Symptoms of dementia – advanced stages
As dementia progresses, memory loss and difficulties with communication often become very severe. In the later stages, more care and support from a range of people will be required. People in the advanced stages of dementia may experience some or all of the following symptoms.
In the later stages of dementia, people may not recognise family and friends; may forget where they live; and may not know where they are. They might find it difficult to understand simple pieces of information, carry out basic tasks or follow instructions.
People with dementia often have difficulty speaking and they may eventually lose the ability to speak altogether. It’s important to keep communicating with someone who has dementia, and to recognise and use other, non-verbal, means of communication such as expression, touch and gestures.
Many people with dementia can become less mobile and need help to move around. They might appear increasingly clumsy when carrying out everyday tasks, and be more susceptible to accidents or falls. In the later stages of dementia, they may be unable to walk and need help with moving.
Bladder incontinence is increasingly likely in the later stages of dementia. If you’re caring for someone at home, you’ll need a continence assessment and advice from the community nursing team about management and care. Your GP can arrange this for you.
Eating, appetite and weight loss
Loss of appetite and weight loss are common in the later stages of dementia as people’s interest in food changes, and their tastes and likes can change. It’s important that people with dementia get help at mealtimes to ensure that they eat enough. Offering food that is appetising and appealing is a key part of the day and offering smaller amounts more frequently might be more successful. Seek advice from a dietician or the nursing team in the community or care facility. Being creative and adaptable is key.
Some people have trouble eating or swallowing, causing risk of choking, chest infections and other problems. If you have any concerns, speak to the clinical professionals in charge of your family member’s care.
Dementia care in the advanced stages
In the later stages of dementia it’s likely that your loved one will become increasingly frail and dependent on others, meaning that they need 24/7 care. Their behaviour might mean that they need constant supervision to make sure that they don’t hurt themselves or get lost.
Caring for someone with advanced dementia
If you or other family members are able to take care of your loved one, either in their home or yours, it’s likely that you’ll need additional support. Local social services or the NHS can provide care at home.
Admiral Nurses are specialist dementia nurses who work with families, carers and supporters of people with dementia. They can provide practical advice, emotional support, information and professional skills.
When to consider residential care
Some people may need to go into a residential care home during the later stages of their condition. As well as information about choosing a care home and paying for a care home, use our care services directory to find a care home that specialises in looking after people with dementia.
In a care home that specialises in dementia, the staff build up an expertise in dealing with how their residents behave. They go on courses and have specific training.
Being admitted to hospital
If your loved one becomes ill, they may be admitted to hospital. Usually, people with dementia are only hospitalised because of secondary illnesses, such as pneumonia, or injury.
When your loved one might need a hospice
In some cases, a person nearing the end of their life will require specialist palliative care. They may be cared for in a hospice or be supported at home by a community palliative care team or by support staff from a local hospice. Palliative care focuses on reducing physical and psychological distress, and providing support to the family. The palliative care team can help in managing symptoms and provide expert advice, generally provided by district nurses.
We explain the Mental Capacity Act, and how the law protects those who are finding it difficult to make decisions.
As a person’s dementia worsens, their behaviour is likely to change. We explain how you can prepare yourself.
A needs assessment is key to getting the support you need. You have a right to this assessment and it's free of charge.