Brain & Nervous System Alzheimer's Dementia & Related Cognitive Disorders Dying From Dementia With Late-Stage Symptoms By Angela Morrow, RN Updated on October 26, 2022 Medically reviewed by Brigid Dwyer, MD Print Knowing what to expect can help when your loved one has late-stage dementia. The death of your loved one can be a hard concept to wrap your head around and accept. It's important to understand what's coming in the future so you can prepare emotionally and practically. This article explains how dementia progresses and what happens during late-stage dementia. Progression of Dementia A person with dementia will follow a typical pattern of decline. But the pace varies depending on the person. Someone with Alzheimer's disease may struggle to remember new information. Names, events, or recent conversations are no longer easy to recall. Planning or completing usual tasks might become difficult. As the disease progresses, a person can frequently become confused and disoriented. They have trouble communicating (both speaking and writing) and understanding complex information. Poor judgment and withdrawal from activities they once enjoyed are also common. Finally, in late-stage disease, a person with dementia is no longer able to care for themselves. They are also at high risk for certain health conditions. 10 Signs Death Is Near in People With Dementia In the period of time leading up to the end of life, an individual with dementia may show signs that they are nearing death. They may:Have more infectionsExperience more medical complicationsMove around less/be unable to move without helpBecome very frailFall more oftenHave trouble swallowingHave problems eating and drinkingBe unable to speakHave difficulty showing facial expressionsSleep more It's important to note that there are different types of dementia. The patterns of symptoms vary due to the specific brain changes that occur in each type. Common Types of Dementia Most people who have dementia experience problems with cognitive skills, depression, indifference, and a lack of interest in doing things. People with Lewy body dementia and Alzheimer's disease may have similar early symptoms. Memory loss is common in both conditions, for example. Lewy body dementia also commonly causes fluctuations in arousal, hallucinations, sleep problems, and difficulty walking. In contrast, people in the early stages of frontotemporal dementia usually don't have memory problems. Instead, they might have obvious changes in personality and behavior. Vascular dementia, which occurs as a result of having many strokes throughout the brain, can cause problems understanding concepts, emotional and personality changes, and memory problems. This type of dementia may accompany other types, making the decline more severe. And chronic traumatic encephalopathy (CTE), which occurs after repeated head trauma, often begins to cause symptoms years after the traumatic brain injuries, with a significant progression of mood changes, personality changes, and a decline in memory and cognitive skills. With Lewy body dementia, frontotemporal dementia, vascular dementia, and CTE, the memory problems may respond to cues/reminders, while in Alzheimer's there is often a forgetting of recent events altogether. In the final stage of all types of dementia, a person goes through a major decline in everyday functioning. Verywell / Cindy Chung Late-Stage Dementia One day, your loved one with dementia will reach the late stage of dementia. This stage is also called end-stage dementia or advanced dementia. In this stage, their symptoms become severe. A person will have problems with everyday functions. These include bathing, dressing, eating, and going to the bathroom. At this point, your loved one might not be able to walk or sit up without help. They will become bedbound and need care all the time. They may also lose the ability to speak and show facial expressions, like smiling. This change can be especially challenging for loved ones to see. Symptoms in the Late Stages of Alzheimer's Disease How Dementia Causes Death A person in the late stage of dementia is at risk for many medical complications. Because they might not be able to move, they're at especially high risk for certain conditions. They could get a urinary tract infection (UTI) or pneumonia (an infection of the lungs). They can also experience skin breakdown, pressure ulcers (bedsores), or blood clots. Trouble swallowing, eating, and drinking leads to weight loss, dehydration, and malnutrition. This further increases their risk of infection. In the end, most people with late-stage dementia die from underlying dementia or a related complication. For example: A person may die from an infection like aspiration pneumonia. If someone has trouble swallowing, food or liquids may go down the wrong tube. Instead of going into the esophagus or stomach, it's breathed into the airways or lungs. This leads to a type of pneumonia called aspiration pneumonia. Dementia increases the risk of death from a blood clot in the lung because they are bedbound and not mobile. It's important to know that late-stage dementia is a terminal illness and can lead to death. In these cases, the death certificate may list dementia as the cause of death. Dementia Support Groups Summary In the beginning stages of dementia, symptoms vary depending on the type of dementia. As time goes on and dementia progresses, the symptoms start to be the same among all types of dementia. People call this late-stage or end-stage dementia. During this stage, your loved one may be at a very high risk of complications. People with end-stage dementia often die from a complication related to their dementia. A Word From Verywell While advanced dementia of these types has no cure and ultimately leads to death, you can still help your loved one. You can provide comfort and play an active role in their care. Memory care units in skilled nursing facilities and hospice care are available and encouraged for individuals with late-stage dementia. Hospice focuses on pain relief and managing your loved one's symptoms. With this approach, you can be proactive in providing love and support, without putting your loved one through unnecessary medical treatments. Coping With Advanced Alzheimer's Disease 5 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Insitute on Aging. Alzheimer's disease fact sheet. McKeith IG, Boeve BF, Dickson DW, et al. Diagnosis and management of dementia with Lewy bodies: fourth consensus report of the DLB Consortium. Neurology. 2017;89(1):88-100. doi:10.1212/WNL.000000000000405 Young JJ, Lavakumar M, Tampi D, Balachandran S, Tampi RR. Frontotemporal dementia: latest evidence and clinical implications. Therapeutic Advances in Psychopharmacology. 2018;8(1):33-48. doi:10.1177/2045125317739818 World Health Organization. Dementia. Kumar CS, Kuriakose JR. End-of-life care issues in advanced dementia. Ment Health Fam Med. 2013;10(3):129-132. PMID:24427179 Additional Reading Alzheimer's Society. Symptoms and memory in the later stages of dementia. Alzheimer’s Association. 2021 Alzheimer’s disease facts and figures. Arcand M. End-of-life issues in advanced dementia: Part 1: goals of care, decision-making process, and family education. Can Fam Physician. 2015;61(4):330-334. PMID:25873700 By Angela Morrow, RN Angela Morrow, RN, BSN, CHPN, is a certified hospice and palliative care nurse. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit