Book: Course Summary

There were also a lot of materials in the end of life symptom management book. Some of you may not be at this stage yet, and you might find it difficult to immerse yourself in this topic. However, as course organisers, we feel it is important to introduce you to these important, though difficult issues in good time. 

So, we looked at some of the signs of end of life stage. In general, these included limited speech, needing a lot of help with everyday tasks, eating and swallowing issues as well as incontinence. In the last days and hours of life symptoms can include loss of consciousness, inability to swallow, becoming agitated and restless, irregular breathing and cold hands and feet. 

At this stage, the focus of care is to maximise comfort for the person with dementia (as per the diagram on page 2) There is less focus on quality of life more on comfort.

Pain may be a consideration at End of Life and the person may not be able to tell you they are in pain. If you are worried, then it is important to contact the GP and/ or PHN.

Delirium was discussed - it can be identifiable as it usually comes on suddenly. Symptoms can include restlessness and agitation, drowsiness and slow responses, disturbed sleep, fear and anxiety and hallucinations. 

It is recommend to seek advice and support from a doctor, public health nurse or other health professional.

You the carer can also help re-orientate the person with dementia (bring them back to the present moment) if they appear to have some of the symptoms of delirium. You can provide visual clues such as clocks to tell the time, newspapers with today's date. 

Agitation may occur in the last few days or hours of life. It may present as restlessness, anguish or confusion. It can manifest itself in calling out or shouting, jerking or twitching. It may be difficult to deal with this agitation. Speaking gently to the person and / or gentle touch may help sooth or calm the person.

Food and hydration was discussed in relation to the end stages of dementia (that is, in the last few months, weeks and days of life). The person's fluid intake tends to decrease slowly over time and the body adjusts to this slowing down.

For more detail on any of the above you can go back and read the full Book: End of Life Symptoms.