Late stage dementia patients - what are they thinking?

[ElizaW]

I am pretty new at this, working with my first late stage dementia patient. I learned a little about this in school. Very little. I consider a patient to be disoriented if s/he cannot tell me his/her name, location, and the current date. My pateint's family believes that s/he is oriented to place and also recognizes family members. Is this possible or is it wishful thinking?

I wish I could tell what is going on in my patient's mind. Do dementia patient's brains retain any kind of organized functioning in the later stages? Is vocalization always a failed attempt at verbalization or could it just be random? How much awareness does a patient have when his or her brain is full of beta-amyloid plaques? I know every one is different, but I don't know what is possible.

[Rob72, ASN, RN]

It depends. It depends a great deal on exactly who made the diagnosis, as well, there are an unknown number of dementia patients with undiagnosed seizure activity, and possibly more, depending on the ability and thoroughness of the MD.

But, long-term memories are generally the last things to go, so recognizing family(possibly more by voice than face), certain smells and sounds, or pictures, is certainly possible. It is very much a regression, so in late-stage, gruntings/noises may simply be investigation of what sounds they can make, discomfort, concern, etc., much as it would be for newborn-3mos.