A big challenge and source of stress in Alzheimer’s disease and dementia is the uncertainty. No one can predict what will happen with an older adult’s cognitive ability or when changes will happen. Understanding the stages of dementia can give a sense of what to expect and serve as guidelines for planning for the future.
Here we will explain the 3 typical stages of dementia (including Alzheimer’s), the common symptoms, and why symptoms don’t always fit into these stages. It’s important to remember that the progression of the disease is unique to each person.
Stage 1: Early – mild dementia
During this stage, the person can live independently but may have memory lapses, such as forgetting familiar words or the location of everyday objects. Other people may start to notice something “seems off”.
Symptoms may include:
- Struggling to find the right word or name
- Finding it difficult to do everyday tasks in social or work settings
- Forgetting something that they just read
- Frequently losing or misplacing things
- Increasing trouble with planning or organizing
- Making decisions with uncharacteristically poor judgment
Stage 2: Middle – moderate dementia
This is the longest stage that can last many years. You may notice that they mix up words, are often frustrated or angry, or act in unexpected ways, such as refusing to bathe. Brain damage can make it difficult to express oneself and do everyday tasks.
Symptoms may include:
- Forgetting things that happened recently or major events in their life
- Being moody or withdrawn, especially in social situations or when something requires too much thought
- Not being able to remember significant things like their address, phone number or where they went to high school
- Getting confused about where they are or what day it is
- Needing help choosing appropriate clothes for the season or occasion
- For some, trouble with incontinence
- Changing sleep patterns, like sleeping during the day and being restless at night
- An increased risk of wandering and getting lost
- Personality and behavior changes, including paranoia, delusions, and compulsive, repetitive behavior like hand wringing
If you’re managing care during this stage, our memory care services are designed specifically for the challenges that come with moderate dementia.
Stage 3: Late – end-stage dementia
During the end stage of dementia, the patient progressively loses the ability to engage in the world, hold conversations, and control their muscles. They may still be able to talk, but communicating and expressing thoughts becomes difficult – even something as basic as pain.
You may see significant personality changes or the fading of their personality altogether.
At this stage, symptoms and needs typically include:
- 24/7 help with daily activities and personal care
- Increasing difficulty communicating
- Loss of awareness of recent experiences and their surroundings
- Gradual and progressive loss of physical abilities, including walking, sitting and swallowing
- More likely to develop infections, especially pneumonia
Lowering the Risk
While some cognitive decline may be genetic, there are several ways to keep your brain healthy and active. The Alzheimer’s Association recommends the following steps to lower the risk of cognitive decline:
- Challenge your mind with something new
- Stay in school and continue your education
- Get moving with regular exercise
- Protect your head during certain activities, like biking
- Avoid smoking
- Maintain a healthy blood pressure
- Control or prevent type 2 diabetes
- Eat healthy
- Keep a healthy weight
- Get good quality sleep
Read more here or download the “10 Healthy Habits” flyer.
Dementia Symptoms Across all Stages
A person with dementia doesn’t always fit into one stage. It affects each person uniquely and changes different parts of the brain at different points in the disease progression. Plus, different types of dementia tend to have different symptoms. For example, someone with frontotemporal dementia may first show extreme behavior and personality changes. But someone with Alzheimer’s would first experience short-term memory loss and struggle with everyday tasks.
Another common occurrence is for someone in the middle stages to suddenly have a clear moment, hour, or day and seem like they’re back to their pre-dementia abilities. They could be sharp for a little while, only to go back to having obvious cognitive impairment. When this happens, some may feel like the person is “faking” their symptoms or just not trying hard enough. This is not true. It’s the dementia that’s causing their declining abilities, as well as those moments of clarity.
Even if the stages aren’t exact and the symptoms still unpredictable, being able to plan ahead is essential. Dementia care is expensive and time-consuming, and being financially prepared for increasing care needs is a necessity. On an emotional level, having an understanding of what to expect can help you find ways to cope with challenging behaviors and give you a chance to mentally prepare yourself for the inevitable changes in your loved one. Our care coordination services can help families build a plan before the next stage arrives.
Chesapeake Caregivers is Here to Help
If you’re trying to understand what your loved one needs now or what’s coming, we’re here to help you think it through. Chesapeake Caregivers has been supporting families across Anne Arundel County, Queen Anne’s County, and the greater Maryland region since 1997.
Contact us today to find the right care and support during your journey.
Source: DailyCaring Editorial Team (DailyCaring.com; award-winning senior caregiving website)
