The last stages of dementia see cognitive, physical and emotional symptoms become more severe, impacting quality of life and independence. It can be incredibly daunting and distressing to think about, but being prepared and knowing quality care is available can be reassuring so here's a look at what to possibly expect.

Cognitive and communicative function

Dementia covers a range of symptoms that result from disease or damage to the brain, the most common form being Alzheimer’s. This is a progressive condition, whereby symptoms may begin gradually but increase in severity and impact on life over time. During the last stages of dementia, many will find severe difficulties with language and communication, problem-solving, memory, and orientation.

You may find it difficult to describe and communicate your needs or wishes, or have trouble recalling the right words when communicating. Changes in behaviour are common, whether that’s in terms of aggressive or socially inappropriate behaviour, restlessness, hallucinations, or anxiety and depression. A carer will pay close attention to body language and other cues and be better placed to try to understand what you need and how you’re feeling. They will also be equipped with your background and medical history, along with your preferences when it comes to treatments.

The decline of memory can be particularly painful; short-term memory can be very impaired and earlier memories fragmented, leading some to believe they’re in an earlier time period or living in the past, and there may be difficulties recognising loved ones. A familiar environment at the end-stages of dementia may help you feel more relaxed and thus react more positively with the challenges faced, while a carer will be there to offer emotional support and companionship.

Physical impact

Physical impairments also become more obvious and pronounced, with problems in day to day living that can significantly inhibit independence, from cooking, drinking and cleaning, to continence and personal care. A carer will make sure that your needs are attended to with dignity and that your wishes are respected.

Additional health problems can occur as complications from the disease, such as diabetes or heart disease, putting further strain on the body and physical functioning. Weight loss often results from difficulties with eating, and some medications can cause unwanted side-effects. With reduction in mobility comes the possibility of blood clots and infections, so a carer will ensure enough movement is undertaken safely.

While cognitive and physical impairments may limit choices, it’s still possible to gain enjoyment and positive emotions and associations from activities, which a carer can help arrange, keeping senses stimulated. Carers can assist with each aspect of day to day care; they can be a companion and ensure a safe environment to allow you to live your best life during the challenges of dementia as comfortably as possible.