Advanced dementia: The best way to care for someone

Over time, the condition of people living with dementia deteriorates. As the person weakens, other problems can arise, adding complexity to caring for a person at this often difficult stage of their life.

Though dementia is caused by degenerative brain diseases, the symptoms of advanced dementia usually become increasingly physical.

What happens to someone who has advanced dementia?

As dementia progresses, it takes an increasingly physical toll on a person’s body. People with advanced dementia:

• May not be able to walk unassisted,
• May become incontinent,
• May have advanced memory loss,
• May experience delirium,
• May be mentally confused,
• May lose the ability to communicate,
• May require help with small movements,
• May lose their appetite,
• Their skin may become fragile,
• They may experience low moods,
• They may become constipated,
• May experience shortness of breath,
• May experience pain,
• May experience loss of sight and hearing which can create a sense of disorientation, and
• Poor health is likely to become more common, particularly pneumonia.

What can we do to help those who have advanced dementia?

Diet

As dementia progresses, eating can become a complex matter. People with advanced dementia can have difficulty eating and drinking because they may have problems swallowing (dysphagia), constipation or mouth pain, or they may have psychological issues, such as depression and anxiety that makes them less interested in eating.

You can alter the texture of food to make it easier to digest.

Eventually the difficult decision may be made to withdraw nutrition and hydrations towards the very end of life as it may ease the comfort of the person.

Infections and fever

Infections are very common for people who are living with advanced dementia, and sadly, they are sometimes terminal.

Around one half of infections are respiratory, and one third are urinary tract infections.

Take care when feeding the person with dementia to avoid the risk of developing aspiration pneumonia. Keep them as mobile as possible to help clear their lungs. And try to maintain a healthy diet.

Be sure to maintain good hygiene around the person, washing hands and throwing away used tissues.

Pain

Pain is very common among those with advanced dementia. Though it can be difficult to measure pain, it is essential that pain is managed to avoid physical discomfort. Palliative care specialists may be able to help manage pain to ease symptoms.

By improving communication, you may be able to get a better sense of the person’s pain level.

Communication

As dementia progresses, the person’s ability to communicate lessens. They may be able to use only a few words, or they may not be able to speak at all.

Often people ignore those with advanced dementia, which can make the person feel excluded. It’s important to keep including people in conversation, even in the advanced stages of dementia. Try to find other ways to communicate, and to connect with each other.

Caring for someone in the later stages of dementia can be extremely challenging. Their needs are complex, and can be both physical and psychological. By being prepared and informed about what occurs in the late stages of dementia, you can investigate in advance the best ways to cope with the issues as they arise.