Later-stage symptoms of Alzheimer’s and how to spot them

In the final stage of Alzheimer’s disease, individuals lose the ability to respond to their environment, to carry on a conversation and, eventually, to control movement. They may still say words or phrases, but communicating pain becomes difficult. As memory and cognitive skills further decline, personality changes may take place and individuals need extensive care. Getting help and support for yourself as a carer at this time is also important – be that a listening ear or night time nurses as you support your loved one in the later stages of this distressing disease.

 

Requiring round-the-clock assistance

In the later stage of Alzheimer's disease, a person usually has no ability to speak or communicate and requires assistance with most activities, including walking, dressing and eating.

During this stage, caregivers will focus mostly on providing comfort and quality of life. Care options may exceed what you feel you can provide at home since around-the-clock care will often be needed.

Lose awareness of recent experiences as well as of their surroundings

By the time the person reaches the later stages of dementia, they are likely to have significant memory loss and cognitive difficulties. Recent memories may be lost completely (for example, what they had for breakfast or when they last saw a friend) and they may only remember parts of past memories.

The person may believe they are living in an earlier time period from their life (for example, when they were at school). This can mean they say things and behave in ways that don't make sense to those around them. The person may also confuse those around them for someone else (for example, thinking their partner is their sister).

Experience changes in physical abilities, including walking and sitting

Alzheimer's disease is likely to have a big physical impact on the person in the later stages of the condition. They may gradually lose their ability to walk, stand or get themselves up from the chair or bed. They may also be more likely to fall. These problems can be caused by Alzheimer's, medication, other medical conditions (for example stroke), sight loss, balance problems and the environment.

Many people with Alzheimer's (especially in the later stages) find themselves staying in one position for a long time (such as sitting in a chair) and not moving around much. This means they are at risk of pressure ulcers (bedsores).

Weight loss and difficulties with swallowing and chewing

Many people with Alzheimer's lose weight in the later stages. Weight loss can affect the immune system and make it harder for the person to fight infections and other illnesses. It can also increase the risk of falling and make it harder for the person to remain independent.

People in the later stages of Alzheimer's may also develop difficulties with swallowing (dysphagia) and chewing. People with swallowing problems are at risk of choking and of food or saliva going down the windpipe, causing an infection. Swallowing difficulties can be common in the later stages as the person’s muscles and reflexes no longer work properly. They can be distressing for the person and those supporting them.

Have difficulty communicating

In the later stages of Alzheimer's disease the person is likely to have more problems with verbal communication. They may not understand what is being said to them and are less likely to be able to respond verbally as they may have limited or no speech. They may repeat the same phrase or sound, or may only be able to repeat a couple of words. Some people may start talking lots but their words don’t seem to make sense.

Although the person may not be able to communicate verbally, they may still be able to show their needs and emotions in other ways. Rather than speaking, they may use behaviour, facial expression, gestures and sounds to try and communicate how they are feeling and what their needs are.

At Progress Lifeline, we are here to help. Over on our dedicated Dementia page, we have several resources to help you if you are worried about yourself or a loved one. If you’d like further information about assistive technology and the options available to you and your loved ones, email us at contact@progresslifeline.org.ukor call us on 03333 204 999.