Mental and physical activities in the later stages

As dementia progresses to the later stages, people may have difficulties concentrating and remaining mobile.

Concentration, planning and organisation

The person may also develop increasing difficulties with other mental abilities, such as concentrating, planning and organising. For instance, they may only be able to carry out simple activities, or not be able to concentrate for too long. They may be increasingly disorientated and have difficulties recognising where they are. They may have a limited understanding of time.

Meaningful activities

However, the person may still get enjoyment from past hobbies, interests and activities. Find opportunities to make these meaningful. This could be doing anything that the person benefits from whether this is enjoyment, fulfilment or comfort.

Even if they are restricted with what they can manage, they can still enjoy the feelings and sensations of an activity. For example, they may enjoy the feel of wool even if they can no longer knit, or listening to favourite songs even if they can’t sing along. In the later stages people may respond more to things that stimulate their senses (sight, hearing, smell, touch and taste), than to words. Think of ways to stimulate the person’s senses and help with how they feel in that moment. For example, they may enjoy stroking a pet, tasting their favourite food or looking at familiar photos.

Mobility

Dementia is likely to have a big physical impact on the person in the later stages of the condition. They may gradually lose their ability to walk, stand or get themselves up from the chair or bed. They may also be more likely to fall. These problems can be caused by dementia, medication, other medical conditions (for example stroke), sight loss, balance problems and the environment. However, not all people will have problems with mobility.

Many people with dementia (especially in the later stages) find themselves staying in one position for a long time (such as sitting in a chair) and not moving around much. This means they are at risk of pressure ulcers (bedsores). If you notice a pressure ulcer or have concerns speak to the GP or community nurse. They can be easy to prevent early on, but if they go unnoticed they can get worse and become painful and infected. 

Pressure ulcers and bedsores

Find out how to spot and treat pressure ulcers in people with dementia.

Pressure ulcers

As a person’s mobility decreases they are also at risk of infections and blood clots. The person should be supported and encouraged to move around as much as they are able, for example through support to walk or chair-based exercises. An occupational therapist or physiotherapist can help with this. Read more about exercise and physical activity for people in the later stages of dementia.

Ask for advice on the best ways to support the person to move without injuring themselves. Speak to the GP, or a community nurse, occupational therapist or physiotherapist for more advice. An occupational therapist can give advice about equipment and adaptations to help with mobility. Find out about equipment and adaptations to the home.

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