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 can be used as guidelines to plan 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 and different for each person.
Early – mild dementia
- Able to live independently, but may have memory lapses, like forgetting familiar words or the location of everyday objects. Other people that 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
Middle – moderate dementia
- This is the longest stage that can last many years. You may notice that they get words mixed up, are often frustrated or angry, or act in unexpected ways, like refusing to bathe. Damage in the brain can make it difficult to express themselves and do everyday things.
- 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- Being moody or withdrawn, especially in social situations or when something requires too much thought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
Late-stage dementia
- Progressively lose the ability to engage in the world, to 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 or recent experiences and their surroundings
- Gradual and progressive loss of physical abilities, including walking, sitting and swallowing
- More likely to develop infections, especially pneumonia
A person with dementia doesn’t always fit into one stage. It affects each person in a unique way 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.
Content provided by DailyCaring Editorial Team (DailyCaring.com; award winning senior caregiving website)
