Symptoms and care for the advanced stages of dementia
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As dementia progresses, the symptoms that your relative experiences will change. We explain what might happen, and ways in which you can help your relative.
Symptoms of dementia - advanced stages
As dementia progresses, memory loss and difficulties with communication often become very severe. In the later stages, your relative is likely to need more care and support from a range of people. Some of these changes will require you to seek more help and support for yourself and the person concerned. People in the advanced stages of dementia may experience some or all of the following symptoms.
Memory loss
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.
Communication problems
People with dementia often have difficulty speaking and they may eventually lose the ability to speak altogether. It is important to keep communicating with them, and to recognise and use other, non-verbal, means of communication such as expression, touch and gestures (see Communicating with someone who has dementia).
Mobility
Many people with dementia gradually 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, your relative might be unable to walk and need help with moving.
Incontinence
Bladder incontinence is increasingly likely in the later stages of dementia and some people will also experience bowel incontinence. If you are caring for the person at home, you will 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 you may need to offer small and more frequent amounts. 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 relative’s care.
Dementia care in the advanced stages
In the later stages of dementia it is likely that your relative 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 wander off.
Family care, with support
If you or other family members are able to take care of your relative, either in their home or yours, it’s likely that you will need additional support. Local social services or the NHS can provide care at home (see Domiciliary care).
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. Find out what help is available in your relative’s area on this page of the Dementia UK website.
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 care, use our Care services directory to find a care home that specialises in looking after people with dementia.
Hospice
In some cases, a person nearing the end of their life may be cared for in a hospice or be supported at home by the community palliative care team. 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.
Hospital
If your relative becomes ill, they may be admitted to hospital during the later stages of their condition. Usually, people with dementia are only hospitalised because of secondary illnesses such as pneumonia.
More information
Dealing with changing care needs: advice for how to get more care and support as symptoms progress.
Carer's allowance: if you provide substantial care for a relative with dementia, you may be entitled to this government benefit.
Respite care: for information about taking a break from care.
Page last reviewed: May 2016
Next review due: August 2018