Dementia may be progressing, but the person is still there

Dementia may be progressing, but the person is still there

Activities for people with advanced and final stage dementia

By Notis Paraskevopoulos, MSc in Dementia


The philosophy of care for people living with advanced and final stage dementia is based on preserving the patients’ comfort, dignity and quality of life, as well as the support of their caregivers.

As dementia progresses towards its final stage, it is useful to know that his may last from a few weeks to several years. In any case, as dementia progresses, continuous care becomes necessary.

It is easy to suppose that when a person with dementia has serious speech problems and there seems to be no other channel of communication, or when that person spends the biggest part of their day bed-bound, that more emphasis should be given to their physical condition and comfort and less on activities. However, even at an advanced stage, a person living with dementia can still feel loneliness, boredom or even displeasure.

Activities – Planning and objective

Even though at the final stage of dementia the focus is usually at swallowing, early infection treatment and pain management, research has shown that part of the individual identity of the person is still there. This means that we can keep up our effort to communicate with the patient even at that stage of the condition.

When dementia is at an advanced stage, the environment is usually perceived through the senses. By focusing on the senses, it is possible to convey positive feelings of relief and satisfaction to the patient. For example:

  • Smell: Flowers, food being prepared, essences, a favourite after-shave lotion
  • Hearing: Favourite music, a song sung by the personnel, a musical instrument, the sound of laughter, the birdsong, reading extracts from books, magazines or newspapers.
  • Touch: Simply holding and/or caressing their hand, softly touching their face, hugging, treating their hair.
  • Taste: The sense of sweet, a cold drink.
  • Eyesight: Intense and clear colours within their field of vision, periodical change of position (bed, wheelchair, armchair) for varying views, smiling staff, old photos and pictures.

It should be kept in mind that the objective is not for a stimulus to confuse the person, but to trigger reaction and communication. The choice of activities should be systematic and periodical, and they should be implemented with empathy, patience, sensitivity and respect. Attention should be given to realistic expectations, and it is necessary to monitor and record any change in movement, expression, or sound.

Communication does not come to a halt as dementia progresses, but is rather restricted to visual contact, hands movement and touch. Below are some activities which relieve, reduce confusion, and develop a sense of well-being.

  • Light massage to the palms with a lightly scented hand cream.
  • Providing accessories such as sensory pillows.
  • Contact with pet animals.

The important role of the care-giver and the daily life of the health professional

Even though the weight of care is, reasonably, directed to the persons with dementia, providing support to care-givers and healthcare professionals is also necessary, so as to provide time for emotional release and access to appropriate information and training on managing the emotional load and the stress accumulated from their contact with the persons with dementia. Especially in the case of health professionals, it is crucial that clear guidelines be provided for the different ways of approaching and communicating with people with advanced and final stage dementia.

In conclusion, it is important to know and to really believe that whatever can help a person with dementia feel loved and cared about is a safe and sometimes the only path to care-giving.

For more details and available services, visit or call our ‘Information and support line for the Elderly and People living with Dementia’ at (0030) 212 000 8711


Alzheimer’s Association 

social care institute for excellence 



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