5 Things You Need to Know About the Senses at End of Life with Dementia

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By Polly LoganSeptember 15th, 2021

5 Things You Need to Know About the Senses at End of Life with Dementia

Knowledge and Tips to Help You Offer Comfort
By Polly Logan
Are you caring for a loved one living with dementia? The end of life is not always a topic that is easy or comfortable to discuss. Thinking about the end of your loved one’s life can certainly be extremely painful, but most would agree that they would wish their friend or family member to be as comfortable as possible as their time on earth draws to a close.

Being willing to learn and have a better understanding of end-of-life care can greatly increase the chances of a more positive experience for all. To help you provide comfort during their end of life phase, here are five things for you to keep in mind as you offer care:
1. Hearing
An image of an earWhen individuals are approaching the end of life, they often spend more time asleep than awake. During the last few days, they may be in such a deep sleep that they do not respond when you try to wake them. This state of lowered consciousness is normal at end of life.

However, what you may not realize, is that the medical community generally believes that the individual can still hear what is going on around them. Even if they are not able to visibly respond to you, it is thought that they can hear and recognize familiar voices, music, and other sounds.

So, it is important to be aware of the conversations you are having while near to them. Try speaking directly to the individual in a calm, slow voice, or playing their favorite music. You don’t have to speak to them all of the time or have music constantly playing – some silence is definitely fine – but keep in mind that familiar voices and music can be an important source of comfort.
2. Sight
At the end of life, sight is frequently not a sense that is used as often as the others. If the person is living with dementia, their visual field may be dramatically reduced. Other conditions such as cataracts or glaucoma may have reduced their vision. Even if their vision is still clear, people at the end of life generally spend quite a bit of time with their eyes closed, either sleeping or resting. 

If they do open their eyes, keep in mind that their visual processing speed may be reduced. Hold still so that they can more easily focus on your face. Try to be within an arm’s length or so away – if you are too close or too far from them, they may not be able to focus as easily. You might also provide other pleasant objects in close range for them to look at, such as flowers, favorite photos, or paintings.
3. Taste
An image of a man about to taste something on a spoonIt is very normal for individuals to stop eating and drinking much of anything towards the end of their lives. Many don’t realize that the body’s hunger and thirst mechanisms typically decline, so they are no longer experiencing hunger or thirst as we do. However, some people still enjoy a small taste of their favorite foods or beverages as a source of comfort.

Think about how something like the taste of coffee, homemade apple pie, or a favorite family recipe can bring joy. This can often still be true for those at the end of life. Even if they are no longer eating for nourishment, your person may enjoy a taste of something that is a favorite. If they are no longer having an easy time swallowing, you could put a small amount of their favorite beverage or food on a mouth swab and encourage them to gently close their mouth around it to get some of the flavor. If it is not something too appealing to them at that moment, it is typically pretty easy to tell from their response.
4. Smell
An image of lavender blossoms and a bottle with essential oilWhile it is thought that the sense of smell can be diminished at end of life, especially for those living with dementia, providing pleasant fragrances can be another way to offer comfort. It is especially helpful if you can make a list of their favorite smells and scents while they are still able to verbalize this. Some ideas are favorite perfumes or colognes, outdoor scents such as grass or particular flowers, and food scents.

Essential oils can be very convenient and portable for providing scents. You can try putting a bit of one of their favorite scents on a scarf that they can have close to them. This is typically more effective – and sensitive to those nearby – than trying to spritz a scent into the air. Try several scents, and notice if they react differently to any of them. Just as you may not enjoy smelling the same scent at all times, provide them a variety of pleasant scents for them to experience.
5. Touch
An image of a person holding an old person's handJust as it is believed that those at the end of life can still hear and recognize sounds, it is also felt that they are able to recognize touch, as well. Even when they may no longer have the strength to squeeze your hand or move their head in response to your touch, it is most likely that they are still experiencing a sense of comfort in this contact.

Keep in mind that light, fleeting touch can evoke an unpleasant ticklish sensation and can be a bit alarming, like the feeling of a bug crawling on one’s skin. Instead, use slow, gentle pressure. Some individuals respond well to gentle massage as pain relief, while others prefer the sensation of a still hand placed firmly on the back of their hand, their shoulder, or just above their knee.

Even if the individual is not able to offer much of a response, it is always recommended to alert them to your presence visually and verbally before touching them. For instance, if they have their eyes closed, then you may try softly saying Hi Nancy, it’s Becky from several feet away. If they do not respond, come a bit closer and repeat it, before touching them. Coming close and abruptly speaking into their ear or touching them before alerting them to your presence may startle them unpleasantly. 

When the very end of life is near, many hospice professionals and others in the field of health care have noticed that giving an individual permission to go can be very helpful. Simply speaking to them and letting them know that you will be okay and they can let go may be very painful for you, but may be what is needed to help them make the final transition and be at peace.
An image of a woman holding her husband's hand in a hospitalSeeing a loved one experience their end of life can be extremely painful. Being aware of how the person’s senses change can help and allow you to offer the most comfort possible.

By speaking to them softly or playing their favorite tune, staying close to them so they can see you, offering bits of tastes and smells they like, and knowing that you’re near through touch, you can let them know that they are loved and cared for.

And while this journey is so very challenging, knowing that you were able to offer comfort may help bring a little peace and calm to your heart as well.
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Looking to Learn More about End of Life Care?
Watch Teepa Snow's End of Life Care and Letting Go online now:
Learn to recognize a person’s progression into the final stages of dementia and provide the best care with Teepa Snow’s hands-on, disease-level appropriate techniques.
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5 Comments on “5 Things You Need to Know About the Senses at End of Life with Dementia”

  1. Your information about Dementia is very helpful to apply for the best of care giving needed to effectively help those who have dementia.

  2. These suggestions were very helpful.
    I would like to have an article or video on how to deal with incontinence. Not about the types of supplies available, but how to convince my spouse to wear them. This is my current challenge any any help you can give me would be appreciated.
    Thank you.

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