In the final stage of dementia, sometimes called stage 7, there are recognisable signs that death may be approaching. The person typically becomes largely or entirely non-verbal, spending most of their time asleep. They lose the ability to walk, sit upright, or hold their head up, and muscle contractures can develop. Swallowing becomes very difficult, leading to reduced food and fluid intake. The skin may become mottled, particularly on the hands, feet, and knees. Breathing often becomes irregular, with longer gaps between breaths. Hands and feet may feel cold to the touch while the core remains warm. These changes can occur over days or weeks. Specialist palliative care teams and hospice nurses can support both the person and their family through this final stage.