It is God's action and doesn't depend upon one's reasoning ability. Most people, nevertheless, will still understand what is taking place. God keeps them connected to the body of Christ. It will be good to invite family members to participate with their loved one in receiving communion at this stage. Alert family members have a need to stay connected to God as well.
Some Alzheimer patients regress back to a fetal position in bed when they approach death.
However, the majority of them die from other causes, such as heart disease, kidney failure, aspiration in the lung, or pneumonia. When the patient dies, family members often feel relief and a sense of peace for the person. Later, in the grieving process, the family members may feel guilty for feeling relief. Pastors should touch upon these feelings in a sensitive way in the funeral homily. Let the family member know that it's okay to feel relief that their loved one has taken on the new resurrected body promised by God.