.

Tom

There are people I trust and there are people I don't trust in the 'caring professions' I don't trust my Husband's SW (he talks a good talk, but no action). I trust the Carers at his CH.I didn't trust his previous CPN (lazy/hopeless/patronising) I think I trust his new CPN. I trust his Consultant because whenever P has been sectioned (5 tmies in under 8 years) she's helped him become less tormented (he also has bi-polar as well as AD) I trust his outpatient consultant who has been nothing but efficient and kind. I DON't trust the community team who visit Pete twice a day and don't even acknowledge him or me and upset the carers. They are jobsworths.

So as you see I give a level of competence to some-none to others. I fight the ones who treat me like a fool and show no respect to my husband. This I will continue to do.

As far as knowing what information to ask for=well I've learnt as I've gone along and taken advice fro m the kind people on this forum who know a lot more than I do, and who have been Carers for much longer.

Take care

Lyn T
 

tom0591

Registered User
Dec 18, 2013
59
0
Well thanks for the posts and good wishes.

I don't have much else to say, because everything else describing my ' carer's journey ' is personal between my Dad and I.
I could have done better caring for him, and it hurts to know it.

I hope some of what I have posted will be of some help to others - my Dad would have wanted it.
 

JCF

Registered User
Jan 3, 2014
12
0
I've seen many posts on here of people talking about their loved ones in the 'later stages of dementia'.

How do you know it's late stages? Have you been told by medical professionals or is it a feeling? Are there certain things to look out for which determines late stage of dementia?

I'm not sure where my Dad is, to me it feels bad but I just want to know where we all are. Somedays it feels unbareable? Does that make sense?

Xx


Such a simple question. I came here to ask the same question myself in the hope that there was some “official” answer.
The fact that I had to come to the forums to find the question even being asked does not give me great hope.
I am another who can quite easily tick off 75% of the criteria on Toms list for my Father. I am a carer for My mother who has almost nil mobility and my Father who has Parkinson’s dementia. The main problem with Parkinson’s dementia is that it is extremely inconsistent.
There can be days when there are glimpses of my Father as he once was, when he is calm and seems to recognize where he is and who we are. But then there are bad days ranging from aggressive behavior through total disorientation, to what can only be described as vegetative times, when he seems to degenerate into a world of his own where he cannot be reached.
Unfortunately the lucid times grow less and less with the passing of time. And just recently he seems terribly confused almost all the time. We have gotten so that we prey for sleep. Because when he is asleep he at least does not take 100% attention and care for fear that he may fall or wander off when we fall asleep due to endless nights spent watching him.
For myself I have found that I am a better carer when I detach myself from emotional connections. I no longer dwell upon the sadness of the situation, but only upon the practicality of dealing with the endless small tragedies that occur unendingly every day. In this way I feel am different to Tom, I know full well that I am doing all I can and that is all I can do.
What happens beyond that passes into the realm of, what will be will be. My Father had a good life, a good innings, as we say here.
It is of course devastating, especially for my mother, to have to watch him daily deconstruct all that he is from the inside, to be reduced to the basics of human existence.
I believe you cannot expect anyone who has not experienced it to even begin to understand. Therefore I do not criticize to greatly those who cannot understand.
As a Dementia carer you become part of a secret order of beings, who you recognize simply by the hard worn expressions that they wear upon their faces, and the resigned look they have deep in their eyes.
Recently I had to visit the hospital myself with suspected heart attack. Long story short, it was mostly stress. Before I left I was introduced to a nurse, quit clearly a member of the secret order.
Strangely enough it was the first time I laughed for a while as we again and again struck hidden chords.
When I was eventually told the results of my angiogram, all good, I joked that I felt like a soldier, who having been wounded and sent back to the medical unit, was then informed that” its all ok, You are fine now, you can return to the front line”
Please excuse what might seem like wallowing in self pity in the face of those who have such a terrible disease.
I think though that in many cases the carer can suffer as much as the sufferer. Maybe even more so, as many Dementia sufferers are, thankfully, unaware of their predicament, or so it seems in the so called latter stages of the disease.
So we are really no wiser as to how far down the road our loved ones have traveled. Or how long we are supposed to watch the gradual decay before we crack.
Maybe the final stages are more in the hands of the carer, how much can they take before they themselves have to finally give in.
 

CINDYJANE

Registered User
Feb 9, 2012
60
0
Devon/somerset
I've seen many posts on here of people talking about their loved ones in the 'later stages of dementia'.

How do you know it's late stages? Have you been told by medical professionals or is it a feeling? Are there certain things to look out for which determines late stage of dementia?

I'm not sure where my Dad is, to me it feels bad but I just want to know where we all are. Somedays it feels unbareable? Does that make sense?

Xx

Isn't it so easy after the event, to realise where things went wrong? We trust, we do what feels right at the time, and later as events take over, we find out that maybe we should have dealt with things in different ways.




Such a simple question. I came here to ask the same question myself in the hope that there was some “official” answer.
The fact that I had to come to the forums to find the question even being asked does not give me great hope.
I am another who can quite easily tick off 75% of the criteria on Toms list for my Father. I am a carer for My mother who has almost nil mobility and my Father who has Parkinson’s dementia. The main problem with Parkinson’s dementia is that it is extremely inconsistent.
There can be days when there are glimpses of my Father as he once was, when he is calm and seems to recognize where he is and who we are. But then there are bad days ranging from aggressive behavior through total disorientation, to what can only be described as vegetative times, when he seems to degenerate into a world of his own where he cannot be reached.
Unfortunately the lucid times grow less and less with the passing of time. And just recently he seems terribly confused almost all the time. We have gotten so that we prey for sleep. Because when he is asleep he at least does not take 100% attention and care for fear that he may fall or wander off when we fall asleep due to endless nights spent watching him.
For myself I have found that I am a better carer when I detach myself from emotional connections. I no longer dwell upon the sadness of the situation, but only upon the practicality of dealing with the endless small tragedies that occur unendingly every day. In this way I feel am different to Tom, I know full well that I am doing all I can and that is all I can do.
What happens beyond that passes into the realm of, what will be will be. My Father had a good life, a good innings, as we say here.
It is of course devastating, especially for my mother, to have to watch him daily deconstruct all that he is from the inside, to be reduced to the basics of human existence.
I believe you cannot expect anyone who has not experienced it to even begin to understand. Therefore I do not criticize to greatly those who cannot understand.
As a Dementia carer you become part of a secret order of beings, who you recognize simply by the hard worn expressions that they wear upon their faces, and the resigned look they have deep in their eyes.
Recently I had to visit the hospital myself with suspected heart attack. Long story short, it was mostly stress. Before I left I was introduced to a nurse, quit clearly a member of the secret order.
Strangely enough it was the first time I laughed for a while as we again and again struck hidden chords.
When I was eventually told the results of my angiogram, all good, I joked that I felt like a soldier, who having been wounded and sent back to the medical unit, was then informed that” its all ok, You are fine now, you can return to the front line”
Please excuse what might seem like wallowing in self pity in the face of those who have such a terrible disease.
I think though that in many cases the carer can suffer as much as the sufferer. Maybe even more so, as many Dementia sufferers are, thankfully, unaware of their predicament, or so it seems in the so called latter stages of the disease.
So we are really no wiser as to how far down the road our loved ones have traveled. Or how long we are supposed to watch the gradual decay before we crack.
Maybe the final stages are more in the hands of the carer, how much can they take before they themselves have to finally give in.

JCF, I was really moved by your experiences. You are not wallowing in self pity. It is so helpful to others to realise that the problems we face are being experienced by others too, and it helps so much to share these thoughts.
I am just reading Keeping Mum by Marianne Talbot, a book I would thoroughly recommend to any carer. I am learning an awful lot from her experiences in caring for her mother, and her words of wisdom.