Editing Dementia (section)

=== Late ===
People with late-stage dementia typically turn increasingly inward and need assistance with most or all of their personal care. People with dementia in the late stages usually need 24-hour supervision to ensure their personal safety, and meeting of basic needs. If left unsupervised, they may [[Wandering (dementia)|wander]] or fall; may not recognize common dangers such as a hot stove; or may not realize that they need to use the bathroom and become [[Urinary incontinence|incontinent]].<ref name=hugo/> They may not want to get out of bed, or may need assistance doing so. Commonly, the person no longer recognizes familiar faces. They may have significant changes in sleeping habits or have trouble sleeping at all.<ref name="Memory Loss" />

Changes in eating frequently occur. Cognitive awareness is needed for eating and swallowing and progressive cognitive decline results in eating and [[swallowing difficulties]]. This can cause food to be refused, or choked on, and help with feeding will often be required.<ref name="Payne">{{cite journal | vauthors = Payne M, Morley JE | title = Editorial: Dysphagia, Dementia and Frailty | journal = The Journal of Nutrition, Health & Aging | volume = 22 | issue = 5 | pages = 562–565 | date = May 1, 2018 | pmid = 29717753 | doi = 10.1007/s12603-018-1033-5 | s2cid = 13753522 | doi-access = free }}</ref> For ease of feeding, food may be liquidized into a thick purée. They may also struggle to walk, particularly among those with [[Alzheimer's disease]].<ref name="Sala Della et al. 2004">{{cite journal | vauthors = Della Sala S, Spinnler H, Venneri A | title = Walking difficulties in patients with Alzheimer's disease might originate from gait apraxia | journal = Journal of Neurology, Neurosurgery, and Psychiatry | volume = 75 | issue = 2 | pages = 196–201 | date = February 2004 | pmid = 14742586 | pmc = 1738895 | url = https://jnnp.bmj.com/content/jnnp/75/2/196.full.pdf | url-status = live | archive-url = https://ghostarchive.org/archive/20221009/https://jnnp.bmj.com/content/jnnp/75/2/196.full.pdf | archive-date = October 9, 2022 }}</ref><ref>{{cite journal | vauthors = Mc Ardle R, Galna B, Donaghy P, Thomas A, Rochester L | title = Do Alzheimer's and Lewy body disease have discrete pathological signatures of gait? | journal = Alzheimer's & Dementia | volume = 15 | issue = 10 | pages = 1367–1377 | date = October 2019 | pmid = 31548122 | doi = 10.1016/j.jalz.2019.06.4953 | doi-access = free }}</ref><ref>{{cite web |title=Mental, physical and speech abilities in later stages of dementia |url=https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/how-dementia-progresses/mental-and-physical-activities |website=Alzheimer's Society |date=June 29, 2022 |access-date=July 30, 2022}}</ref> In some cases, [[terminal lucidity]], a form of [[paradoxical lucidity]], occurs immediately before death; in this phenomenon, there is an unexpected recovery of mental clarity.<ref>{{cite journal | vauthors = Mashour GA, Frank L, Batthyany A, Kolanowski AM, Nahm M, Schulman-Green D, Greyson B, Pakhomov S, Karlawish J, Shah RC | display-authors = 6 | title = Paradoxical lucidity: A potential paradigm shift for the neurobiology and treatment of severe dementias | journal = Alzheimer's & Dementia | volume = 15 | issue = 8 | pages = 1107–1114 | date = August 2019 | pmid = 31229433 | doi = 10.1016/j.jalz.2019.04.002 | doi-access = free | hdl = 2027.42/153062 | hdl-access = free }}</ref>