Dementia is recognised as a life-limiting condition for which palliative care is appropriate and beneficial. Advanced dementia leads to severe memory loss, loss of verbal communication, difficulty swallowing, and full dependence on care. For you, this stage requires a strong focus on comfort, dignity, and symptom management. Recognising pain, managing distress, and supporting families are essential to providing compassionate care.
What I can do
People with advanced dementia may struggle to express their needs but you can help by:
- Using touch, eye contact, and facial expressions to foster connection
- Identifying signs of discomfort, such as restlessness or changes in breathing, and responding promptly
- Speaking calmly and reassuringly, even if the person cannot respond with words.
Each person’s history, preferences, and routines matter. To support people in your care:
- Maintain familiar daily routines as much as possible
- Encourage family and carers to do what brings the person comfort
- Create a soothing environment using familiar objects, music, or scents.
People with advanced dementia may experience distressing symptoms. You can support them by:
- Recognising distress through changes in facial expressions, body language, or behaviour
- Using validated assessment tools such as the IPOS-Dem or Abbey Pain Scale (226kb pdf)
- Looking for signs of choking or difficulty swallowing and working with the team to adjust food textures and offer support at mealtimes.
What I can learn
The palliAGED Practice Tip Sheets give helpful guidance on supporting older people with advanced dementia near the end of life. There are topics on:
To learn more about advanced dementia:
Use these learning opportunities to build skills and knowledge (free but registration required):
What I can give
If an older person, their family or carers wishes to learn more about advanced dementia, these resources may help:
What I can suggest
Develop staff knowledge and skills in caring for people with advanced dementia by:
- Offering regular mandatory dementia-specific training focused on person-centred communication, behavioural support, and end-of-life care
- Implementing the Dementia toolkit from ELDAC
- Making the team aware of the supportive resources offered by Dementia Australia and Dementia Training Australia.
Create dementia-friendly end-of-life care environments. Consider:
- Designing dedicated spaces for people in the final stages of dementia, ensuring reduced noise, natural lighting, and personalised familiar objects
- Offering open-door visiting policies to allow families to stay overnight and be actively involved in care
- Using personalised sensory interventions such as aromatherapy, therapeutic touch, and familiar music to enhance comfort in the last days.
Recognise the important role of family and carers and offer them support through:
- Practical strategies and resources for supporting people with dementia at home
- Guidance on what to expect in the final stages, including symptoms and their management
- Acknowledging their ‘living grief’ and the emotional toll of witnessing dementia progression.
Page updated 17 March 2025