What are the symptoms of later-stage dementia?
Memory problems
Many people with later-stage dementia will struggle with their memory of recent events. They may often think they are at an earlier period of their life (known as ‘time shifting’). This can cause challenging situations, for example, if they ask to see someone who is no longer alive.
People with dementia in the later stages may also stop recognising familiar places, objects, and people. A personmay not recognise themselves in a mirror, nor a close friend or family member.
This might happen because they only remember how a person looked when they were much younger.
Language difficulties
If a person with later-stage dementia speaks more than one language, they may lose one of the languages they learned later in life. Eventually, they may only understand the language of their childhood.
A person’s spoken language may eventually be reduced to only a few words or lost altogether. They may also understand fewer words.
But people with dementia at this stagemay still be able to understand gestures, facial expressions and body language. They may also use non-verbal communication to express their feelings or needs.
Changes in mood, emotions and perceptions
Changes in mood remain in the later stages of dementia. Depression and apathy are particularly common.
Delusions and hallucinations (especially of sight and hearing) are most common in the late stage of dementia. They are not always distressing but they can explain some changes in behaviour because the person’s perception of reality is altered.
People with later stage dementia often respond more to senses than words. They may like listening to songs or enjoy textures. For example, they may like the feel of different types of material.
Changes in behaviour
The changes in behaviour that can happen in the middle stage of dementia can alsohappen in the later stages.
Aggressionin the later stage of dementia is often a reaction to personal care. Someone may hit or push away those trying to help them or shout out to be left alone.
The person with dementia may have felt scared, threatened or confused.
Restlessness is also very common. Sometimes the person may seem to be searching for someone or something.
As in other stages, it is also important to consider whether the person has other needs that are not being met. Someone with later-stage dementia will often be unable to tell others how they are feeling. A sudden change in behaviour can point to a medical problem (for example, pain, infection or delirium).
Physical difficulties in the later stages of dementia
The physical changes of late-stage dementia are partly why the person is likely to need much more support with daily living. At this stage they may:
- walk more slowly, with a shuffle and less steadily – eventually they may spend more time in a chair or in bed
- be at increased risk of falls
- need a lot of help with eating – and so lose weight
- have difficulty swallowing
- be incontinent – losing control of their bladder and bowels.
The person’s reduced mobility, in particular, raises their chances of blood clots and infections. These can be very serious or even fatal so it is vital that the person is supported to be as mobile as they can.
