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Understanding the Stages of Dementia

Writer's picture: Adria ThompsonAdria Thompson

As a caregiver for someone with dementia, understanding the progression of the disease can help you provide the best care and support.


There are many scales that exist that describe the changes over time for someone with dementia. You may hear a doctor refer to stage as “mild/moderate/severe” or even “early/middle/late”. However, those descriptions tend to be highly subjective and can mean different things for different people.


One of the most widely used tools for this is the Global Deterioration Scale (GDS), developed by Dr. Barry Reisberg in the 1980s. This scale ranges from one to seven, outlining the cognitive decline experienced by individuals with dementia, particularly those with Alzheimer's disease. Let’s explore these stages in detail.


Stage 1: Normal Cognition

At this stage, there are no noticeable cognitive impairments. Individuals function normally in their daily lives, with no signs of dementia.


Stage 2: Age-Associated Memory Impairment

This stage involves minor memory lapses that are considered a normal part of aging. For example, occasionally misplacing items or taking longer to recall names. Although they may be frustrating, these changes are not noticeable to others and do not interfere with daily functioning. The best tip for this stage is to implement brain healthy habits by keeping active physically, cognitively, and socially!


Stage 3: Mild Cognitive Impairment (MCI)

In Stage 3, changes become noticeable to both the individual and those around them. While this stage does not necessarily lead to dementia, it marks a decline in cognitive abilities that can affect job performance and daily activities. Approximately one-third of people with MCI remain stable, one-third improve, and one-third progress to dementia.


Tips:

- Encourage regular medical check-ups and cognitive assessments.

- Help with organizational tasks and provide supportive routines.


Stage 4: Mild Dementia

Here, cognitive decline begins to impact daily life. Short-term memory loss becomes evident by asking repetitive questions, telling repetitive stories or struggling with new learning tasks. At this stage, instrumental activities of daily living (IADLs) like managing medications and finances will require assistance, leading to frustration. Individuals in this stage will often resort to isolating and withdrawing from others or they may take their frustration out on those around them in anger.


Caregiver Tips:

- Assist with complex daily tasks and introduce memory aids like calendars and labels.

- Maintain an understanding and calm and supportive environment to reduce frustration.

- Engage in familiar activities and hobbies to promote independence and a sense of normalcy.


Stage 5: Moderate Dementia

Individuals in Stage 5 can no longer survive without assistance from others. They may forget personal details like their address or phone number and become disoriented about time and place. Despite this, they often retain long-term memories and can recognize close family members. However, their attention span is shorter, and they may require prompts for basic self-care tasks known as activiteis of daily living (ADLs) like showering, dressing, toileting and grooming.


Caregiver Tips:

- Provide 24-hour supervision and ensure a safe environment.

- Use stories, music, and familiar activities to engage and comfort.

- Establish a consistent daily routine to reduce confusion.


Stage 6: Moderately Severe Dementia

Stage 6 requires more hands-on assistance as individuals can only complete about 25% of daily tasks independently. They might not remember recent events at all or understand the passage of time. They live very much in the moment. Communication becomes challenging and is no longer functional, and they may resist care due to confusion and feeling unsafe. At this stage, maintaining a sense of safety and familiarity is crucial.


Caregiver Tips:

- Be patient and gentle, using gestures, touch and eye contact to communicate.

- Simplify tasks and allow plenty of tiem for processing.

- Play familiar music and use sensory activities to connect and soothe.


Stage 7: Severe Dementia

In the final stage, individuals are unable to care for themselves. They lose the ability to walk and communicate, often only exchanging simple pleasantries. This stage is characterized by significant physical and cognitive decline, with caregivers providing complete support for all daily activities.


Caregiver Tips:

- Focus on comfort and quality of life, using gentle touch and sensory stimulation.

- Play favorite music and show familiar pictures.

- Ensure a calm and loving presence, even if verbal communication is minimal.


It is important to know that each individual's experience with dementia is unique, and their journey may not fit neatly into one stage. It's essential to remain flexible, patient, and compassionate, adapting care strategies as needed.


By understanding the stages of dementia, caregivers can better navigate the challenges of providing care, ensuring that individuals with dementia receive the support and dignity they deserve at every stage of their journey.

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Disclaimer: The information provided on this website is for general informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of information on this website. The use of any information provided on this site is solely at your own risk. The owner and contributors of this website do not provide medical advice or guarantee the accuracy or completeness of any information on this site.

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