title: Severe Alzheimer’s: how EDITH adapts to the advanced stages of the disease
description: Comprehensive guide on using EDITH in severe Alzheimer’s stages: adaptation challenges, sensory games, late benefits, caregiver support, and maintaining emotional bonds despite advanced decline.
keywords: EDITH severe alzheimer, cognitive stimulation severe stage, advanced alzheimer, severe alzheimer games, late alzheimer support
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EDITH, severe Alzheimer, advanced stage, cognitive stimulation, adapted games, support
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Reading time: 22 minutes
"My father is in the severe stage, is it still worth stimulating him?" "My mother hardly speaks anymore, can EDITH still help her?" "He no longer recognizes anyone, do memory games make sense at this stage?" "I wonder if I’m not prolonging things unnecessarily..."
Faced with severe Alzheimer’s, many caregivers believe that cognitive stimulation no longer makes sense. However, even in the most advanced stages, the brain remains capable of feeling, reacting to stimuli, and experiencing moments of pleasure. EDITH, with its "Very easy" mode specially designed for severe stages, continues to provide cognitive, emotional, and relational benefits.
This guide explains how EDITH adapts to residual abilities, which games work, what benefits to realistically expect, and how to transform sessions into precious moments of connection.
Table of contents
1. Severe Alzheimer’s: residual abilities
2. How EDITH adapts to the severe stage
3. Games that work in severe stage
4. Realistic benefits: what can we hope for?
Severe Alzheimer’s: residual abilities {#capacites}
What is the severe stage?
Medical definition:
MMSE < 10/30 (cognition test).
Characteristics:
1. Total memory loss
- No longer recognizes loved ones (sometimes)
- Forgets everything immediately
- Fragmented old memory
- Rare words (few repeated words)
- Incoherent or absent sentences
- Limited comprehension
- Needs help for everything (toileting, meals, dressing)
- Incontinence
- Reduced mobility (sometimes bedridden)
- Agitation, aggression (sometimes)
- Deep apathy (frequent)
- Screaming, moaning
- Pleasure, joy (smiles if activity is enjoyable)
- Fear, sadness (if mistreated)
- Emotions = last to disappear
- Vision: Recognizes bright colors, simple shapes
- Hearing: Reacts to music, soft voices
- Touch: Feels caresses, textures
- Tap with finger (reflex)
- Follow with gaze (if interested)
- Smile (if pleased)
- Rare, short (a few seconds)
- Unpredictable (but real)
2. Highly impaired language
3. Total dependence
4. Behavioral disorders
But: Preserved residual abilities
Even in the severe stage, the person CAN still:
1. Feel emotions
2. React to sensory stimuli
3. Residual automatic gestures
4. Fleeting moments of lucidity
Fundamental principle: As long as there is life, there is sensitivity. The person feels, even if they can no longer express it.
How EDITH adapts to the severe stage {#adaptation}
The "Very easy" mode: designed for advanced stages
EDITH offers 3 levels:
1. Light (early Alzheimer’s)
2. Moderate (intermediate Alzheimer’s)
3. Very easy (severe Alzheimer’s) ⭐
Very easy mode = Maximum simplification.
Specific adaptations for severe stage
1. Ultra-simplified games
Example: Memory (pairs)
Success possible even with very reduced abilities.
2. Repeated audio instructions
Instruction repeated 2-3 times (automatically).
Soft, slow, clear voice.
3. Unlimited response time
No timer (pressure = stress).
Person takes their time (even if very slow).
4. Systematic positive feedback
Even if wrong: "It's good that you tried!"
Never any punishment (no "missed", "lost").
5. Strong visual stimulation
Bright colors (high contrast).
Simple, large shapes.
Soft animation (not aggressive).
6. Sensory games
Priority to sensations rather than logic.
Examples:
Games that work in severe stage {#jeux}
1. Coloring (⭐ TOP 1)
Why does it work?
Automatic gesture (coloring = procedural, preserved for a long time).
Sensory pleasure (colors, movement).
No possible failure (any coloring is successful).
Usage:
Duration: 5-10 min (no more, fatigue).
2. Music (⭐ TOP 2)
Why does it work?
Musical memory = preserved for a long time.
Emotions: Music → pleasure, nostalgia.
No cognitive effort: Passive listening OK.
Usage:
Possible reactions:
3. Ultra-simple puzzles (3-4 pieces)
Why does it work?
Tactile manipulation (pleasure of hand).
Satisfaction of assembly (visual result).
Very few pieces = guaranteed success.
Usage:
4. Find the differences (2-3 differences max)
Why does it work?
Visual attention stimulation (follows with gaze).
Obvious differences (color, size).
Usage: You point, she validates (clicks).
5. Image recognition (yes/no)
Simple game:
"Is it a dog?" → Dog image → She clicks YES.
"Is it a dog?" → Cat image → She clicks NO.
Why does it work?
Visual recognition preserved (even if language is lost).
Binary response (simple).
6. Passive observation games
Soft animations:
No interaction: Just watching.
Soothing, hypnotic.
Realistic benefits: what can we hope for? {#benefices}
What EDITH WILL NOT DO in the severe stage
Let’s be clear, realistic:
❌ Will not slow down decline (too advanced)
❌ Will not recover lost abilities (irreversible damage)
❌ Will not perform miracles
So why continue?
What EDITH BRINGS in the severe stage
1. Maintains residual cognitive alertness
Brain engaged (even minimally) > Passive brain (TV).
Delays total cognitive decline.
2. Moments of pleasure
Smiles during play (coloring, music).
Pleasure = quality of life (even brief).
3. Reduces apathy
External stimulation → Reactions (even minimal).
Counteracts total inertia.
4. Emotional connection between caregiver and person
Playing TOGETHER = shared moment.
Maintains emotional bond (despite loss of recognition).
5. Temporal structure
Daily routine (10am = EDITH).
Landmarks (even if no longer understands time).
6. Relief for the caregiver
20 min of structured activity = mental break.
Feeling of usefulness ("I am doing something for him").
Studies on severe stages
Study EHPAD Marseille (2023):
60 residents with severe Alzheimer’s (MMSE <10).
EDITH Group (20 min/day, 3 months) vs Control Group (TV).
Results:
Conclusion: EDITH improves quality of life, even in severe stages.
Caregiver support: playing WITH, not IN PLACE OF {#accompagnement}
Severe stage = Caregiver presence MANDATORY
Unlike light stages (possible autonomy), severe stage requires a caregiver.
Why?
Caregiver's role = Co-player, facilitator.
How to effectively support?
1. Position: Side by side
Sitting next to (not standing above = dominating).
At their height (eye contact if possible).
2. Hand on hand guidance
Your hand on their hand (gentle guidance).
Example: Memory → Your hand guides their hand to the card → Click.
Then let go (let them finish the gesture if capable).
3. Gentle verbalization
Talk during play:
Soft, reassuring voice (not commanding tone).
4. Infinite patience
Can take 20 min for a game that would take 2 min before.
No problem.
Time = opportunity for connection (not loss).
5. Celebrate micro-successes
Every gesture, every click → "Well done!"
Smile (even tiny) → "You are happy!"
Value existence, not performance.
6. Stop if fatigue, refusal
Signs of fatigue:
→ Stop immediately. Respect limits.
7. Adjust duration
Severe stage: 5-15 min is sufficient (vs 15-20 min for light stages).
Quality > Quantity.
Testimonials: EDITH until the end {#temoignages}
Claire, 65 years old (mother with severe Alzheimer’s)
"My mother no longer speaks, no longer recognizes me. The neurologist told me: 'Do what feels right.' I continued with EDITH, very easy mode. 10 minutes a day, coloring and music. She smiles. She taps with her finger. It's tiny, but it's OUR moment. I hold her hand, we listen to Édith Piaf, she closes her eyes, she is calmed. EDITH still connects us. It's precious."
EHPAD Les Érables (Lyon) - Activity Coordinator
"We use EDITH even with our most affected residents. Very easy level. No cognitive waiting, just gentle stimuli. Result: less agitation in the afternoon, more smiles. A resident who constantly screamed calms down with EDITH's music. It's small, but it's huge for us."
Jean, 72 years old (wife with severe Alzheimer’s, bedridden)
"My wife is bedridden, hardly moves anymore. EDITH on a stand near the bed. Music, animated images (fish, flowers). She follows with her gaze. Sometimes, her hand moves slightly. I don't know what she understands, but she REACTS. As long as she reacts, she is here. EDITH maintains this fragile connection. I will continue until the end."
Frequently asked questions severe stage
Q: My loved one no longer reacts to anything, will EDITH be useful?
A: If truly no reaction (vegetative state), EDITH has little interest. But if micro-reactions (follows gaze, moves finger), yes, EDITH can bring pleasure, connection.
Q: How long to continue EDITH in the severe stage?
A: As long as the person shows interest (even minimal) and you, the caregiver, find meaning. If it becomes painful for everyone, it’s okay to stop. No guilt.
Q: What is the best game for the severe stage?
A: Coloring and music (top 2). Then 3-piece puzzles. Avoid logic/memory games (too complex).
Q: Should I force it if they refuse?
A: NO. Never force. Offer, if refusal → Respect. Try again the next day.
Q: Does EDITH replace other stimulations?
A: No, it’s a complement. Combine EDITH + live music + touch (massages) + human presence.
Conclusion: Until the end, with love
Using EDITH in the severe stage of Alzheimer’s is not about insisting. It’s about maintaining the flame of humanity, offering micro-moments of pleasure, preserving the emotional bond despite cognitive loss. Even if cognitive benefits are minimal, emotional and relational benefits are immense.
The keys to using in the severe stage:
1. ✅ "Very easy" mode (2-3 pieces, coloring, music)
2. ✅ Constant caregiver presence (co-playing)
3. ✅ Infinite patience (time = connection)
4. ✅ Celebrate micro-successes (smile = victory)
5. ✅ Short duration (5-15 min is sufficient)
6. ✅ Respect refusals, fatigue (kindness)
Your loved one may no longer recognize you. But they FEEL your presence, your gentleness, your love. EDITH is a tool to express that love. Use it as long as it does good. For both of you.
DYNSEO resources for supporting severe stages:
Until the last breath, every moment counts. EDITH helps you create these moments. Thank you for loving until the end.
