End-stage dementia is marked by severe cognitive decline, and is an indication that the brain has lost the ability to communicate with the body. When dementia patients reach the final stages of the disease, most require around-the-clock nursing care by trained care providers. Although end-stage dementia patients frequently receive aggressive medical treatment until death, palliative and hospice care that focuses on symptom management and comfort measures are the preferred end-of-life treatment, according to the Alzheimer’s Association.
Loss of Psychomotor Skills and Continence
In the final stages of dementia, the patient loses control of basic motor function, is no longer able to sit, stand or hold up the head, and must rely upon care providers for personal care, nutrition and hydration. Neurological impairment and a lack of mobility increases the likelihood of urinary and bowel incontinence, and subsequent catheterization raises the risk of infection.
Eating and Feeding Problems
End stage dementia is often marked by the patient’s refusal or inability to eat food. Some dementia patients may lose interest in eating while others simply forget how to swallow. When a dementia patient can no longer eat or drink, medical professionals may recommend tube feeding to prolong life, although the practice does not increase survival nor improve the comfort of the patient. Tube feeding may require restraints for proper placement, and can cause further medical complications. Evidence suggests that feeding tubes are more frequently used in for-profit hospitals and large medical facilities, according to researchers at Warren Alpert Medical School of Brown University. If the patient is able to swallow food, hand feeding is the preferred method of providing nutrition because it allows personal contact with care providers who offer companionship and comfort to the patient.
Loss of Verbal Abilities
A loss of verbal abilities frequently accompanies late-stage dementia. Degeneration of the part of the brain that involves language can make it difficult for the dementia patient to find the right words, making it increasingly difficult to speak complete sentences and communicate needs to others. Global aphasia, or the complete loss of language function, is less common but can still occur in late-stage dementia. With global aphasia, the patient often loses the ability to speak and may only be able to understand a few words or phrases. The patients is also unable to read or write, or repeat words spoken to him.
