(Minimal awareness, almost total dependence, profound memory loss)

Stage 8 represents a deep level of dementia progression.
A person now requires 24-hour full care, with greatly reduced awareness of surroundings, minimal communication, and major physical decline.

Although verbal ability and memory are extremely limited, the person can still feel:

• Comfort
• Warmth
• Touch
• Familiar voices
• Soothing music
• Emotional presence

This is a stage focused on comfort, safety, and dignity.

• Does not recognise family or familiar environments
• No awareness of recent or past events
• Very limited connection to external world

• May only make sounds, murmurs, or occasional words
• Cannot engage in meaningful conversation
• Uses body language or facial expressions instead

• Requires full assistance with all activities
• Cannot stand or walk without full support
• May be bed-bound or wheelchair-dependent
• Muscles become stiff or lose strength

• High risk of choking
• Slow, weak chewing
• May hold food in the mouth
• Needs soft or puréed food and supervised feeding

• Full loss of bladder and bowel control
• Needs regular hygiene support
• Increased risk of skin breakdown

• Long hours of sleep
• Short periods of wakefulness
• Confusion day and night

• Moaning, calling out, repetitive sounds
• Restlessness, especially if uncomfortable
• Occasional agitation or fear
• May appear disconnected or withdrawn

• High risk of infections (UTIs, chest infections)
• Difficulty regulating body temperature
• Weight loss due to reduced eating
• Pain may be present but hard to express

At Stage 8, the person:

• Depends completely on caregivers
• Cannot move safely without support
• Needs help with every aspect of care
• Has extremely limited understanding of surroundings
• Benefits deeply from comfort care, not correction or expectation
• Responds to gentle touch, soothing music, soft lighting, emotional presence

Though communication is limited, their emotional world is still alive.

• Speak softly and slowly
• Maintain eye contact even if they cannot respond
• Use gentle touch: holding hands, stroking the arm, warm blankets
• Play soft, familiar music regularly
• Ensure safe feeding with small amounts, slow pace
• Keep the room calm, warm, quiet, and comfortable
• Reposition frequently to prevent pressure sores
• Use simple reassurance: “I’m here”… “You’re safe.”
• Reduce bright lights, cold rooms, and loud noises

Love and presence matter more than words.

• Prevent pressure sores: reposition every 2–3 hours
• Monitor swallowing closely
• Use fall-prevention supports (rails, padding, supervision)
• Keep pathways completely clear
• Watch for signs of pain: facial expressions, body tension, moaning
• Maintain skin care, hydration, and body comfort

Contact healthcare professionals if you notice:

• Signs of pain or discomfort
• Fever, chesty cough, or breathing difficulty
• Rapid weight loss
• Repeated refusal of food or drink
• Sudden agitation or distress
• Bed sores or skin breakdown

Palliative or hospice support may be recommended to prioritise comfort and quality of life.