What are the stages of dementia?
What are dementia stages?
Dementia UK tells us that “Dementia is a progressive condition that gets gradually worse over time… It can be helpful to think of dementia progressing in three stages – early, middle and late stages.” Receiving a diagnosis of dementia can take a big emotional toll on the person and their loved ones; however, learning more about what the future may hold, the therapies available, and how to live as well as possible with dementia can all make the transition easier.
Dementia is generally categorised into three stages, early, middle and late, however everyone’s experiences will be different, even if they’re diagnosed with the same type of dementia, such as Alzheimer’s disease. It’s natural to want to know exactly how dementia will progress once diagnosed, but it’s impossible to predict how it will affect each person, as it depends on many different factors.
These include how old the person is, how quickly they received a diagnosis, the type of dementia they’ve been diagnosed with, their current state of physical and emotional health, and lifestyle factors such as whether they exercise and the diet they eat. However, worrying about the future won’t benefit the person or those around them, so it’s better to try and focus on making memories together while providing for future needs, such as dementia care.
Early-stage dementia
According to the Alzheimer’s Society, “As a very rough guide, the early stage of dementia lasts on average about two years.” However, it’s difficult to put an accurate figure on it because dementia is so individualised, and everyone has different experiences. Many people stay relatively independent in early-stage dementia, and it’s important to encourage them to continue doing things for themselves wherever possible. Establishing a routine using reminders for important tasks, appointments and lists will help them to live well. Difficulties may include:
Memory difficulties
It’s presumed that problems with memory are one of the first signs of dementia, such as losing items or forgetting names and events, and while this can be common in Alzheimer’s disease, it’s not always the case in other types.
Planning
As confusion increases, planning can become more difficult. Making complex decisions and problem-solving can also be challenging. It’s important that provision is made for future care needs and financial well-being while possible.
Communication and language
Conversations may become harder to follow or the person living with dementia may find it difficult to find the words they want to say. Language difficulties can be more pronounced when they are experiencing vascular dementia or Frontotemporal dementia.
Orientation problems
Once-familiar areas may become alien to the person living with dementia, causing them to get lost easily. This can leave them vulnerable and lead to heightened anxiety for both them and their loved ones.
Visual difficulties
In early-stage Alzheimer’s, people can find it difficult to judge distances, for example when using the stairs. This can lead to increased fall risks, for instance. Visual hallucinations, often of people or animals, are possible with Dementia with Lewy Bodies.
Mood or emotional changes
Dementia can leave the person at risk of depression, anxiety and emotionally vulnerable. Some people experience anger or irritability or become easily upset. Dementia can affect their self-confidence and cause them to lose interest in things, becoming more withdrawn.
Middle-stage dementia
Dementia UK tells us that “in the middle stages, the mild problems that the person first experienced become more pronounced and start to affect their ability to live without some form of support.” Some people can live well for longer on a gradual decline, while other people’s dementia progresses rapidly. As well as the symptoms already discussed, they may experience:
Lack of inhibition
They may behave in a way that would normally be unlike them, often overtly sexual or inappropriate in other ways. They may also use outdated speech or expressions without realising they could now offend someone.
Following loved ones
The person living with dementia may feel anxious when a loved one leaves the room and is no longer in their line of sight, and may follow them everywhere. They may also feel restless and have an inability to sit still.
Difficulty sleeping
Sleep patterns can be affected by dementia, such as waking during the night and struggling to fall asleep. They may behave as if it’s daytime at night and have no perception of the time of day or how to conduct themselves when others are trying to rest.
Distracted behaviour
Some people may rub their clothes repetitively, ask the same questions continuously, and not believe what people tell them. They may also feel they are at risk of harm by certain individuals and believe that they are stealing from them.
Communication
Communication can become more difficult in middle-stage dementia, as the person may struggle to find words, distinguish sounds, or follow a conversation. Their speech may also be affected and they may swear or make inappropriate comments.
Sundowning
Sundowning can cause intense anxiety for a person around sunset. They may feel they are in the wrong place, insist they need to go home – even if they are at home – or claim they are late for something important but unnecessary, such as picking up their children or going to work.
Late-stage dementia
As dementia progresses, a person will likely need full-time care, and assistance with daily living. Help with personal care, meal preparation, eating and drinking, and mobility will ensure they still get to live as well as possible. According to the Alzheimer’s Society, “By the late stage, the symptoms of all types of dementia become very similar. The later stage of dementia tends to be the shortest. On average it lasts about one to two years.”
Memory problems
As dementia progresses, the person may think they’re at an earlier stage of their life. This change in perception is known as ‘time shifting’. They may talk about someone who has passed away and ask to see them. They may not recognise loved ones or confuse them with other people.
Language difficulties
Language abilities may be affected. For instance, if a person learnt a second language later in life, they may no longer be able to speak or understand it. They may eventually become nonverbal or have a very limited vocabulary. They may rely on other methods of communication instead.
Changes in mood and emotion
In later-stage dementia, hallucinations become more common. The person’s reality alters and their perception is affected. They may respond to other senses rather than words, such as songs they always enjoyed or the feel of particular textures.
Behaviour changes
Behaviours may continue to alter, sometimes aggressively. This is usually because the person feels vulnerable, scared, or confused. If they don’t feel safe, they may react in the only way left available to them, which may be through behaviour rather than speech.
Physical changes
The person may walk more slowly or shuffle, and they may be unsteady on their feet. They can also be at an increased risk of falls. This may lead to them eventually remaining in a chair or bed. They may also become incontinent and have difficulty swallowing, leading to a reluctance to eat and drink.
Eliminating other causes
It is important at all stages of dementia that the person’s complete needs are being met. As dementia progresses the person may not be able to express how they’re feeling, so it’s important to be vigilant to changes that may be caused by medication, infection or some other cause.
How Helping Hands Can Assist With All Stages Of Dementia
Helping Hands has assisted people to live well at every stage of dementia since we were established in 1989. We work tirelessly to ensure that people living with dementia can comfortably remain living in the home they love for as long as possible. Because our carers are dedicated to supporting every aspect of our customers’ needs, they will go above and beyond to help. This means that all of the practical and emotional necessities are taken care of because we focus on the ‘whole-person’ – we don’t and never have believed that ‘one size fits all’ when it comes to dementia care.
We offer support on both a visiting and live-in care basis, designing flexible support that empowers you to continue living the way you want to in the place you love best. We understand dementia and we’ll support you as your needs change, while helping your loved ones to understand how your condition is affecting you.
We understand that dementia doesn’t define you, you’re still the person they’ve always loved but with additional needs. We equip our carers with all the skills they need to support you on your dementia journey, and you’ll soon wonder how you managed without them. The care your local team delivers is fully regulated by the Care Quality Commission and the Care Inspectorate Wales, so it’s no surprise we’re the UK’s most trusted home care provider.