Knowing what to expect can help when your loved one has late-stage dementia. The death of your loved one can be a hard concept to wrap your head around and accept. It's important to understand what's coming in the future so you can prepare emotionally and practically.
This article goes over how dementia progresses, what happens during late-stage dementia, and 10 signs that death is near.
Progression of Dementia
A person with dementia will follow a typical pattern of decline. But the pace varies depending on the person.
Someone with Alzheimer's disease may struggle to remember new information. Names, events, or recent conversations are no longer easy to recall. Planning or completing usual tasks might become difficult.
As the disease progresses, a person can frequently become confused and disoriented. They have trouble communicating (both speaking and writing) and understanding complex information. Poor judgment and withdrawal from activities they once enjoyed are also common.
Finally, in late-stage disease, a person with dementia is no longer able to care for themselves. They are also at high risk for certain health conditions.
It's important to note that there are different types of dementia. The patterns of symptoms vary due to the specific brain changes that occur in each type.
What Does Late-Stage Dementia Look Like?
One day, your loved one with dementia will reach the late stage of dementia. This stage is also called end-stage dementia or advanced dementia. In this stage, their symptoms become severe.
A person will have problems with everyday functions. These include bathing, dressing, eating, and going to the bathroom.
At this point, your loved one might not be able to communicate and may seem unaware of their surroundings. They will become bedbound and need care all the time.
They may also lose the ability to speak and show facial expressions, like smiling. This change can be especially challenging for loved ones to see.
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10 Signs Death Is Near in People With Dementia
In the period of time leading up to the end of life, an individual with dementia may show signs that they are nearing death. They may:
- Have more infections
- Experience more medical complications
- Move around less/be unable to move without help
- Become very frail
- Fall more often
- Have trouble swallowing
- Have problems eating and drinking
- Be unable to speak
- Have difficulty showing facial expressions
- Sleep more
End-of-Life Symptoms in Final Days
In the days and hours before death, a person with dementia may:
- Seem to be deteriorating rapidly
- Lose the ability to swallow
- Develop cold hands or feet
- Lose consciousness
- Breathe irregularly or have "rattly" breath
Types of Dementia Symptoms
Symptoms in the early and late stages of dementia can sometimes vary depending on the type of dementia.
- Alzheimer's disease is the most common type of dementia. It causes memory loss, poor judgement, difficulty keeping track of objects and dates, and mood and personality changes.
- Lewy body dementia commonly causes fluctuations in arousal, hallucinations, sleep problems, and difficulty walking.
- Frontotemporal dementia doesn't usually cause memory problems in the early stages. Instead, people with this type of dementia might have obvious changes in personality and behavior.
- Vascular dementia, which occurs as a result of having many strokes throughout the brain, can cause problems understanding concepts, emotional and personality changes, and memory problems. This type of dementia may accompany other types, making the decline more severe.
- Chronic traumatic encephalopathy (CTE), which occurs after repeated head trauma, often begins to cause symptoms years after the traumatic brain injuries, with a significant progression of mood changes, personality changes, and a decline in memory and cognitive skills.
With Lewy body dementia, frontotemporal dementia, vascular dementia, and CTE, the memory problems may respond to cues/reminders, while in Alzheimer's there is often a forgetting of recent events altogether.
In the final stage of all types of dementia, a person goes through a major decline in everyday functioning.
Symptoms in the Late Stages of Alzheimer's Disease
How Dementia Causes Death
A person in the late stage of dementia is at risk for many medical complications. Because they might not be able to move, they're at especially high risk for certain conditions.
They could get a urinary tract infection (UTI) or pneumonia (an infection of the lungs). They can also experience skin breakdown, pressure ulcers (bedsores), or blood clots.
Trouble swallowing, eating, and drinking leads to weight loss, dehydration, and malnutrition. This further increases their risk of infection.
In the end, most people with late-stage dementia die from underlying dementia or a related complication.
For example:
- A person may die from an infection like aspiration pneumonia. If someone has trouble swallowing, food or liquids may go down the wrong tube. Instead of going into the esophagus or stomach, it's breathed into the airways or lungs. This leads to a type of pneumonia called aspiration pneumonia.
- Dementia increases the risk of death from a blood clot in the lung because they are bedbound and not mobile.
It's important to know that late-stage dementia is a terminal illness and can lead to death. In these cases, the death certificate may list dementia as the cause of death.
Dementia Support Groups
Managing End-of Life Signs with Dementia
While advanced dementia of these types has no cure and ultimately leads to death, you can still help your loved one. You can provide comfort and play an active role in their care.
Memory care units in skilled nursing facilities and hospice care are available and encouraged for individuals with late-stage dementia. Memory care facilities offer personal care services and help with daily activities such as bathing, dressing, and walking.
Hospice focuses on pain relief and managing your loved one's symptoms. It can provide medical equipment, physical therapy, dietary counseling, and respite care. If needed, hospice can also provide spiritual services for your loved one and family.
With this approach, you can be proactive in providing love and support, without putting your loved one through unnecessary medical treatments.
Summary
In the beginning stages of dementia, symptoms vary depending on the type of dementia.
As time goes on and dementia progresses, the symptoms start to be the same among all types of dementia. People call this late-stage or end-stage dementia. During this stage, your loved one may be at high risk of complications. Signs that death may be near include having more infections and losing the ability to speak, eat, move, and make facial expressions.
People with end-stage dementia often die from a complication related to their dementia. Hospice services can help provide pain relief and manage symptoms when death is near in the final stages of illness.
Coping With Advanced Alzheimer's Disease
