Activities for Late-Stage Dementia, Including in Bed or a Chair

In the late stage of dementia, a person may speak very little, need help with all daily care and spend much of the day in bed or a chair. It can feel as if there is nothing left to do together. There is. The Alzheimer’s Association notes that some core of the person’s self may remain, and that at this stage the world is experienced mainly through the senses. Music, touch, a familiar voice and your calm company can still bring comfort and moments of connection.

What activities help in late-stage dementia?

Simple sensory activities and quiet company help most in the late stage. The Alzheimer’s Association suggests playing favorite music, reading parts of meaningful books, rubbing lotion with a favorite scent into the skin, and sitting outside together on a nice day. The National Institute on Aging adds telling stories, showing photos, gentle touch or massage, and music, white noise or nature sounds, and says your presence alone can be calming.

The Alzheimer’s Foundation of America notes that people in the late stage often have a strong need to hold something close for comfort, and suggests simple sensory activities, gentle stretches, scarf movement, music, animal visits, human touch and free-form art.

Activities for someone in bed or a chair

1. Play their music. Choose songs from their young adult years, their faith or their family. Keep the volume soft and sit close. Even now, some people tap a finger or hum. See music activities.
2. Hold hands. Just holding a hand, with a gentle thumb stroke, is an activity. Say what you are doing first.
3. Give a slow hand massage. Warm a little lotion in your palms and stroke from wrist to fingertips. Choose unscented lotion, or a scent they always loved if their skin tolerates it.
4. Read aloud. A favorite poem, a passage from a well-loved book, scripture or the sports page. The rhythm of your voice matters more than the words.
5. Tell a story. Talk about a family trip or the day they got married. You do not need replies.
6. Show photos. Hold one large photo at a time at eye level and describe it warmly. Avoid asking who is in it.
7. Offer something soft to hold. A folded washcloth, a fleece square or a soft animal. The NIA suggests giving the person a washcloth to hold while being moved, so they are less likely to grab at you or the furniture.
8. Play nature sounds. Rain, waves or birdsong at low volume can soften a noisy room.
9. Bring the outside in. Open the curtains, place a bird feeder outside the window, or bring in a few fresh flowers or leaves to look at and touch.
10. Go outside. If the person can sit in a wheelchair, a few minutes in the shade on a mild day can be lovely.
11. Brush their hair or offer a warm cloth. Slow, gentle grooming and a warm washcloth for hands and face can feel caring.
12. Move gently with music. Wave a light scarf together, or sway hands in time to a song. For stretches and joint movement, ask a physical therapist or nurse to show you safe ways first.
13. Make free-form art. Spread non-toxic paint on large paper with a sponge or a hand, guided by yours. There is no right result.
14. Welcome animal visits. A calm pet on the bed or lap, if the person enjoyed animals and the setting allows it.
15. Breathe slowly together. Sit close and breathe slowly and audibly. Calm breathing can pace you both, and you start and stop it.
16. Simply be there. Sit nearby, hum, knit or read quietly. Being present is enough.

How to share an activity at this stage

• Approach from the front. Say their name and your name, and speak slowly and softly before you touch.
• Offer one thing at a time. Turn off the TV before playing music. Do one sense at a time.
• Keep it short. A few minutes may be plenty. Several short moments across the day are better than one long session.
• Get comfortable first. Check that the person is well supported. The NIA suggests a lap board to rest the arms and support the upper body when sitting up.
• Watch the response. Relaxed hands, a softer face, eye contact or humming suggest comfort. The NIA notes that groans, grimacing, guarding part of the body or sudden agitation can be signs of pain. Stop, and tell the care team.

A quick guide by sense

Safety at this stage

Swallowing can become difficult in the late stage, and the NIA warns that this raises the risk of choking. Do not leave small objects within reach, and only offer food or drink in the textures and positions the care team recommends. Check skin gently during touch activities, since skin can tear or bruise easily. For more on safe sensory ideas, see sensory activities.

Looking after yourself too

Late-stage caregiving is physically and emotionally demanding, whether at home or during visits to a care home. Hospice and palliative care teams can help with comfort, support and planning, and the NIA lists them as a source of help. Short, calm visits are worthwhile; see visiting someone with dementia. If you lead groups, care home group activities has ideas for adapting sessions. And please read caregiver self-care: rest is part of caring well.