Physical Care in Severe Late Stage Alzheimer's

by Christine Kennard Health Professional

The different stages of Alzheimer's bring with them different problems. In late severe stage Alzheimer's, the caregiver is now relied on to take the lead in directing and carrying out everyday tasks and looking out for all aspects of their care. You must pay special attention to non-verbal forms of communication, learn to read their body language and try to interpret the meaning of minimal words they express. Moods can be labile but they will gradually become more and more unresponsive. In the most severe stage of Alzheimer's, the person will have significant difficulties moving around and will become bedridden.

In this sharepost I have put together some information about main aspects of physical caregiving. I also provide some links to more information that I hope will help you.

Mobility Problems in Severe/Late Stage Alzheimer's

By this stage of Alzheimer's many people have significant mobility difficulties. Wandering often becomes a significant problem. You have to take steps to make the environment as safe as possible. Bed mattresses may have to be put on the bedroom floor. Safe garden layouts can help, but caregivers will probably need to escort them to avoid falls, which are very common at this stage of the disease. Medication to decrease anxiety may help but they have to be carefully prescribed and
monitored to avoid increasing falls further. Too much sedation can increase the likelihood of the person becoming bedridden, and can even hasten death.

Nutrition in Severe/Late Stage Alzheimer's

Giving someone in the severe stage of Alzheimer's a balanced diet can be difficult. Feeding problems, poor appetite, swallowing difficulties and general ill health can make getting the right amount of calories, fluids and vitamins, a challenge. Weight loss is common. A
feeding tube may
need to be considered. A dietician may be helpful to give you ideas on an appropriate diet, food supplement drinks, liquefying foods and feeding aids.

Avoiding Pressure Ulcers/Sores in Severe/Late Stage Alzheimer's

Skin care and frequent changes of position will help prevent pressure ulcers.

Pressure ulcers occur when you stay in one position too long. The blood supply to the area becomes depleted and the skin eventually breaks down especially if the skin is unclean and nutrition is poor. The areas particularly at risk are the elbows, heels, ankles, buttocks, shoulders, and the back of the head. A doctor should be consulted if the skin breaks down. More information about the treatment of pressure ulcers

Incontinence in Severe Late Stage Alzheimer's

Loss of continence, urinary and fecal, become an inevitable part of severe, late stage Alzheimer's. You will have to purchase appropriate materials and equipment such as mattress protectors, flannel coated rubber pads, nappies and may need to consider catheterization.

More information on incontinence in severe stage Alzheimer's

Incontinence in Elders

Toileting and Alzheimer's-Question and Answer

Incontinence: Insurance, Medicare and Medicade Coverage-Incontinence Products

Pain Control in Late Stage Alzheimer's

Effective pain management for people with late stage Alzheimer's is a complex issue. Families and health care professionals have to improve their observational skills and be sensitive to non verbal forms of communication to assess whether pain is present and then locate the area causing problems.

More information on Pain Assessment in Late Stage Alzheimer's

Christine Kennard
Meet Our Writer
Christine Kennard

Christine Kennard wrote about Alzheimer's for HealthCentral. She has many years of experience in private and public sector nursing care homes for people with dementia. She has worked in a variety of hospital, public and private health settings and specialized in community nursing. Christine is qualified in group analytic psychotherapy, is registered in general and mental health nursing and has a Masters degree.