Stages Of Dementia: What To Expect

Every Person’s Experience Is Unique

The symptoms and stages of dementia will look a bit different for everyone.  This depends on what type of dementia they have and other factors. Dementia progression rate will also be different for each person. 

Caregiver hugging elderly woman

As you learn about the stages, you’ll see that over time, the person you care for  will lose more of their abilities. Expect to need more support to care for them as  their disease progresses. But, it gives you time to think about what each stage  might look like for the person and what that means for them, your relationship,  and you. This can help you plan how you’d like to manage, face, or make the most  out of each stage.

Mild or Early Dementia

You may recognize the symptoms of mild or early dementia because they are  similar to the warning signs of dementia. Examples of these symptoms include: 

  • Losing items often, like their keys or wallet  
  • Difficulty remembering new information, like what they just read or a new name
  • Problems with communication, like following conversations or finding the  right word
  • Difficulty concentrating on tasks, like reading a book or following a recipe
  • Changes in mood, like depression or withdrawing from daily activities
  • Not doing regular activities, which could look like apathy but is actually forgetting how to start a familiar activity

How Caregivers Can Support

People with dementia often need a little help at this stage. It’s important not  to take over and start doing things for them. Instead, try to find ways to work  together that allow them to stay as independent as possible. For example: 

  • Help them find memory strategies that work for them. This can include using  labels, post-its, calendars, alarms, reminders, and pill dispensers.
  • Break tasks into smaller steps. Instead of asking for help cleaning the whole house, start by asking for help sweeping the kitchen floors.
  • Help them process their emotions. In the early stages, many people still have insight into their changing abilities and diagnosis. They may feel worried or sad.
  • Make communication easier for them. You can do this by asking them what  you can do to help during a conversation, like talking slower or limiting the  number of people in a conversation.

Expert Tip

It is a good idea to talk about advance care planning in the earliest stage possible. This includes things like power of attorney and a living will. Doing this as early as possible helps ensure that the person you care for has as much control as possible in deciding what happens to them as the disease progresses.

Middle or Mid-Stage Dementia

As the dementia progresses, the person you care for may have more difficulty  with things that were already hard and experience new symptoms. Examples of  these symptoms include: 

  • Increased memory problems, like not remembering their son’s name or their address Difficulty with daily tasks, like going to the bathroom, getting dressed,  or bathing  
  • Disorientation or confusion, like not knowing what season it is or getting  lost often  
  • Mood changes, like anger, anxiety, or suspiciousness 
  • Behavior changes, like withdrawing from activities, pacing, or having delusions  or hallucinations 
  • Poor judgment, like wearing winter clothes in the summer or vice-versa  

How Caregivers Can Support  

Caregivers help more in this stage as the person they care for has increased  difficulty with daily tasks. You can support them by: 

  • Coordinating programs and care. This can include respite care, adult day  programs, meal deliveries, occupational therapy home assessments, and other  services.  
  • Helping with daily activities. Your care recipient may have more trouble in  some areas compared to others. Make sure you assess what type of help they  need and how much to give. Options include verbal, visual, or tactile cues, and  physical assistance. You can also break activities down into smaller steps.  
  • Establish a routine. This is one of the most helpful things you can do. It gives  your care recipient a sense of comfort and safety, helping them cope with the  day more effectively. 
  • Use communication strategies. Try things like removing distractions, using  facial expressions, maintaining eye contact, using gestures and non-verbal  cues, having relaxed body language, and sticking to simple statements.  
  • Set up the environment to keep them safe. They might be confused by an  overwhelming environment. Simple changes can make a big difference, like  reducing noise, opening the curtains during the day, and removing clutter.  
  • Engage them in meaningful activities. This is essential for well-being. Choose  activities that incorporate their interests or past roles. Make it appropriate for  their stage of dementia by adapting the activity, level of support, environment,  or timing. 

Advanced or Late-Stage Dementia

In this stage of dementia, the person you care for will have symptoms that are  more severe than in previous stages. These symptoms will have a big impact on  their daily functioning. Examples of these symptoms include: 

  • Increased problems with communication, like not talking much (or at all) or  not making sense when talking 
  • Challenges with simple physical tasks, like eating, swallowing, or sitting up
  • Relying on others for daily tasks, like going to the bathroom, personal care,  and dressing  
  • Difficulty responding to their environment, and may keep their eyes closed  

How Caregivers Can Support  

People with advanced or late-stage dementia will eventually need 24-hour care.  This could mean moving the person to a long-term care community or bringing more help into the home. The goal of this stage is to maintain and enhance the person’s quality of life. You can help by: 

  • Referring back to advance planning documents. If they arranged a living will,  you can help ensure their wishes are upheld by making sure anyone involved  knows about it.  
  • Prevent pressure sores. If the person you’re caring for spends a lot of time in a chair or bed, it is important to help them change positions often to prevent  pressure sores.
  • Use sensory stimulation. This can help you both connect and engage. Try  playing their favorite music, giving them their favorite perfume to smell, or gently massaging their hand.

Consider This

Did your care recipient have other medical conditions like anxiety or arthritis before dementia? Just because someone has dementia doesn’t mean their other conditions go away. Talk to their doctor about any treatments the person might still need. 


Additional Resources

  • Elderly woman driving

    Care Chat: Dementia & Driving

  • Caregiver helping with aggressive behavior

    Dementia and Aggressive Behavior

  • Caregiver assisting senior man out of bed

    Dementia and Skills for Responding to Communication Changes

  • Two elderly men talking

    Dementia Caregiver Checklist