Knowing if an elderly person is "failing" involves observing physical, cognitive, and functional declines like increased confusion, poor hygiene, appetite loss, incontinence, mobility issues, withdrawal, and changes in sleep or breathing patterns, signaling a need for increased support, potential medical assessment, or end-of-life care discussions, according to Healthline, MedlinePlus (.gov), Always Best Care Senior Services, and the Alzheimer's Society.
Key signs 2 weeks before death at the end-of-life stages timeline: Extreme fatigue and increased sleep. A marked decrease in appetite and fluid intake. Irregular breathing patterns (Cheyne-Stokes breathing)
Sadock described sundowning as "a syndrome in older persons that usually occurs at night and is characterized by drowsiness, confusion, ataxia, and falling as the result of being overly sedated with medications".
Seven Signs Elderly Parents Need More Support at Home
The 7 physical needs of the elderly typically include proper nutrition, hydration, regular exercise, adequate rest, safe mobility, personal hygiene, and access to healthcare. These needs are essential for maintaining good health and preventing common age-related issues.
Do you care for your elderly parents? If so, you could be eligible for Carer's Allowance. This is a government benefit that supports people who provide unpaid care. Caring for your parents can be very rewarding, but it can also place a strain on your finances.
Signs of late-stage dementia
The 10 warning signs of dementia include memory loss, difficulty with familiar tasks, confusion about time/place, trouble with language, poor judgment, misplacing things, personality changes, loss of initiative, and problems with visual/spatial skills, requiring professional assessment to distinguish from normal aging.
Never argue, correct, or overwhelm your loved one with dementia; instead, avoid telling them they are wrong, don't bring up upsetting topics like the death of loved ones, and don't treat them like a child or talk down to them, focusing instead on validation and gentle redirection to maintain their dignity and reduce anxiety.
A Few Months Before Death
At first, usually over a period of 1–3 months, your loved one is likely to: Feel weak and become less active. Sleep or doze more. Eat and drink less, often preferring soft foods.
The following symptoms are often a sign that the person is about to die:
Hospice Isn't About Giving Up
It's not a place to speed up the process of dying. A doctor suggesting hospice does not mean they're giving up on providing care and medical treatment. It's end-of-life care, but this doesn't mean giving up hope. It means shifting focus from curative treatments to comfort and support.
Increased sleeping.
An increasing amount of time may be spent sleeping. The person may become unresponsive, uncommunicative, and difficult to arouse. This may be stressful for both the individual and their caregivers, as it may signal the approach of death and limit opportunities for communication and interaction.
Common risk factors associated with functional decline include history of falls, acute illness, delirium, cognitive impairment, depression, medication side effects, malnutrition, pressure ulcers, and decreased mobility secondary to incontinence.
Physical signs that death is near include:
The "2-finger test" for dementia involves an examiner showing a hand gesture (like interlocking index and middle fingers) and asking the patient to copy it, testing motor skills, visual memory, and coordination, as difficulties can signal early cognitive decline, but it's a screening tool, not a definitive diagnosis, prompting further medical evaluation. Other related tests include finger-tapping and finger-to-nose, looking for hesitation or misjudgment in movement.
Smoking, low physical activity, and a poor diet are all lifestyle and environmental influences that have been linked to rapid dementia decline. Physical activity promotes cardiovascular health, which in turn improves brain function. Those who lead a sedentary lifestyle may experience faster cognitive decline.
Terminal lucidity, or “the surge,” is an unexpected episode (occurrence) of clarity and energy before death. Neurodegenerative conditions that lead to dementia, like Alzheimer's disease, cause irreversible mental decline that can be hard to watch in a loved one.
Weird Things Dementia Patients Do: Strange Behaviors, Odd Symptoms, And Tips. Dementia can manifest in unexpected and often unsettling ways. From hoarding and wandering to aggression and hallucinations, these behaviors can be distressing for both the individual and their caregivers.
Life expectancy after a diagnosis of dementia decreases with increasing age. For example, an average person diagnosed with Alzheimer's disease between ages 70-79 can expect to survive seven more years, while a diagnosis after age 90 is associated with an expected survival of only 2.8 additional years.
Benefits for people with dementia
These include: Attendance Allowance – for those over State Pension age who need help at home; you can claim Attendance Allowance regardless of your income and savings. Personal Independence Payment (PIP) – for those under State Pension age who need help at home.
So, here are expert tips for what to do when elderly parents refuse needed care.
You may not think of yourself as a carer, particularly if the person with dementia is a partner, parent or close friend. But both you and the person with dementia will need support to cope with the symptoms and changes in behaviour. It's a good idea to: make sure you're registered as a carer with your GP.