Alzheimers late stage is the last stage of the disease and it can last from 1 to 3 years. It is the most physically demanding stage of the disease. During the late stage, they become completely dependent on others for all of their needs. Their personality will fade and you will see rare glimpses of the person they were.
Communication skills are almost completely gone. They can no longer find the words to speak, if they do speak it is often nonsense or unable to be understood. They will reach a point where they can no longer recognize anyone.
Behaviors are fading. They are being replaced by the inability to function. They will lose the ability to walk. During the transition from middle stage to late stage is when they are at the highest risk for falls. They will need physical assistance to transfer from bed to chair.
Nutrition becomes increasingly difficult as the appetite fades along with the memory of how to eat. I have found that the sweet tooth is often the last to go. You will need to find what works for your family member and stick with it. There are several types of health drinks on the market now, try to find one they like and keep it on hand (they usually taste better cold).
They will reach the point when they become completely incontinent. All of their hygiene needs will have to be completed by someone else. They will become chair or bedridden and bathing in water will become a thing of the past. Sponge baths will become a part of your daily routine and it is best if you have a daily routine. Keeping them on a routine from the beginning will help them hold onto their memory for daily activities as long as possible
Sleep will overtake more of their day as the disease progresses. At this point you will need to begin to reposition them while they are sleeping. They will lose the ability to reposition themselves in bed or a chair. If they lay or sit for long periods of time their skin will break down. This will lead to what most people refer to as bed sores. I recommend repositioning them every 2-3 hours to maintain blood flow to those areas.
Often in the Alzheimers late stage caregivers are at home alone with their family member. This should not be your situation! You need what is referred to as respite time. You need to take time away several times a week. If you don't you will wear down and become sick. Most caregivers feel guilty about leaving their family member at home and going out for social activities. This is a very important part of your life that you should make time for. Failure to take time out for yourself can lead to caregiver burnout.
End stage dementia patients usually qualify for Hospice benefits under medicaid, medicare, and private insurances. Hospice can provide care to patients in the home or long term care facility. Hospice can help with direct patient care, medication management, and emotional support for the caregiver. Please check with the hospice providers in your area to determine if you are eligible for these benefits!
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