3. What are the signs of end of life stage?

It is difficult to know when a person with dementia is coming to the end of their life. However, there are some symptoms that may indicate the person is at the end of their life including:

  • limited speech (single words or phrases)

  • needing 24 hour help with everyday activities

  • eating less and swallowing difficulties

  • incontinence and becoming bed bound.

When these are combined with frailty, recurrent infections and/or pressure ulcers, the person is likely to be nearing the end of their life. If the person has another life limiting condition (e.g. cancer), their condition is likely to worsen in a more predictable way.

When a person gets to within a few weeks, days or hours of dying, further changes are common. These may include:

  • deteriorating more quickly

  • loss of consciousness

  • inability to swallow

  • becoming agitated or restless

  • irregular breathing

  • cold hands and feet.

While we do not know what unconscious persons can actually hear, experience suggests that at times their awareness may be greater than their ability to respond. So even though the person is unconscious it is assumed that he/ she can hear everything. 

Often, the last hours of life are the time when some family members most want to communicate with their loved one. Some family members may find this stage distressing. It may be helpful to surround the person with the people, things, music, and sounds that he or she would like and include the person in everyday conversations. It may be the time for family members to say the things they need to say.