Navigating the Last Stages of Dementia with Understanding, Care, and Compassion

Caring for a loved one in the last stages of dementia can be an emotionally challenging journey. As dementia progresses, many changes may become more pronounced, making providing compassionate care and support essential. 

Whether you’re a spouse, child, or caregiver, understanding what to expect during late-stage dementia and how to recognize the signs and symptoms can provide comfort. In our guide, we explain:

• Late-Stage Symptoms: Learn to identify the common physical and cognitive signs that mark the final stages of dementia, such as severe memory loss, difficulty communicating, and needing full assistance with daily tasks.
• End-of-Life Care: Learn about the critical role of palliative and hospice care during this phase, explaining how these supports focus on maintaining comfort, dignity, and quality of life for the resident.
• Practical Caregiving Guidance: Find supportive strategies and tips for providing compassionate care during this challenging time, emphasizing the importance of presence, non-verbal communication, and seeking professional support.

Read on to learn about the symptoms of the last stages of dementia, practical caregiving tips, and how you can navigate this time with support.

How Long Can Someone Live After a Dementia Diagnosis?

Dementia is a life-limiting condition, especially as it progresses through its many stages. However, life expectancy varies and is dependent on many factors, including:

• Type of dementia 
• Age of diagnosis
• Stage of dementia
• Other life-limiting conditions
• Mobility and independence

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

What Is Considered the Last Stages of Dementia?

Dementia is classified as three phases — pre or early phase, moderate or middle phase, and final or end phase. How quickly someone progresses through the stages of dementia depends on their age at the time of diagnosis and what type of dementia they have.

The last stages of dementia happen in the final or end phase. They are known as end-stage or severe dementia due to the cognitive impairment and loss of physical abilities that occur here. During these stages, the patient typically requires full care for all daily activities.

Senior Services of America offers Memory Care communities for patients living with end-stage dementia. Our professional and compassionate teams offer full-time care to help these patients with all daily activities, from dressing and bathing to eating, walking, helping them use the restroom, and more. 

What Are the Symptoms of the Last Stages of Dementia? 10 Signs Your Loved One Is Nearing the End of Life

#1: Memory Loss

How a person’s memory changes as they enter the last stages of dementia can be a sign confirming the disease’s progression. Short-term memory is often most affected as patients experience “time-shifting,” where they believe they are living in an earlier period of their life. 

Questions about emotional events in the past may be difficult to manage. They might not recall the passing of a loved one or may insist on going home to their old house. During this phase of end-stage dementia, the brain cannot retain new learning.

As a caregiver, it’s important to remember that inconsistent lucidity is standard and will likely worsen as the disease progresses.

#2: Difficulty Communicating

Dementia is a progressive disease, so as a patient moves through its stages, the centers in the brain that control speech and communication are affected. This often results in the inability to:

• Focus on a conversation 
• Express ideas and emotions
• Understand what is being said
• Speak clearly
• Hold a normal conversation

#3: Changes in Mood and Emotions

Dementia is a brain disease and, therefore, alters the way a person perceives the world. This can lead to a dramatic shift in mood and emotions, causing dementia patients to exhibit a variety of symptoms. Typically, these symptoms include things like:

• Anger and frustrations
• Restlessness
• Mood disorders
• Delusions and hallucinations
• Changes in perception

#4: Behavioral Changes

Many behavior changes that happen in the earlier stages of dementia still occur during late-stage dementia, often just more pronounced. These might include:

• Aggression
• Restlessness
• The need to sleep more
• Decreased appetite
• Inability to identify or express discomfort

#5: Increased Physical Difficulties

As a person approaches the end of the disease’s progression, there are common confirming signs of physical difficulty, including:

• Moving less or becoming bed-bound
• Experiencing more falls
• Experiencing bladder or bowel incontinence
• Having difficulty swallowing

Physical care needs, like help with bathing and other personal care tasks, increase dramatically at this point, and full-time caregiver support may be required. 

Senior Services of America provides all of the necessary support for dementia patients in our communities. Use our senior living community finder to find one that works for you.

#6: Difficulty Eating and Weight Loss

Studies show that in the final stages of dementia, roughly one in every two or three people experience significant weight loss. In advanced dementia, weight loss is often part of the body’s natural progression, despite being offered regular meals.

Common reasons for weight loss may include:

• Loss of appetite
• Cachexia
• Medical problems that cause weight loss (depression, pain, medication, constipation, etc.)

#7: Increased Risk of Infections

The immune system naturally becomes slower to respond as we age, making it harder to fight off infections or recover from injuries. In older adults, especially those with dementia, this decline in immune function can have serious consequences. 

A delayed reaction to infection often results in systemic inflammation, which not only impacts the body but also brain function. A breakdown in communication between brain cells can worsen with cognitive decline and may play a role in the development or progression of different dementias.

#8: Changes in Sleep Patterns

As dementia progresses, the parts of the brain that regulate sleep become damaged. This disruption can cause dementia patients to sleep more during the day and struggle to sleep at night. They may also wake frequently, have trouble falling back to sleep, or feel confused about the time of the day, making it difficult to follow regular sleep routines. 

Not only are these changes frustrating, but they can also impact health and quality of life. Poor or irregular sleep can worsen confusion, agitation, and memory loss. Additional factors, like inactivity, medications, and other health conditions, can further disrupt sleep.

#9: Loss of Mobility

Many people with dementia gradually lose their ability to stand, walk, or do everyday tasks without help. Some of the first signs of a mobility issue are when a dementia patient can no longer stand up from a chair or bed, or they begin to shuffle or walk unsteadily. They may also seem clumsier, drop things, or fall often. 

Eventually, many people with end-stage dementia become confined to their bed or chair. At this point, having around-the-clock care is essential. 

#10: Problems with Continence

Losing control of the bladder is a common symptom of end-stage dementia. It can happen often or as an occasional accident. This happens because the brain can no longer send and receive signals needed to control the bladder and bowel, but it could also be due to a treatable medical condition like:

• A urinary tract infection
• Severe constipation
• Prostate gland trouble
• Medication side-effects

How To Help Someone Through the Last Stages of Dementia

As dementia progresses, around-the-clock care for in-home caregivers might begin to feel impossible. Transitioning into facility-based care is a difficult decision, but a beneficial one for everyone involved. Not only does a senior living facility provide physical safety, but it also provides medical supervision, a designated care team, and support for loved ones. 

During the process of facing late-stage dementia, caregivers and loved ones can offer touch and contact to bring comfort. Studies show that touch can lessen both physical discomfort and emotional pain. 

You can also work to meet spiritual and cultural needs to honor your loved one’s wishes about religious traditions, pain management and comfort care, and more as they reach the end of life.

How Healthcare Professionals Can Help with the Last Stages of Dementia

Healthcare professionals typically help with the last stages of dementia in two ways — palliative care and end-of-life care. 

Palliative care, or supportive 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, not replace medical care. It offers services and support that complement the medical care team, focusing on symptom management. 

Palliative care provides comfort in many ways, including:

• Using medication to mitigate pain or distress
• Supporting family members and loved ones
• Providing nutritional guidance and support
• Having culturally sensitive discussions with family and patients about what to expect

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

Coordination of the hospice plan happens with the involvement of family and caregivers. Usually, hospice is activated when the primary physician feels life expectancy is less than six months. 

Some of the comfort measures provided in hospice are:

• Using medication to alleviate pain and discomfort
• Focusing on comfort rather than treatment
• Grief counseling
• End-of-life counseling and guidance

Senior Services of America: Providing Compassionate Support During All Stages of Dementia

The last stages of dementia are marked by profound change — but also by the love, connection, and presence of everyone involved. Although this time is emotionally and physically challenging, your loved one’s days can still be filled with peace and dignity.

By understanding the signs of late-stage dementia and seeking support when needed, you can make the right choices for you and your loved one. 

Senior Services of America offers a range of communities in the Pacific Northwest that support dementia throughout all of its stages. Our teams of trained and compassionate professionals will ensure the comfort, safety, and care of your loved one as they progress through the stages of dementia and reach the end of life. 

Learn more about how our communities can help. Find your nearest community today.