The later stage of dementia

By the later stage of dementia, the person will eventually need full-time care and support with daily living and personal care, such as eating, washing and dressing. Whatever kind of dementia a person has, their life expectancy is on average lower.

Dementia is a life-limiting condition and there is information about life expectancy on this page. Some people may find this upsetting and difficult to think about.

For more general information about the stages see The progression and stages of dementia page.

By the late stage of dementia, the condition will have a severe impact on most aspects of a person’s life. The person will eventually need full-time care and support with daily living and personal care, such as eating, washing and dressing. This support can be provided by care at home but is more often given in a care home setting.

Symptoms of all kinds are likely to cause the person considerable difficulties by this stage, but altered perception and physical problems are often the most noticeable.

By the late stage of dementia, the symptoms of all types of dementia become very similar. This stage tends to be the shortest. On average it lasts about one to two years. 

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What are the symptoms of late-stage dementia?

Memory and language difficulties in the later stages of dementia

Many people will struggle with memory of recent events and they may often think they are at an earlier period of their life (‘time shifting’). This can cause challenging situations, for example if they ask to see someone who is no longer alive.

People in the later stages may also stop recognising familiar places, objects and people. A person may not recognise themselves in a mirror, nor a close friend or family member. This is because they only remember how the person looked when they were much younger.

If a person speaks more than one language, they may lose the one they learned later in life. Eventually, they may only understand the language of their childhood.

A person’s spoken language in late-stage dementia may eventually be reduced to a few words or lost altogether. They may also understand fewer words. But a person may still be able to understand gestures, facial expressions and body language. They may also use non-verbal communication to express their feelings or needs.

Mood, emotions and perceptions in the later stages of dementia 

Changes in mood remain in the later stages of dementia. Depression and apathy are particularly common.

Delusions and hallucinations (especially of sight and hearing) are most common in the late stage of dementia. They are not always distressing but they can explain some changes in behaviour, because the person’s perception of reality is altered.

People with late-stage dementia often respond more to senses than to words. For example, they may like listening to songs or enjoy textures (for example, the feel of different types of material).
 

Changes in behaviour in the later stages of dementia

The changes in behaviour that can happen in the middle stage of dementia can also all happen in the late stage.

Aggression at this stage is often a reaction to personal care. Someone may hit or push away those trying to help them, or shout out to be left alone.

The person with dementia may have felt scared, threatened or confused.

Restlessness is also very common. Sometimes the person may seem to be searching for someone or something.

As in other stages, it is also important to consider whether the person has other needs that aren’t being met. Someone with late-stage dementia will often be unable to tell others how they are feeling. A sudden change in behaviour can point to a medical problem (for example, pain, infection or delirium).

Physical difficulties in the later stages of dementia 

The physical changes of late-stage dementia are partly why the person is likely to need much more support with daily living. At this stage they may:

  • walk more slowly, with a shuffle and less steadily – eventually they may spend more time in a chair or in bed
  • be at increased risk of falls
  • need a lot of help with eating – and so lose weight
  • have difficulty swallowing 
  • be incontinent – losing control of their bladder and bowels.

The person’s reduced mobility in particular raises their chances of blood clots and infections. These can be very serious or even fatal so it is vital that the person is supported to be as mobile as they can.

How long will a person with dementia live for?

Whatever kind of dementia a person has, their life expectancy is on average lower. This is why dementia is called a life-limiting condition. This can be very upsetting to think about. However, it’s important to remember that, no matter how a person’s dementia changes over time, there are ways to live well with the condition.

Good support can make a huge difference to the person’s quality of life at all stages.

How long a person lives with dementia varies greatly from person to person. It depends on many factors, such as the ones listed on The progression and stages of dementia page.

Other factors include:

  • how far the dementia had progressed when the person was diagnosed
  • what other serious health conditions the person has – such as diabetes, cancer or heart problems (and how long they have had these) 
  • how old the person was when their symptoms started – older people (over 65) are more likely than younger people (under 65) to have other health conditions that may lower their life expectancy. A person in their 90s who is diagnosed with dementia is more likely to die from other health problems before they reach the later stages than is a person diagnosed in their 70s.

How does dementia reduce life expectancy?

Dementia reduces life expectancy in two ways.

First, some of the diseases that are closely linked to Alzheimer’s disease and vascular dementia, such as diabetes and cardiovascular disease, lower life expectancy. For example, vascular dementia is closely linked to heart disease and stroke. A person with vascular dementia is at risk of dying, at any stage of dementia, from one of these.

The other way that dementia reduces life expectancy is through the effects of severe disease. By the late stage a person is often very frail with a weakened immune response, likely to be spending a lot of time in bed and possibly having problems swallowing. These all make them much more likely to develop other medical problems that can lead to death, such as infections (like pneumonia) or cardiovascular problems (like a blood clot in the brain or lungs). This is why the late stage of dementia is often the shortest.

A person with dementia can also die at any stage from another condition not closely related to their dementia. Cancer and lung disease are common examples.

Does the type of dementia affect life expectancy?

The type of dementia a person has can also affect how long they live with dementia. These figures for the number of years a person may live after a diagnosis are just averages and some people live longer than this.

This information may be upsetting to read and think about but it is very important to remember that, with the right support, people with dementia can live well at all stages. 

What are the average life expectancy figures for the most common types of dementia?

The average life expectancy figures for the most common types of dementia are as follows:

  • Alzheimer’s disease – around eight to 10 years. This is less if the person is diagnosed in their 80s or 90s. A few people with Alzheimer’s live for longer, sometimes for 15 or even 20 years.
  • Vascular dementia – around five years. This is lower than the average for Alzheimer’s mostly because someone with vascular dementia is more likely to die from a stroke or heart attack than from the dementia itself.
  • Dementia with Lewy bodies– about six years. This is slightly less than the average for Alzheimer’s disease. The physical symptoms of DLB increase a person’s risk of falls and infections.
  • Frontotemporal dementia – about six to eight years. If a person has FTD mixed with motor neurone disease – a movement disorder, their dementia tends to progress much quicker. Life expectancy for people who have both conditions is on average about two to three years after diagnosis.

To find out about the support available to someone at the end of their life, and to their carers, family and friends, see our End of life care information.

You can also call Alzheimer’s Society on 0333 150 3456 for personalised advice and support on living well with dementia, at any stage.

Dementia Connect support line
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