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What Are the Symptoms of the Final Stages of Alzheimer’s? Caregiver Tips

The final stages of Alzheimer’s or severe or late stage of Alzheimer’s can result in loss of many functions and present in the following symptoms.

Forgetfulness or misplacing things are part and parcel of daily lives. However, if it gets severe or if you or your loved ones are diagnosed with Alzheimer’s, it can be an emotional turmoil for the entire family.

Alzheimer’s can eventually affect a person’s daily activities. The final stages of Alzheimer’s or severe or late stage of Alzheimer’s can result in loss of many functions.

The final stages may last for several weeks to several years and require intensive and continuous care.

Some of the symptoms of the final stages of Alzheimer’s are:

  • Severe stage: In this stage, the person may experience
    • Total memory loss
    • Weight loss
    • Loss of awareness of recent experiences
    • Difficulty communicating
    • Difficulty in eating and swallowing
    • Stool incontinence
    • Difficulty in walking and sitting independently
    • Declining quality of life
  • Late-stage: In this stage, the person may
    • Lose the ability to communicate because speech becomes limited to a few words or phrases
    • Forget to swallow, leading to the entry of food into the lungs, causing infection
    • Lose the ability to control bowel and bladder function
    • Become susceptible to different kinds of infection

Role of a caregiver in managing their loved ones in their final stage of Alzheimer’s

As a caregiver, you have an important role in preserving the quality of life and dignity of your loved ones. In this stage, the person may lose the ability to talk and express their needs, although they may still hold some core values that can be utilized for connecting with them.

Senses are the only way to communicate with these people. You can express care through touch, sound, sight, smell, and taste.

Some ways by which a caregiver can care for their loved ones include:

  • Preparing their favorite food
  • Playing their favorite music
  • Reading books that may interest the person
  • Brushing the person’s hair
  • Rubbing lotion with their favorite scent into the skin
  • Sitting outside together on a nice, sunny day
  • Looking at old photos together

What are final stage care options for Alzheimer’s?

Caring for someone with Alzheimer’s can be a monumental task. Home care may not be sufficient even with additional assistance.

Some areas that need utmost care include foods and fluids, bowel and bladder function, skin and body health, infections and pneumonia, and pain and illness.

Here are some things to keep in mind:

  • Food and fluids: In the final stages, a person may find it difficult to eat and swallow. Hence, it becomes essential to monitor their eating.
    • As they are less active, they may require less food. At times, they may forget to eat or lose their appetite. If they show disinterest in food, as a caregiver, you can add sugar to foods or make their favorite food to encourage them to eat more.
    • If weight loss is an issue, you can add supplements between meals to maintain calories.
    • Try the following tips to help a person in late-stage Alzheimer’s to stay nourished:
      • Allow plenty of time to eat.
      • Make the person sit in a comfortable upright position and ensure they remain in that position 30 minutes after eating.
      • If swallowing is a problem, choose soft foods that are easy to swallow. Thickening liquids is a good option. Thickening agents, such as cornstarch or unflavored gelatin, can be added to water, juice, milk, and soup to increase its viscosity.
      • Encourage self-feeding. Sometimes, a person may need a cue to start eating. You can guide the person to feed themselves. Finger foods are another alternative if the person has difficulty using cutlery.
      • Guide the person with feeding. At times, you need to remind them to chew or swallow. Make sure the person has swallowed the food before serving the next bite.
      • Monitor their fluid intake. They might forget to drink water or may have trouble swallowing water. Find ways to ensure adequate fluid intake and prevent dehydration. Alternatives, such as fruit juice, sherbet, or soup, can be tried. Make sure that you don’t serve scalding hot water to them.
  • Bowel and bladder function: People in the final stages of Alzheimer’s are bound to lose their bowel and bladder function. The person may even need to be guided through the process.
    • Here are some tips to maintain bowel and bladder function in a person with Alzheimer’s.
      • Set and maintain a toilet schedule. It is essential to retain a written record about their daily routine. A bedside commode is a feasible option for those who are unable to go to the toilet.
      • Limit liquids at least two hours before bedtime. Be sure to keep them hydrated throughout the day to prevent dehydration.
      • Using adult disposable briefs and bed pads can give you some relief during the night.
      • If the person does not have bowel movements for three consecutive days, it could indicate constipation. In such cases, it is necessary to add natural laxatives to the diet, such as prunes or fiber-rich foods.
  • Skin and body health: People in their final stages may be bedridden or chair-bound, leading to the development of pressure sores, skin breakdown, and freezing of joints. 
    • Some tips to keep their skin and body healthy include
      • Change the person’s seating position at least every two hours to relieve pressure and improve blood circulation. Ensure that the person is comfortably seated or aligned.
      • Use gentle motions and avoid friction while cleaning to prevent injury.
      • Protect elbows, heels, hips, and other bony parts using pillows or pads. Apply skin moisturizer gently onto these areas.
      • Engage in range-of-motion exercises by carefully moving their arms and legs to prevent joint freezing, which is commonly seen in chair-confined people.
  • Infections and pneumonia: Infections are common in the final stage of Alzheimer’s. 
    • To prevent infections, you should
      • Keep their teeth and mouth clean to reduce the risk of developing bacteria inside the mouth.
      • Always clean the cuts with warm water and soapy solution and apply antibiotics afterward.
      • Protect yourself and the person with Alzheimer’s from flu and pneumonia by getting them regular vaccination.
  • QUESTION

    One of the first symptoms of Alzheimer’s disease is __________________.
    See Answer

    Medically Reviewed on 12/30/2021

    References

    Image Source: iStock Images

    Alzheimer’s Association. Late-Stage Caregiving. https://www.alz.org/help-support/caregiving/stages-behaviors/late-stage

    Cleveland Clinic. Stages of Alzheimer’s Disease. https://my.clevelandclinic.org/health/articles/11825-stages-of-alzheimers-disease

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