How can I help someone in late stage dementia?
Most dementias in older persons are slow to develop. Alzheimer’s disease, the leading cause of dementia, progresses over many years.
Late-stage dementia is tough on everyone. The person with dementia may be fully incontinent, need help with eating, have difficulty walking, no longer be able to communicate, and almost certainly requires significant care. Families grieve their loss, particularly if the person no longer recognizes close friends and relatives.
How can you help someone during this part of life’s journey? Dementia expert David Troxel, who worked with the Home Instead Senior Care® network to develop its Alzheimer’s and Other Dementias Training Program, recommends these approaches:
Always approach persons with late-stage dementia with dignity. Never talk about them in their presence as though they aren’t there. Encourage caregivers to keep them well groomed, neatly dressed and clean.
Provide a reassuring touch. A gentle shoulder massage, hand rub, or friendly hug creates that needed human connection and shows the person he or she is valued.
Enjoy music. Music and song lyrics are in a different part of the brain than speech. Many individuals with late-stage dementia respond to beautiful music. They may even be able to sing an old, familiar song. Music brings happiness and joy.
Manage pain. Most persons with late-stage dementia are not able to let you know in words that they are in pain. If the person cries out, grimaces when touched, or shows other signs of pain, talk to your medical provider about appropriate medications. Watch for skin tears or bruises. Consult with a physical therapist about chair exercises or other simple stretches that can help keep them limber.
Consider a visit from a friendly cat or dog. Animals give unconditional love and the late-stage person will often take great joy from the wet nose or kiss of a dog. A cat in the lap provides an opportunity to pet the cat and enjoy its soothing purr. While it is always important to treat the person as an adult, some individuals in this stage do take comfort from holding a soft teddy bear (or substitute a baby doll).
Go outside. When possible, take the person outside to get some fresh air and sunshine, and to experience the beauty of nature. Use a wheelchair if needed. Going outside is sensory, spiritual and life-affirming. The person will likely enjoy feeling the sun’s warmth and seeing flowers, birds, and neighborhood children.
Take care of yourself. Seek out a support group or counselor to share your feelings of loss and obtain necessary support. Try to make time to exercise, eat well and spend time with family and friends.
Take a break. When you need a break, consider a professional caregiver who is trained in all stages of dementia care. “My goal was to get one smile an hour, but guess what? I often ended up with two or three,” Angela G., a Home Instead CAREGiverSM said about her experience with a late-stage person. “He seemed to understand some of my silly jokes. I enjoyed my time with him and I hope he enjoyed his time with me too.”
Take advantage of hospice care. Hospice offers wonderful services for home-bound individuals in the late stages of dementia, including assistance with nursing and medication, help with bathing, all-important respite, and spiritual support for the patient and his or her family.
Remember, the most important thing you can do during this part of life’s journey is to make sure the person with dementia knows the love and warmth of family and friends, and for you, the caregiver, to enjoy the special moments when they happen. Be sure to focus on taking care of yourself or you won’t be able to do either.
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