In the late stage, dementia has progressed significantly, affecting all aspects of the person’s abilities. There may be a significant impact on memory and other cognitive functions. Their language abilities may also have changed, making it harder for them to express themselves with words, or to understand all that has been said to them. Participants will benefit from changes in your approach, particularly how you ask questions, and the kinds of activities you offer will have different results. At this stage engagement may look different from other groups – non-verbal responses like thumbs up or down, simply eye contact become some of the measures we look for – but engagement, and the benefits that come from it are still very powerful. This will be further explored in Module 6: Engagement and Wellbeing.
Kelly is in the later stages of dementia. She lives in long term care, and has lots of help with everyday activities. At the Gallery she listens to the conversation, and nods or signals when we ask questions. She paints every week, but needs some help getting paint on her paint brush. She and her husband usually make an artwork together, with her pointing to tell him where to paint. Sometimes she does it herself too. The paintings she makes don’t look like the steps we demonstrated, but she is really happy with her work. Her husband is really happy to see how engaged she is in the conversations and hands-on activities, and enjoys the time they spend working together.
When working with participants in the late stage, you will need to develop a good sense of each participant’s abilities and adapt your Approach, which we will discuss in Module 4: Understanding Approach, as well as your Activities, covered in Module 5: Understanding Activity. There are a lot of strategies for participants whose verbal or physical abilities have changed, as well as changes in cognition or perception. The way you plan, present and offer support in these instances are different, but have an amazing opportunity for enjoyment and engagement in the moment.