Signs that the end is near with dementia include extreme weakness, little or no eating or drinking, much more sleeping, trouble swallowing, shallow breathing, and skin changes like cold hands or bluish colour. The person may not respond much or seem restless at times. Infections become harder to fight, and the body slows down overall. These changes often happen in the final weeks or months. Comfort care is the main focus, with pain relief, mouth care, and a calm environment. Families should talk to hospice or doctors about what to expect.