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Dementia Stages And Symptoms And How To Help Your Beloved Cope With Them

America is an aging nation. By 2040, 80 million of us will be 65 and older. And the population in their 80s will exceed 20%.

This means there will be many of us – forgetful, moody, and stubborn. Of course, none of these traits mean that we are demented.

Statistically, however, the older we get, the higher the chances of being diagnosed with it. Some form of dementia affects 5%-8% of adults over 65, while this percentage goes as high as 50% for those in their 80s.

If you are concerned for yourself or your loved ones because of other cases of dementia in the family and want to be better prepared for what to expect, read on. From this article, you will learn what the symptoms and stages of this progressive condition, broadly named dementia, are.

This knowledge can help you assess your or your beloved’s care needs and ensure you make the best decisions about it in a timely manner.

The Many Forms of Dementia

Dementia is the general term for a number of conditions that affect our cognitive abilities.

stages of dementia in elderly

Among these, perhaps the most well-known and common is Alzheimer’s disease. Of all people with dementia, those who have Alzheimer’s are between 60 to 80%.

However, there are other forms of dementia, such as:

  • Parkinson’s disease dementia (PDD)
  • Vascular dementia
  • Lewy body dementia
  • Frontotemporal dementia (Pick’s disease)
  • Early-onset dementia
  • Alcoholic dementia

Each of these conditions may present with different signs and symptoms, but they all impact our ability to think, focus, and reason.

All types of dementia are also progressive, which means that the condition worsens with time, i.e., its symptoms and effects typically amplify.

Dementia Treatment

Unfortunately, despite promising research, so far, scientists haven’t come up with a comprehensive, successful cure for any of the dementia kinds.

Some treatment plans that help slow down the progression of the disease or the severity of the symptoms are available today.

Some promising directions in which researchers are working are:

Stem cell research

Scientists in the UK Alzheimer’s Research Center are currently looking into how damage in the brain happens and how to prevent it from happening with the help of stem cells.

Immunotherapy

At present, there are a few ongoing studies that aim to discover how certain antibodies can prevent or slow down the progression of the early stages of Alzheimer’s dementia. Additionally, researchers are trying to figure out how to avert the overstimulation of immune cells in the brain, a process that may be causing brain damage.

Gene therapy

Scientists are looking to identify the genes responsible for frontotemporal dementia and Alzheimer’s, as well as genes that can help lower the production of dementia-causing proteins such as ‘tau’ and ‘alpha-synuclein.’

Medications that have been proven to temporarily slow down the progression and increase the quality of life of people diagnosed with dementia are:

Anti-amloyid drugs

Administered with an IV infusion, these drugs reduce the accumulation of amyloid plaques in the brain and thus can slow down memory loss and other cognitive symptoms.

Acetylcholinesterase inhibitors

These medications help brain cells communicate with each other better by balancing the levels and stimulating the production of neurotransmitters.

medications address signs and symptoms of dementia stages

Memantine

Used at moderate and advanced stages of dementia, Memantine decreases the effect of excessive glutamate in the nerve cells and alleviates some of the symptoms of dementia.

Non-drug approaches to the treatment of dementia may include lifestyle changes, nutrition adjustments, and the others mentioned below.

Physical exercise

Regular physical activity can have cognitive and emotional benefits for people with dementia. It helps improve mood and maintain physical function, and it may even slow cognitive decline.

Cognitive stimulation

Engaging in activities that challenge the brain, such as puzzles, games, and social interactions, can help maintain mental awareness.

Diet

A heart-healthy diet, such as the Mediterranean diet, rich in fruits, vegetables, whole grains, and healthy fats, may help reduce the risk of cognitive decline.

Management of Underlying Health Conditions

Treating conditions like high blood pressure, diabetes, and high cholesterol may help reduce the risk of vascular dementia caused by impaired blood flow to the brain.

Social engagement

Staying socially active and maintaining relationships can help improve the overall well-being of people with dementia.

While these approaches may be promising in some, there is no one-size-fits-all solution for dementia, and treatment plans should be tailored to your or your loved one’s individual needs.

Main Stages of Dementia

Being diagnosed with dementia may mean that you or your loved one have lived with it for years, a condition called preclinical Alzheimer’s, as the changes in the brain do not happen overnight but begin long before you notice any symptoms.

After diagnosis, life expectancy can be anywhere between 4 and 20 years, and it depends on the type of dementia as well as how progressed the condition is.

While the advancement of the disease can vary from person to person, dementia is often categorized into three general phases and seven more detailed stages, as per the Global Deterioration Scale (GDS) developed by Dr. Barry Reisberg.

If you are a caregiver of someone with dementia, the following descriptions will give you an idea of where your loved one is at this moment and what to expect in the future.

Early Stage (Mild Dementia)

  • This stage is characterized by subtle cognitive changes that may not be immediately noticeable to you or your loved ones.
  • Common symptoms include slight forgetfulness, occasional difficulty finding words, and small changes in reasoning and judgment.
  • In the early stage of dementia, people can usually manage day-to-day activities with minimal assistance.
  • They may still be able to live independently, although some support may be needed for tasks that require more complex thinking or organization.

Middle Stage (Moderate Dementia)

  • In this stage, cognitive decline becomes more apparent, and your loved one may experience more significant memory loss, language difficulties, and problems with reasoning and problem-solving.
  • Common symptoms include increased confusion, trouble recognizing familiar people, difficulty with activities of daily living (e.g., dressing, bathing, cooking), and behavioral changes.
  • During the middle stage, individuals often require more assistance and supervision, and safety concerns become more pronounced.
  • Behavioral and psychological symptoms, such as agitation, sundowning, wandering, and mood swings, may also start to appear during this phase.

seniors with Alzheimer dementia often go through worsening stages

Late Stage (Severe Dementia)

  • In the late stage of dementia, a severe cognitive impairment is observed where individuals often can not communicate effectively or recognize their surroundings.
  • Memory loss is significant, and your loved one may forget the names of family members and basic information about themselves.
  • Individuals may become immobile and are highly dependent on caregivers for all of their needs, as they require assistance with all aspects of care, including feeding, toileting, and personal hygiene.
  • Often, at this stage, your loved one may experience difficulty swallowing, leading to additional health complications.

It’s important to note that the rate of progression can vary significantly from person to person. Some may remain in one stage for an extended period, while others may progress more rapidly.

Additionally, the specific symptoms and challenges your loved one face can vary depending on the type of dementia they have (e.g., Alzheimer’s disease, vascular dementia, Lewy body dementia).

Early diagnosis and appropriate interventions can help improve the quality of life for both individuals with dementia and their caregivers.

The main staging system is just one of several approaches to conceptualizing the progression of dementia.

Seven Stages of Dementia

The seven-stage division is one of the most well-known models and is often associated with the Alzheimer’s Association. It applies mostly to Alzheimer’s disease symptoms and deterioration.

Stage 1: No Impairment (Normal Functioning):

  • In this stage, your loved one won’t show any visible or detectable signs of dementia or cognitive decline—they can function normally in daily life.

Stage 2: Very Mild Cognitive Decline (Normal Forgetfulness):

  • At this stage, people may demonstrate normal age-related forgetfulness, such as occasionally forgetting names or where they have placed everyday items. These memory lapses do not interfere significantly with daily life.

Stage 3: Mild Cognitive Decline (Mild Cognitive Impairment):

  • You may start to notice that your loved one experiences mild cognitive changes, especially if you communicate with them daily. Forgetfulness starts to occur more frequently, and they may have difficulty finding the right words to express themselves.

Stage 4: Moderate Cognitive Decline (Mild Dementia):

  • At stage four, clear cognitive impairment becomes evident. Memory problems are more apparent, and your beloved may have trouble with tasks like managing finances or organizing their daily routines.

Stage 5: Moderately Severe Cognitive Decline (Moderate Dementia):

  • During this stage, your loved one will require more assistance with daily activities. They may not remember important details about themselves, such as their address or phone number. You may notice personality changes and behavioral symptoms, such as sudden mood swings.

Stage 6: Severe Cognitive Decline (Moderately Severe Dementia):

  • Significant memory loss and cognitive decline characterize this stage. Your beloved may be unable to recognize close family members and require constant supervision and assistance with daily activities.

Stage 7: Very Severe Cognitive Decline (Severe Dementia):

  • At this final stage, people have severe cognitive and physical impairment. They may lose the ability to communicate verbally, eat, swallow, walk, and perform basic self-care tasks. Your loved one will be entirely dependent on caregivers for their needs.

Again, it’s important to note that this seven-stage model is just one way of describing the progression of dementia, and it may not precisely match the experiences of all people who suffer from it.

the 7 stages of dementia

The specific symptoms and timeline can vary widely depending on the type of dementia and their unique circumstances.

Healthcare professionals typically use more comprehensive assessment tools to diagnose and stage dementia, and they tailor care plans accordingly.

Symptoms of Dementia

Being a degenerative disease, unfortunately, means that with time, the condition of people suffering from dementia will worsen, and their symptoms will become more and more pronounced.

Early Symptoms of Dementia

The early symptoms of dementia can drastically vary depending on the type and the individual. However, there are some common signs and symptoms that shouldn’t be dismissed.

Keep in mind that other medical conditions can also cause these symptoms, so it’s essential to consult a healthcare professional for a proper evaluation if you or a loved one are experiencing these symptoms.

Some early signs of dementia may include:

Forgetfulness

This is one of the most common early signs. People may forget recently learned information, important dates, or events. They may repeatedly ask the same questions or rely on memory aids like notes. Your loved one may start to forget their address, phone number, or where they have placed common items like keys or glasses.

Difficulty with Everyday Tasks

Having trouble performing familiar tasks, such as cooking a meal, following a recipe, managing finances, or getting lost in a familiar neighborhood, should be considered a red flag.

Confusion

Early-stage dementia may cause confusion about the time, place, or identity of people, even close family members.

Language Problems

Your loved one may struggle to find the right words, have difficulty following or joining in conversations, or repeat themselves.

Difficulties Planning and Organizing

Organizing thoughts, making decisions, and planning tasks can become challenging.

Misplacing Items

People with early-stage dementia may put things in unusual places and then have difficulty retracing their steps to find them.

Changes in Mood or Personality

You may start to notice that your loved one has sudden changes in their moods. They may become more irritable, anxious, depressed, more withdrawn, or less interested in social activities.

anxiety and wandering are some of the symptoms evident in all stages of dementia

Decreased Judgment

Exhibiting poor judgment or decision-making, such as making knee-jerk decisions, giving large amounts of money to telemarketers, or easily trusting strangers, is another symptom of early-stage dementia.

Loss of Initiative

Some people lose interest in activities they previously enjoyed and may have difficulty starting or completing tasks.

Again, it’s important to emphasize that not everyone with these symptoms has dementia, and other medical conditions can cause similar issues.

Additionally, the progression and severity of symptoms can vary widely among individuals with dementia.

If you or someone you know is experiencing these early signs, it is crucial to seek a comprehensive evaluation from a healthcare professional, preferably a specialist in neurology or geriatrics.

Early diagnosis can be valuable for planning and implementing appropriate interventions and support for the individual and their family.

Symptoms of Middle Stage Dementia

The middle stage of dementia is usually the longest of the three. During this period, also called moderate dementia, your loved one may experience more pronounced memory loss, and it might become more difficult for them to communicate with others. Thus, they will need more care and assistance with daily activities.

Memory Loss

Your loved one struggle with remembering things will become more severe and noticeable.

They may have difficulty recalling recent events or conversations they have partaken in just hours or days ago and even some long-term events.

They may not recognize close family members or friends, and their repetitive questions and stories become more frequent.

Difficulty Communicating

Struggling to find the right words during conversations can lead to pauses or circumlocutions (talking around a word).

They may find it difficult to follow or join in conversations and express their thoughts coherently.

Their speech may become disorganized or fragmented.

Impaired Judgment and Decision-Making

Your loved one may demonstrate poor judgment and difficulty making sound decisions, often leading to risky behaviors or financial mismanagement.

Challenges in Problem Solving and Planning

Your beloved may find it very challenging to plan and organize tasks or to manage their finances.

They may take longer to complete familiar activities that involve multiple steps.

Difficulty with Daily Activities

They may require assistance with activities of daily living (ADLs), such as dressing, bathing, toileting, and grooming.

Managing medications on their own and preparing meals may become increasingly challenging.

Disorientation

They may become confused about their time, place, and personal identity.

Often, they may not be sure what the current date is, where they are, or how they got there.

stages of dementia timeline is not exact

Psychological and Behavioral Changes

Agitation, aggression, and mood swings may become more frequent.

Your beloved may start wandering, pacing, or being restless.

Their sleep may become less sound, they may start to experience nighttime awakenings.

Hallucinations and Delusions

In some types of dementia, people may experience hallucinations (seeing or hearing things that are not there) or delusions (false beliefs).

Loss of Motor Skills

Motor skills decline affects mobility making it difficult for them to walk and coordinate balanced movements. Falls become a significant concern.

Incontinence

Loss of bladder or bowel control can occur in the middle stage of dementia.

Social Withdrawal and Loss of Initiative

Your beloved may become increasingly withdrawn from social interactions, including with family and friends.

Another symptom is losing interest in activities they once enjoyed and may need encouragement to engage in any form of activity.

Difficulty Recognizing Familiar Objects

They may start to struggle to recognize familiar objects or their purpose, such as not recognizing a toothbrush or how to use it.

The middle stage of dementia is often marked by significant challenges in daily functioning. They will need to rely increasingly on caregivers for care and support.

As a caregiver, you may face more stress and responsibilities during this stage, and it’s essential to seek help from healthcare professionals and support services, such as Amy’s Eden, to provide appropriate care and maintain your beloved’s safety and well-being.

Care planning should include strategies for managing behavioral symptoms and ensuring comfort and dignity.

Symptoms of Late-stage Dementia

In the late stages of dementia, your loved one will experience profound cognitive and functional decline, leading to significant challenges in daily life.

The specific symptoms can vary depending on the type of dementia (e.g., Alzheimer’s disease, vascular dementia, Lewy body dementia), but here are some common symptoms and characteristics often associated with this stage.

Severe Memory Damage

Memory loss is extensive, and your beloved may have difficulty recognizing even close family members or recalling significant life events.

They may have no awareness of recent or past events.

Language and Communication Difficulties

Communication becomes extremely difficult as they may struggle to understand or produce meaningful speech.

Nonverbal communication, such as gestures or facial expressions, may also be limited.

Loss of Motor Skills

Muscle weakness and loss of motor skills can lead to immobility or difficulty walking. Often, people become bedridden or require a wheelchair.

Inability to Perform Basic Activities of Daily Living (ADLs)

Your beloved will require full assistance for ADLs, including dressing, bathing, toileting, grooming, and feeding.

They may also lose the ability to swallow properly, increasing the risk of choking or suffocating.

Weight Loss and Malnutrition

Difficulty eating and swallowing can lead to weight loss and malnutrition.

dementia stages symptoms include difficulty swallowing

Loss of Bowel and Bladder Control

Similarly to the moderate stage, bowel and bladder incontinence is common in the late stages.

Profound Disorientation

They may have no awareness of time, place, or personal identity – not recognizing their own reflection in a mirror.

Severe Behavioral and Psychological Impairment

Often, they could be agitated or aggressive or have emotional outbursts.

At the same time, they may become numb and unresponsive or exhibit repetitive behaviors.

Hallucinations and Delusions

Some may experience vivid hallucinations and persistent delusions.

Vulnerability to Infections

A weakened immune system and decreased mobility can make your beloved more prone to infections, such as pneumonia.

Complete Dependency on Caregivers

In the late stages, your loved one will require full-time care and will be entirely dependent on caregivers for all their needs.

Pain and Discomfort

They may feel pain or discomfort but may have difficulty communicating it to others.

The late stages of dementia are emotionally challenging for both people with dementia and their caregivers.

Caregivers play a crucial role in providing comfort, ensuring safety, and maintaining dignity and quality of life.

Palliative and end-of-life care principles such as:

  • Providing pain management and relief for other distressing symptoms,
  • Affirming life but regarding dying as a normal process,
  • Incorporating psychological and spiritual aspects of patient care,
  • Offering a support system to help patients live as actively as possible until death.

may be applied to manage symptoms and improve your beloved’s comfort in this stage.

Receiving support and having reliable resources as a caregiver is crucial to help you cope with the demands of caregiving.

How to Support a Loved One with Dementia

Supporting someone with dementia involves addressing various key areas to enhance their well-being and maintain their quality of life.

Here are some crucial key areas to consider when providing support for a loved one with dementia.

Learn to communicate in a new way

Practice clear and simple communication.

Use nonverbal cues, such as facial expressions and gestures.

Be patient, listen actively, and give the person ample time to respond.

Take care of their safety

Create a safe environment by removing hazards and ensuring proper lighting.

Consider safety devices like door alarms to prevent wandering.

Ensure the person is wearing appropriate identification and a medical alert bracelet if needed.

Provide routine and structure

Establish a consistent daily routine and schedule to provide predictability.

Use visual aids, such as calendars and clocks, to reinforce the routine.

caregiver with her loved one suffering from moderate dementia

Help with medication management

Ensure medications are taken as prescribed.

Consider using pill organizers or medication management services.

Regularly review medications with their healthcare professionals.

Provide sufficient nutrition and hydration

Offer well-balanced, nutritious meals and monitor fluid intake to prevent dehydration.

Address any dietary restrictions or swallowing difficulties with a healthcare provider.

Support physical activity

Encourage regular physical exercises appropriate for the person’s abilities.

Activities like gentle workouts and walks can help maintain mobility and improve mood.

Foster emotional well-being

Maintaining a positive and supportive atmosphere.

Be patient, understanding, and empathetic.

Address behavioral and psychological symptoms through non-pharmacological approaches whenever possible.

Encourage social engagement

Facilitate social interaction with family and friends.

Participate in activities that your loved one enjoys, such as music, art, or hobbies.

Consider joining support groups for both the person with dementia and their caregivers.

Arrange for respite care

It is essential to provide caregivers with regular breaks and rest.

Respite care can be provided by family members, friends, or professional caregivers.

Address legal and financial matters

Ensure that legal documents, such as powers of attorney and advance directives, are in place.

Address financial matters and plan for long-term care needs.

Learn coping strategies

Knowing and employing coping strategies to manage stress and caregiver burnout can be very handy.

Seek professional counseling or support groups for caregivers.

Get professional healthcare support

Consult with healthcare professionals, including geriatricians, neurologists, and dementia specialists, for guidance and medical management.

Regularly review and update the care plan as needed.

Plan for advanced care

Discuss and document end-of-life care preferences and decisions.

Ensure that family members and healthcare providers are aware of your beloved’s wishes.

Provide patient advocacy

Advocate for their rights and well-being in healthcare settings and within the community.

Be an informed and proactive advocate for their needs.

Continuously educate yourself

Constantly learn more about dementia, its progression, and available resources.

Stay updated on recent research and treatments.

Providing support for someone with dementia is a complex and evolving process. Tailor your approach to their unique needs, preferences, and stages of dementia. Seek assistance from healthcare professionals, support organizations, and community resources to ensure that you can provide the best possible care and support for your beloved with dementia and yourself as a caregiver.

Recap

Dementia is a progressive condition that typically evolves through several stages, each with its own set of symptoms and challenges.

Today, there isn’t a known cure for this cognitive disorder, but some medications and non-pharmaceutical treatments successfully address certain dementia symptoms.

The coping strategies for dementia should be tailored to the particular stage and symptoms that your loved one is experiencing.

Here’s a short overview of dementia’s stages, common symptoms, and coping strategies for each stage.

  1. Early Stage (Mild Dementia):
    • Symptoms:
      • Mild memory loss
      • Difficulty with word-finding
      • Subtle changes in reasoning and judgment
      • Mood swings and personality changes
    • Coping Strategies:
      • Maintain a structured daily routine.
      • Encourage engagement in cognitive activities and hobbies.
      • Foster open communication with the person and involve them in decision-making.
      • Educate other family members and caregivers about dementia.
  2. Middle Stage (Moderate Dementia):
    • Symptoms:
      • Significant memory impairment
      • Language difficulties
      • Impaired judgment and decision-making
      • Behavioral and psychological symptoms (agitation, aggression)
    • Coping Strategies:
      • Establish a consistent daily routine.
      • Ensure a safe living environment.
      • Provide emotional support and reassurance.
      • Utilize non-pharmacological approaches for managing behavioral symptoms.
  3. Late Stage (Severe Dementia):
    • Symptoms:
      • Profound memory loss
      • Loss of language and communication skills
      • Severe disorientation
      • Loss of motor skills and inability to perform ADLs
    • Coping Strategies:
      • Focus on providing comfort and maintaining dignity.
      • Ensure safety, including fall prevention and monitoring for infections.
      • Provide assistance with all aspects of daily care, including feeding.
      • Seek palliative care and end-of-life planning.

understanding dementia stages is crucial for being able to help

Coping with dementia requires a comprehensive and ever-adapting approach.

Adjust your strategies to your beloved’s specific needs, and seek assistance from healthcare professionals and support organizations.

Getting help from organizations like Amy’s Eden will ensure the best possible care and support for both the person with dementia and their caregivers. Get dementia care here.

 

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