Late-Stage Alzheimer’s Symptoms

Reviewed by: HU Medical Review Board | Last reviewed: May 2023

Alzheimer’s disease has 3 stages. Late-stage Alzheimer’s is the final one. Symptoms become severe. The person with Alzheimer's eventually loses the ability to respond to their environment.1

Someone in this stage may:1

  • Be unable to communicate in full sentences
  • Be unable to carry on a conversation
  • Show significant changes in personality or mood

People with late-stage Alzheimer’s still benefit from care and compassion. Understanding symptoms at every stage can help caregivers. If you are a caregiver, knowing the symptoms can help you tell what is out of the ordinary and respond appropriately.

Physical symptoms

Late-stage Alzheimer’s can cause the most physical symptoms of all the stages. The extent of physical changes is different for each person. Someone with late-stage Alzheimer’s will likely need daily assistance:1-3

  • Walking
  • Sitting
  • Grooming
  • Going to the toilet

People with late-stage Alzheimer’s also experience a general physical decline. They may lose their appetite, causing them to lose weight. Many people develop dental, skin, and foot problems. Bedsores can also be an issue, especially for people who may not be physically active. Sleeping more, seizures, and loss of bladder and bowel control are also common symptoms.1,2

Pneumonia and other infections become more major problems in late-stage Alzheimer’s. In fact, a common cause of death for people with late-stage Alzheimer’s is aspiration pneumonia.2

This type of pneumonia can happen when a person cannot swallow properly. Instead of taking air into their lungs, they breathe in food or liquids. Watch your loved one with Alzheimer's for any issues swallowing food or drink. Help them if you can and alert their doctor to changes.2

Emotional and cognitive symptoms

During late-stage Alzheimer’s, people lose awareness of recent experiences and their surroundings. They have difficulty communicating, especially verbally. They may not be able to speak in full sentences or in ways that make sense to others. However, someone with late-stage Alzheimer’s may still say words or phrases. They may also grunt or moan to communicate.1-3

Assistance and care during late-stage Alzheimer’s

In this stage, the person with Alzheimer’s requires the most amount of assistance with daily care. Someone may need around-the-clock monitoring and assistance with things like toileting and eating. During this stage, caregivers should focus on preserving dignity and quality of life.1,4

Though a person with Alzheimer’s will seem very changed, research has shown us that some of the person’s self may remain. They can still benefit from things like listening to relaxing music or watching their favorite movie. They may not communicate without prompting. But you can still engage and connect with them.1,4

Care needs can begin to exceed what you can provide at home during late-stage Alzheimer’s. A person may need to move into a full-time care facility in order to get the help they need. Deciding on late-stage care can be difficult. There are many ways to get quality care. The most important part is making sure the person is safe and cared for.4

Once late-stage Alzheimer’s moves towards end-of-life care, hospice is another option. Hospice can provide dignity, comfort, and care for people with terminal illnesses and their families. Ideally, the person with Alzheimer's will have shared in making these end-of-life decisions while they still could.4

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