At the final stage of dementia the person has severely limited or no verbal communication, is fully dependent for all activities of daily living, and is often largely immobile. Muscle stiffness and contractures are common. Swallowing becomes very difficult, raising the risk of aspiration pneumonia. The person is typically awake for only brief periods and may show little recognition of you or other family, though emotional responses such as comfort or distress can still be present. Palliative and end-of-life care at this stage focuses entirely on comfort, dignity, and freedom from pain rather than medical intervention aimed at prolonging life.