What Are the Signs of End-Stage Dementia?

Dementia is a scary diagnosis to deal with for both patients and their loved ones. Often, the unknowns leave families with endless questions. One of the biggest questions is:  

“What are the signs of end-stage dementia?”

We have been with families as they handle their loved one’s battle with dementia, and we are here to help.

This guide is designed to help you understand the symptoms of end-stage dementia and explore the care options available for your loved one.

How Long Can Someone Live After a Dementia Diagnosis?

While dementia is a life-limiting condition, the life expectancy after a diagnosis may vary and is dependent on other factors, such as:

• Type of dementia – Alzheimer’s, vascular dementia, Lewy body dementia, and others progress differently and impact lifespan variably.
• Age of diagnosis – A diagnosis for younger individuals (the average age of onset of dementia in the United States is 83.7) often means a longer potential lifespan; older individuals may decline more quickly.
• Stage of dementia – Later stages are associated with life-limiting complications such as a lowered immune system, malnutrition, and pneumonia. 
• Other life-limiting conditions – Conditions not directly related to dementia, such as heart failure, diabetes, or cancer, may also shorten a person with dementia’s lifespan. 
• Mobility and Independence – Maintaining mobility and daily functioning correlates with longer lifespans in dementia patients.

According to a systematic review involving 261 studies and over 5 million participants, the average life expectancy for people with dementia ranged from 5.7 years at age 65 (the time of diagnosis) to 2.2 years at age 85 for men, and from 8.0 to 4.5 years for women, respectively.

Last Stages of Dementia: 8 Signs Your Loved One Is Nearing the End of Their Life

Families often ask:  

“What are the stages of dementia?” 

Although the inconsistent presentation of symptoms can make it difficult to determine just how far along a dementia diagnosis is, there are some signs and symptoms to look for. Keep reading to learn more.

#1: Memory Loss

How a person’s memory changes as they enter the last stage of dementia can be a sign confirming the disease’s progression.  

Short-term memory is most often affected, and your loved one may experience something called “time-shifting,” where they believe they are in an earlier period of their life. 

Questions about emotional periods in the past may be difficult to manage. They may not recall the passing of a loved one or insist on going home when they are home. This phase of the end-stage of dementia is when the brain cannot retain new learning. 

It is important to remember that inconsistent progression and lucidity are standard if you are a caregiver, though these times will decrease as the disease progresses.

#2: Language Difficulties

When experiencing end-stage dementia, it isn’t uncommon for communication skills to change. Because dementia is a progressive brain disorder, the centers in the brain that control speech and communication are also affected. 

This often results in the inability to:

• Focus on a conversation
• Express ideas and emotions 
• Understand what is being said 
• Speech may be limited to short words or phrases that are often unclear
• Hold a normal conversation — speech often becomes garbled and hard to understand

In some patients, the inability to speak at all may be associated with the final stages of dementia. 

#3: Changes in Mood and Emotions

A brain disease like dementia, which alters how a person perceives the world, can often lead to dramatic shifts in mood and emotion.

Everyone is different and exhibits different symptoms, meaning there is no definitive list of what to expect; however, we’re here to offer guidance about some of the most common end-stage dementia symptoms. 

Patients who are experiencing dementia’s last stage symptoms may experience:

• Anger and frustration
• Restlessness
• Mood disorders such as depression and anxiety
• Self-awareness that their faculties are lessening  

#4: Behavioral Changes

One of the significant signs of end-stage dementia is behavioral changes, such as a person’s inability to respond to their environment. Additional signs of end-stage dementia include behavioral changes, such as:

• The need to sleep more
• Having a decreased appetite  
• The inability to identify and express physical discomfort or symptoms of illness

As in earlier stages, it’s essential to consider whether the person has unmet needs. In late-stage dementia, they may no longer be able to express how they’re feeling. Sudden changes in behavior can often signal an underlying medical issue, such as pain, an infection, or delirium.

Senior Services of America offers specialized memory care facilities across Oregon, Washington, and Idaho. Our compassionate teams provide exceptional support, comfort, and safety for individuals in the final stages of dementia and peace of mind for their families.

#5: Increased Physical Difficulties

Toward the end of the disease’s progression, there are common confirming signs that someone is entering one of the final stages of end-stage dementia. Some of these physical difficulties may include: 

• They may move less and be bed-bound 
• Increased risk of falls
• Bladder and bowel incontinence becomes more common
• Difficulty in swallowing 

Physical care needs, such as assistance with bathing and other personal care needs, increase dramatically at this point, and caregiver support may be required.

#6: Weight Loss & Difficult Eating

Studies show that in the final stages of dementia, roughly one in every two or three people experience significant weight loss. This can happen even when they’re offered plenty of food. In advanced dementia, weight loss is often part of the body’s natural progression toward the end of life.

Common reasons for weight loss may include:

• Not eating enough food due to a loss of appetite
• Medical problems associated with dementia that cause weight loss (such as depression, pain, medication, constipation, etc.)
• Cachexia (a metabolic syndrome characterized by muscle and fat loss despite adequate food intake)

#7: Increased Risk of Infections

Our immune system naturally weakens as we age, making it harder to fight off infections like the flu and slower to recover from injuries. In older adults, especially those with dementia, this decline in immune function can have serious consequences.

In individuals with advanced dementia, this weakened immune response can lead to a delayed reaction to infections, often resulting in systemic inflammation. This kind of inflammation doesn’t just impact the body, it can also interfere with brain function, making it even harder for brain cells to communicate.

This breakdown in communication between brain cells can worsen cognitive decline. It may play a role in the development or progression of conditions like Alzheimer’s disease and other forms of dementia.

#8: Sleep Pattern Changes

Sleep disturbances are common in the later stages of dementia and can be deeply concerning for caregivers. As dementia progresses, the parts of the brain that regulate sleep, such as the body clock and the production of sleep hormones like melatonin, become damaged. 

This disruption can cause individuals to sleep more during the day and struggle to sleep at night. They may also wake frequently, have trouble falling back asleep, or feel confused about the time of day, which sometimes leads to nighttime wandering or attempts to follow old routines.

These changes are not just frustrating; they may also impact health and quality of life. Poor or irregular sleep can worsen confusion, agitation, and memory loss. Factors like inactivity, medications, other health conditions, and a weakened immune system can further disrupt sleep. 

For caregivers, this often means balancing nighttime supervision with their need for rest. Supporting good sleep habits, like keeping a consistent daily routine, limiting naps, and encouraging morning sunlight, can make a meaningful difference in comfort and well-being for a person with dementia and their caregiver.

End-Stage Dementia Care Options

Around-the-clock care for in-home caregivers becomes nearly impossible as a patient begins to exhibit the last stages of dementia.   

When you or a loved one reaches the end stages of dementia, it’s not uncommon for social support to diminish and the feeling of isolation to increase in this phase. 

For caregivers, care may begin to feel like it’s consuming most, if not all, of their time. Although confused, your loved one can likely feel the same stressors.

Transitioning into facility-based care is one of the most difficult decisions a family can make, but it can also be the most beneficial for everyone involved. 

At Senior Services of America, we understand how difficult this decision can be, so we are here to guide you. We provide quality end-of-life care and comprehensive around-the-clock support at our memory-care facilities.

What Can Help Someone Through the End-Stage of Dementia?

Although this is a difficult diagnosis for a family to face, there are concrete actions to take when you or your loved one is facing decline.

Offer Touch and Human Contact

Human contact and touch are the most basic of human needs, and in the end stages of dementia, these interactions can be highly beneficial. 

Offering a hand to hold or even the caress of an arm or cheek can bring untold comfort. 

There are scientific studies that have shown that touch can lessen both physical discomfort and emotional pain.  

For example, this Stanford University study about touch found that touch reduces physical and emotional pain – “Interpersonal touch and social support can influence physical health, mental well-being, and pain”.

Provide Physical Comfort and Care

Making the decision to use caregivers outside of the family or using a facility’s care comes with a host of benefits. 

The benefits of a senior care facility include:

• Physical safety
• Support for loved ones 
• Medical supervision of acute and chronic health symptoms
• Care team coordination

Try To Meet Spiritual and Cultural Needs

By being versed in the traditions of your loved one’s cultural approach to end-of-life, caregivers can assist the patient in this final part of their illness. 

At Senior Services America communities, our team members strive to understand your loved one’s wishes about:

• Family culture
• Religious traditions
• Advance directives
• Pain management and comfort care

Common Questions You May Have If Your Loved One Has Recently Been Diagnosed with Late-Stage Dementia

A dementia diagnosis can come with a lot of emotions and a lot of questions. 

How Long Does the Final Stage of Dementia Last?

We wish we could give a firm answer. The final stages of dementia can last anywhere from a few weeks to a few years.  

The intensive end-of-life care required to mitigate the symptoms of end-stage dementia, when provided by professional care staff, can allow caregivers space and emotional energy to spend quality time with their loved one.

What Are Signs of the Dying Process for End-Stage Dementia Patients?

At the end of their illness, some of the signs that they are transitioning may include:

• Less communication
• Refusing to eat or drink 
• Difficulty swallowing
• Inability to get out of bed 
• Sleeping more 
• Increased frailty 
• Cold feet and hands
• Raspy breathing/rattle in the chest
• In and out of awareness of surroundings

It is not unusual for a person with dementia to be unaware of these symptoms. Medical professionals can help ensure that they are as physically comfortable as possible in the last days and weeks of their lives. 

Handling the emotional distress that sometimes comes when dealing with dementia may even involve assistance outside of a physician or their team. A clergy member, or other cultural spiritual leader, may be able to provide support to both you and your loved ones, as the end stages continue.

2 Ways Healthcare Professionals Can Help with Final Dementia Symptoms

Aside from reaching out to a clergy or spiritual leader, there are specific ways that healthcare professionals can help during the final stages of dementia. This care typically involves two types:

1. Palliative care
2. End-of-life care

#1: Palliative Care

Palliative care is sometimes called supportive care.

Palliative care is a specialized form of care for people living with serious illnesses, including end-stage dementia. 

The main focus of palliative care is to improve quality of life. While not replacing medical care, it offers services and support that complement the care team.  Symptom management, rather than curative measures, is the focus. 

Some of the features of palliative care to provide comfort include:

• Treating with medication to mitigate pain or distress
• Supporting family members and loved ones
• Providing nutritional/hydration guidance and support
• Having culturally sensitive discussions with family and patients about the end of life and what to expect

#2: End-of-Life Care

In addition to palliative care, sometimes patients enter a phase of hospice or end-of-life care. This is also considered comfort care and is the last phase in caring for a patient with end-stage dementia symptoms. 

Coordination of the hospice plan happens with the involvement of family and caregivers. It may feel impossible for family members to understand the right time to ask for hospice care for their loved ones. Having an involved care team is vital at this stage. 

Usually, hospice is activated when the primary physician has assessed the patient’s life expectancy as less than six months.  

Some of the comfort measures provided in hospice are: 

• Medicines and medical care to alleviate pain and discomfort
• Care that focuses more on comfort than on treating any disease or complication
• Grief counseling for the family
• End-of-life counseling and guidance are appropriate for the patient’s remaining cognition.

Senior Services of America Is Here for All Stages of the Elder Years, From Independent Living to Memory Care

Whether your loved one is at the end stages of dementia or you are preparing for the future, Senior Services of America has a memory care facility for you.

We’re here to support you and your loved one’s needs — every step of the way. Let us be a trusted partner in your loved one’s journey.

Find your nearest community to see how we can assist you with navigating this vital part of life.