Dementia, a general term encompassing the impairment of cognitive abilities such as thinking, remembering, reasoning, and personality, takes a toll on individuals and their loved ones.
In the journey through the stages of dementia, the decline of patients can be swift, prompting the need for families to prepare for the inevitable. If you need help caring for someone with dementia, a live-in carer can provide 24/7 support to you and your loved one.
But what are the last stages of dementia before death?
In this blog, we explain the signs that can indicate the approaching end of life for individuals with dementia. Furthermore, discover how specialised carers can promote comfort and dignity throughout this challenging journey.
In the advanced stages of dementia, there may be a noticeable decline in physical strength.
The tasks of daily life become challenging, for example, sitting up in bed, bathing, dressing, or nourishing oneself with food and drink become increasingly arduous, often requiring a substantial amount of assistance.
Furthermore, the vulnerability to falls escalates, reflecting compromised motor skills and diminished coordination.
These manifestations of weakness serve as poignant signals that the individual is entering a critical phase in their journey with dementia, hinting at the proximity of the end of life. They will require support with daily living, which a live-in carer can provide within the comforts of their home.
2. Severe Weight Loss
The sudden and unexplained weight loss in dementia patients is common.
One prominent factor contributing to weight loss is the struggle to eat, as individuals may encounter difficulties coordinating the physical act of chewing and swallowing.
Loss of appetite is another significant contributor, as the cognitive decline inherent in dementia can disrupt the recognition of hunger cues or the enjoyment of meals.
Another concerning aspect is the potential difficulty in swallowing, often accompanied by pain, rendering patients at an increased risk of choking.
Moreover, the risk of aspiration becomes heightened; if saliva inadvertently travels down the windpipe, it may lead to respiratory infections.
Weight loss tends to manifest more prominently in the later stages of dementia, accentuating the need for vigilant monitoring, which a live-in carer is qualified to provide. A specialised carer can address nutritional challenges and ensure the overall well-being of a vulnerable individual.
3. Difficulty with Communication
Communication difficulties in dementia patients pose significant challenges, both for the individuals affected and those giving care.
As the disease progresses, a manifestation of this struggle becomes apparent, often expressed through moaning, yelling, or evident frustration as patients grapple with the inability to convey their thoughts effectively.
Early signs of this communication impairment surface when individuals struggle to retrieve words for familiar objects or people, creating a sense of frustration and confusion.
However, it is in the severe stages of dementia that this symptom tends to intensify, rendering verbal expression increasingly elusive.
The frustration arising from the inability to communicate emphasises the importance of adopting alternative means of communication. For example, non-verbal cues, gestures, or visual aids can effectively enhance the quality of interaction in the face of cognitive decline.
4. Difficulty Swallowing
As mentioned, swallowing and choking challenges are pervasive issues for individuals with dementia.
The act of swallowing itself may become a painful and intricate task, leading to potential discomfort and distress for those affected.
In response to this, medications can be administered to alleviate the pain associated with swallowing difficulties, seeking to enhance the overall well-being of dementia patients.
Behavioural changes in eating patterns may also emerge. Some individuals may store food in their mouths, prolong the chewing process, or engage in frequent throat-clearing and coughing episodes.
These behaviours contribute to the intricacies of mealtimes, necessitating a comprehensive approach that encompasses both medical and behavioural interventions, which a live-in carer is adept at.
Incontinence, encompassing both bowel and bladder challenges, is a prevalent and distressing issue among individuals grappling with dementia.
Cognitive and physical impairments contribute to the occurrence of incontinence in various ways.
Memory loss, a hallmark of dementia, often leads to individuals forgetting to attend to essential bodily functions, such as going to the toilet.
Additionally, the decline in mobility accompanying the progression of the disease can make the physical act of reaching the toilet a daunting task.
Communication difficulties further exacerbate the problem, as individuals may need help communicating their need to use the toilet effectively.
Furthermore, the diminishing ability to recognise bodily sensations, such as a full bladder, adds another layer of complexity.
A live-in carer understands and recognises when an individual struggles with incontinence and can provide appropriate, dignified and respectful care.
6. Breathing Pattern Changes
During the later stages of dementia, individuals often experience profound changes in their respiratory patterns, reflecting the advanced nature of the disease.
One noticeable alteration is the development of an irregular breathing pattern, marked by shallow breaths that may be erratic and unpredictable. It is not uncommon for patients to exhibit episodes where they momentarily cease breathing for several seconds or even up to a minute.
This irregularity in respiration can be distressing for individuals and their relatives, signalling the progression of the disease towards its final stages.
As dementia affects various cognitive and physiological functions, including those vital to maintaining a regular breathing rhythm, it necessitates a compassionate and informed approach to end-of-life care.
7. Unable to Walk or Stand
In the later stages of dementia, individuals often experience a profound decline in their ability to stand and walk independently.
The need for assistance in these basic mobility tasks becomes paramount, as the cognitive and physical impairments compromise the individual’s coordination and spatial awareness.
The inability to walk diminishes the individual’s autonomy and poses additional risks to their well-being.
Prolonged immobility can result in skin breakdown, the development of painful sores, and the stiffening of joints, further exacerbating the challenges of caring for individuals in advanced stages of dementia.
A live-in carer can provide the necessary support and assistance, employing strategies to mitigate the potential complications associated with immobility and ensuring the comfort and dignity of the individual.
8. Rattly and Chesty Breathing Sound
In the final stages of life for individuals with advanced dementia, they may exhibit a distinctive sound as they breathe, producing a wet or gurgling noise that can be unsettling for loved ones.
This symptom is often associated with the accumulation of mucus or fluids in the throat and respiratory passages. While it is not directly painful for the individual, the sound can be distressing for those witnessing it.
Carers can gently change the individual’s position, such as elevating their head, to help alleviate the sound and enhance their comfort.
9. Cold Hands and Feet
In the mid to late stages of dementia, individuals may become increasingly cold to the touch, particularly their arms and legs.
In the typical course of bodily function, our systems autoregulate blood temperatures, maintaining a balance conducive to overall well-being. However, dementia damages this regulatory mechanism.
To safeguard vital organs, the brain responds by constricting the blood vessels in the extremities, such as the hands and feet. As a result, the circulation to these peripheral areas is compromised, leading to a noticeable and persistent coldness.
10. Loss of Consciousness
Dementia impairs cognitive functions and disrupts the intricate balance of the sleep-wake cycle. In the later stages, individuals may find themselves drifting into unconsciousness for more extended periods. This heightened need for sleep often reflects the toll the disease takes on the body and mind.
The gradual transition towards increased periods of unconsciousness underscores the challenging nature of providing care for individuals with advanced dementia.
Witnessing a close friend or relative progress through the stages of dementia is an emotionally challenging experience. As the disease advances, individuals face a myriad of physical and cognitive challenges, and the toll on their well-being becomes increasingly evident.
In these challenging times, considering the option of a live-in carer who specialises in palliative care can significantly ease the journey for the individual with dementia and their loved ones.
A live-in carer offers round-the-clock support within the familiar and comforting environment of the individual’s home. This care enhances the individual’s comfort and minimises stress for family members.
IP Live In Care provides live-in carers who specialise in giving comprehensive care to individuals navigating the complexities of dementia. If you are seeking palliative care services for a loved one with dementia, death may be imminent. Contact us today to find out what support we can offer, whether respite care or 24/7 support, to ensure your loved one is well-cared for and comfortable.