10 Signs Death is Near for Dementia Patients
Written By Kobi Nathan, Pharm.D., M.Ed., CDP, BCGP, AGSF
Sleep Disorders
April 7, 2023

Updated May 20, 2023.

Understanding the signs that death is near for people with Dementia can be essential for family members and caregivers in providing the necessary support and care during this difficult time.

This article will discuss ten key indicators that can signal the end of life for individuals suffering from advanced dementia.

My aim is to offer an informative yet understandable guide that will enable you to identify these signs of end-stage dementia and make appropriate arrangements for your loved ones.

Approaching End-of-life: Signs of end-stage dementia


Here are the 10 signs death is near for your loved one:

1. Physical decline and weight loss

  • Gradual decrease in mobility and strength.
  • Difficulty with basic tasks and personal care (getting dressed, toileting, etc).
  • Unintentional and significant weight loss.

2. Difficulty eating and swallowing

3. Increased sleeping and lethargy

  • Sleeping for longer periods.
  • Difficulty staying awake.
  • Unresponsiveness during waking hours.

4. Decreased communication and social withdrawal

  • Limited or no verbal communication.
  • Withdrawal from social interactions.
  • Inability to recognize family and friends.

5. Changes in breathing patterns

6. Incontinence and reduced bowel and bladder control

  • Loss of bladder and bowel control.
  • Increased frequency of incontinence episodes.
  • The need for diapers or incontinence pads.

7. Skin changes and increased susceptibility to infections

  • Pale, cool, and clammy skin.
  • Mottling and blotching of the skin.
  • Recurring infections or pressure sores.

8. Restlessness and agitation

  • Pacing, fidgeting, or repetitive movements.
  • Increased anxiety or distress.
  • Terminal restlessness (involuntary muscle twitching).

9. Disorientation and confusion

  • Increased confusion about time, place, and identity.
  • Hallucinations or delusions.
  • Personality changes.
  • Inability to follow simple instructions.
  • Memory loss is near total.

What are the stages of dementia that indicate death may be near for patients?

The stages of dementia that indicate death may be near for patients include severe cognitive decline, difficulty swallowing, increased vulnerability to infections, and loss of mobility and function. As the disease progresses, patients may require round-the-clock care and support. It is crucial for caregivers to be aware of these signs.

10. Changes in vital signs and lab results

  • Fluctuating blood pressure.
  • Altered heart rate and body temperature.
  • Abnormal laboratory results (kidney and liver function).


The video below from hospice nurses describes the dying process in an empathic and dignified manner:


Recognizing these ten signs and symptoms of impending death in end stage dementia patients can empower caregivers and family members to provide appropriate end-of-life care and comfort during this challenging period.

By understanding these indicators, you can ensure that your loved one receives the necessary support and attention as they transition into this last stage and palliative care or hospice care.

Remember, though, that each person’s experience is unique, and not all patients with dementia may exhibit all of these signs.

It is essential to consult with healthcare professionals for personalized guidance, but this article serves as a helpful starting point in navigating the final stages of dementia.

For more information about dementia, its causes, and its different types, please read my highly informative and detailed articles from the context of my work in clinical practice:

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