How to know when a person with dementia is nearing the end of their life

How long will a person with dementia live for?

Dementia is a life-limiting condition, but it is very difficult to know how long someone with dementia will live for. This depends on many factors.

If the person also has another life-limiting condition (such as cancer or heart failure), it may be clearer how long they may live for and how they will die.

A person may die from another condition at any stage of having dementia. Because of this, they may die before their dementia symptoms become very advanced.

A person in the later stages of dementia may get worse slowly over many months. During this time they will usually:

• become more frail
• have more frequent falls or infections
• have problems eating, drinking and swallowing
• be more likely to need urgent medical care
• become less mobile
• sleep more
• talk less often.

A person in the later stages of dementia is likely to have a weak immune system. This means they have a higher risk of getting infections, which in some cases can last for a long time. One of the most common causes of death for people with dementia is pneumonia caused by an infection.

A person in the later stages of dementia may have symptoms that suggest that they are close to death, but can sometimes live with these symptoms for many months. This uncertainty makes it very difficult to plan and put things in place for the end of someone’s life.

What are the signs that a person with dementia is nearing the end of their life?

Knowing when a person with dementia is nearing the end of their life can help with giving them the right care. However, it can be difficult to know when this time is.

This uncertainty can have a big impact on how the person feels and how their carers, family and friends feel.

Signs of late-stage dementia

Some symptoms of later-stage dementia can suggest the person is reaching the final stage  of their condition. These include:

• speech limited to single words or phrases that may not make sense
• having a limited understanding of what is being said to them
• needing help with most everyday activities
• eating less and having difficulties swallowing
• bowel and bladder incontinence
• being unable to walk or stand, problems sitting up and becoming bed-bound.

If a person with dementia has most or all of these symptoms, they are probably nearing the end of their life. They may have other problems such as being very frail, having infections that keep coming back, or pressure ulcers (bedsores).

Signs of the dying process

As someone’s condition gets worse and they are within a few days or hours of dying, further changes are common. The person may:

• deteriorate more quickly than before
• lose consciousness
• be unable to swallow
• become agitated or restless
• develop an irregular breathing pattern
• have a chesty or rattly sound to their breathing
• have cold hands and feet.

These changes are part of the dying process when the person is often unaware of what is happening.

How can healthcare professionals help at this stage?

Healthcare professionals can explain these changes so you understand what is happening.

Healthcare professionals can also take steps to reduce the person’s pain or distress, often using medication.

If the person can’t swallow, then medication can be provided through patches on the skin, small injections or syringe pumps that provide a steady flow of medication through a small needle under the person’s skin. Speak to a GP or another health professional about this.