In the later stages of dementia a person will be completely dependent on caregivers for activities of daily living.
Many people living with late stage dementia are in residential aged care or receive some form of nursing care at home.
Other health problems can also influence a person’s health and rate of dementia progression. In the late stages of dementia, a person may not recover from an infection or fall.
Common problems experienced during the late stages of dementia include:
- Pronounced memory loss. In the later stages of dementia a person can no longer recognise family but responds to touch and affection.
- Problems with mobility may mean a person is confined to bed or a chair putting them at risk of pressure areas, contractures and pneumonia.
- Loss of speech. Speech is jumbled, confused or incoherent. A person may call out, cry or repeat the same word over and over.
- Weight loss. A person can have problems eating and drinking due to difficulty swallowing or pooling food in their mouth putting them at risk of choking or aspiration.
- Incontinence. A person in late stage dementia can be incontinent of urine and faeces. Problems with excoriation, urinary tract infections and constipation are common.
- Pain. Being confined to bed, contracted limbs and arthritis can cause pain in those with late dementia. Other health conditions can be at play and cause distress. People living with late stage dementia cannot verbalise their pain. They may grimace, call out when moved or cry in pain. Caregivers should be on the lookout for signs of discomfort.
Increasing frailty put the individual with late stage dementia at risk of recurrent infections, bed sores, weight loss and pneumonia.
During the late stages of dementia care is focused on keeping a person comfortable. The most common cause of death in those with late stage dementia is pneumonia.
Any nursing or medical action in the late stages of dementia should intend to increase a person’s quality of life. Palliative care measures can be introduced during this time as an individual’s condition deteriorates.