3. Transitions in later stage

In Later Stage Dementia, caring can turn into 24 hour care.  Carers need to take over tasks such as washing, feeding, toileting and dressing.

This Later Stage can centre around three key points of transition

·         loss of mental capacity

·         loss of ability to eat

·         loss of ability to mobilise

Transitions that may indicate late stage include:

1.       No meaningful verbal communication, stereotypical phrases only or the ability to speak is limited to 6 or fewer intelligible words 

2.       Difficulty swallowing or eating

3.       Unable to move about without assistance. For example, unable to dress without assistance and / or unable to bathe without assistance

4.       Urinary and faecal incontinence,  which could be intermittent or constant

In addition the person with dementia may have the following in the last 12 months:

1.       Aspiration pneumonia (inhaling food/liquid into lungs), kidney infections or other upper respiratory tract infections, septicaemia (poisoning of blood stream) and/ or pressure ulcers

2.       Fever which can reoccur after antibiotics

3.       Dehydration and low calorie intake, this results in weight loss (10% of body weight in 6 months)

People with dementia may not able to participate in discussions about their care and in the absence of an Advanced Care Plan, the Carer becomes the proxy decision maker.