stage: 6

Keeping someone with dementia comfortable at the end — the four things that matter most

Keeping someone with dementia comfortable at the end of life focuses on four areas: pain management, mouth care, positioning, and a calm environment. Pain is common in the final stages and may not be communicated verbally. Signs of discomfort include facial grimacing, restlessness, guarding of a part of the body, or changes in breathing. Medication given regularly, rather than only when distress is obvious, keeps pain consistently controlled. Mouth care matters because the person is likely to be taking very little fluid, and a dry mouth causes distress. Turning and repositioning prevents pressure sores and maintains dignity. The environment should be quiet, warm, and familiar — familiar voices, familiar music if the person responds to it, and the presence of people who knew and loved them. Touch and calm talking remain meaningful even when the person can no longer respond.