Dementia is a progressive neurodegenerative disease that leads to a significant cognitive decline and, in the final stage, to the patient’s complete dependence. As societies age, the number of patients with advanced dementia continues to rise. This paper discusses the key aspects of care for these patients, with particular emphasis on the importance of Advance Care Planning and the limited implementation of these essential strategies in Poland. It presents methods for diagnosing and managing the most common end-stage symptoms such as delirium, pain, dyspnea, mood and behavioral disturbances, infections, and nutritional disorders. The limited effectiveness of certain interventions, including enteral tube feeding, is highlighted, along with the importance of individualized treatment and non-pharmacological approaches. The findings underscore the need for greater availability of care for patients with dementia and emphasize the importance of educating medical personnel about the specific needs of this patient group.