Coping with the Late-Stages of Alzheimer's

Reviewed by: HU Medical Review Board

Alzheimer's disease is a progressive illness that is often broken down into 7 general stages:1

  • Stage 1: Pre-clinical
  • Stage 2: Basic forgetfulness
  • Stage 3: Noticeable memory problems
  • Stage 4: Major memory loss
  • Stage 5: Decreased independence
  • Stage 6: Severe symptoms
  • Stage 7: Decreased or inability to control bodily functions

The stages do have some overlap. But each stage brings different symptoms and severity. Also, each person with the disease is different. So different people will progress through the stages at different times and show different symptoms.1

What is late-stage Alzheimer's?

Late-stage Alzheimer's is the most severe form of Alzheimer's disease. People with late-stage Alzheimer's have lost the ability to communicate and can no longer take care of themselves. They may be unable to recognize loved ones or even understand simple things. Late-stage Alzheimer's is very difficult for caregivers because it requires around-the-clock care.2

What are the symptoms of late-stage Alzheimers?

The symptoms of late-stage Alzheimer's can vary from person to person, but they typically include:2

  • Severe memory loss
  • Inability to communicate
  • Problems with movement and walking
  • Inability to hold urine or stool until it is time to use a toilet (incontinence)

Severe memory loss

In the later stages, memory loss becomes a lot worse. A person with late-stage Alzheimer's may:1,3,4

  • Not recognize family members or close friends
  • Forget relationships
  • Call family members or close friends by other names
  • Become confused about where they live or what year it is
  • Forget the purpose of common items, like a comb or pen

These changes are often very painful for the people who were closest to the person with Alzheimer's. Tips for coping with a loved one's severe memory loss include:3,4

  1. Create a routine and stick to it as much as possible.
  2. Use visual cues, such as pictures or written notes, to help the person remember things.
  3. Encourage the person to express their feelings.
  4. Make sure the person is getting enough sleep.

Inability to communicate

If the person you are caring for has lost the ability to communicate, there are still ways to connect with them:3

  • Try to spend time with the person every day.
  • Talk to them, even if they cannot respond.
  • Tell them about your day, what you have been doing, etc.
  • Read to them or listen to music together.
  • Touch them and hold hands if that comforts them.
  • Try to create a calm and relaxed environment.
  • Make sure they are getting enough sleep.

Problems with movement and walking

If the person with Alzheimer's disease cannot move, sit up, or walk on their own, they might need a professional home health aide. The home health aide can help show caregivers how to safely and correctly move the person or change their position.3

Ways you can help your loved one who has problems moving include:3

  • Help the person to stay active and move around as much as possible.
  • Exercise with them or do range-of-motion exercises.
  • Use assistive devices, such as a walker or wheelchair, if needed.
  • Be careful to avoid injuring yourself as well as the person with Alzheimer's when moving them.

Inability to hold urine or stool

Toileting problems are common in late-stage Alzheimer's. Some tips for coping include:3

  1. Create a daily toileting schedule.
  2. Encourage the person to drink plenty of fluids during the day.
  3. Make sure the toilet is easily accessible.
  4. Use products designed to help with incontinence, such as absorbent pads or underwear.
  5. Be patient and try not to get upset if accidents happen.

How is late-stage Alzheimer's treated?

There is no single treatment that will help every person with late-stage Alzheimer's. Treatment will vary depending on the person's needs. But some common supports for late-stage Alzheimer's are:2,3

Medicine to help with symptoms such as:

  • Memory loss
  • Confusion
  • Agitation

Therapies, such as:

Full-time care in a skilled nursing or assisted living facility
Hospice care for those who are terminally ill and not expected to live more than 6 months

Caring for yourself as a caregiver

Being a caregiver for someone with late-stage Alzheimer's is not easy. The person you once knew is not the same. It can be hard to see someone you care about going through a tough time. You may feel like you cannot do anything to help them.3

It is important to remember to take care of yourself, both physically and emotionally. Here are some tips:2-4

  • Reach out to other caregivers, friends, or family members.
  • Join a support group.
  • Take breaks when you can.
  • Exercise and eat a healthy diet.
  • Make sure to get enough sleep.
  • Find ways to relax and reduce stress.

You are not alone in this. There are millions of other caregivers out there who know how you feel. And there are plenty of resources available to help you cope with the situation.3The Alzheimer's Association offers a variety of resources for caregivers, including a 24/7 helpline (1-800-272-3900) and an online community. The National Institute on Aging also has a website with information and resources for caregivers.

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