&NA;Caregivers for individuals suffering from severe or terminal progressive degenerative dementia must consider the irreversible nature of this condition and adjust appropriately the treatment strategies. Maintaining or enhancing the quality of life should be a goal of care even in advanced dementia. This goal requires attention to the availability of meaningful activities, appropriate management of simultaneous infections and eating difficulties, and effective treatment of behavioral symptoms of dementia. Providing care on a special care unit (SCU) has advantages over care on traditional nursing home units. Advance directives should be formulated as soon as possible to guide end‐of‐life care of each individual with dementia.