As dementia develops, who is usually the first to notice? Answer: A family member or friend. Something may seem off. Your loved one may be getting lost while driving. Bills aren’t getting paid. Things that should be remembered are suddenly forgotten. Caregivers experience physical and emotional toll while watching their loved ones progress through the stages of dementia.
Cognitive Related Conditions
Dementia, Alzheimer’s disease, etc., develop slowly and are progressive diseases. Worsening over time, they affect everyone involved in various ways. For a long time, the early stages of dementia can influence someone with the condition. Others, all at once, seem to fly through every symptom. After diagnosis, dementia victims live, on average, four to eight years. However, 20 years is not unheard of.
So you can plan for the future and understand, in part, what to expect, it’s a good idea to familiarize yourself with dementia’s seven stages. Through time, the following symptoms can change so consider this a basic guide.
Absence of Impairment
Dementia is undetectable in the “no cognitive decline” stage. The individual functions normally and is mentally healthy. Memory impairment has not shown any evident signs yet. There are no dementia-associated symptoms or behavioral problems.
Extremely Mild Cognitive Decline
The keywords here are “extremely mild”. Frequently, in older adults, forgetfulness seems normal and so this stage may not raise any eyebrows. Dementia is not particularly noticeable at this stage to your loved one’s physician or yourself. Symptoms can include the following:
- Simple everyday phrases are forgotten
- Where they placed their eyeglasses, purse, etc. may be forgotten
Mild Cognitive Decline
Symptoms of cognitive decline will start to be noticed. Symptoms commonly include the following:
- Organizing and planning becomes more troublesome
- They can’t find the right word or they repeat things
- They get lost or have difficulty driving
- Valuable objects are misplaced or lost
- Something they just read is immediately forgotten
- Problem-solving and complex tasks are troublesome
- They aren’t paying their bills or keeping their house as clean as they should
- Concentration and focus are difficult
- Forgetfulness increases
Early-Stage Dementia
Here, implementation of a care plan will become necessary. This is also referred to as moderate cognitive decline. Early-stage symptoms can include the following:
- Denial
- Increased feelings of depression, irritability, or anxiety
- They don’t want to try new things
- Items are being misplaced
- They have a hard time managing routine tasks or their expenses
- They’re nonresponsive or moody
- They lose track of the time, date, or day
- Events, names, and recent conversations are forgotten
- Difficulty organizing, planning, or concentrating
- Traveling to new places alone is difficult
- Social withdrawal from friends and family
- Difficulty expressing thoughts and increased forgetfulness
Moderately Severe Cognitive Decline
Your loved one will now need some assistance with ADLs (activities of daily living). This includes meal preparation, dressing, bathing, etc. This is a good time to consider moving your loved one into a memory care community. This stage of decline typically presents the following symptoms:
- Difficulty knowing what day it is, where they are, and other orientation related aspects
- Sleep patterns may change
- Increased irritability and aggression
- Difficulty with ADLs
- Reduced problem-solving abilities and mental acuity
- Difficulty remembering their phone number, home address, and other important information
- Memory loss of current events and personal details
Severe Cognitive Decline
Your loved one may now have problems controlling their bowels and bladder in this stage, also referred to as middle dementia. Symptoms commonly included in this stage are as follows:
- Poor judgment and increased confusion
- Repetitive, compulsive behavior like tissue shredding, hand ringing, etc.
- Particularly in mentally or socially challenging situations, they will feel withdrawn or moody
- Problems with perception
- An increase in becoming lost and/or wandering
- Confusing night and day, and difficulty sleeping
- Hallucinations, anxiety, agitation, delusions, or paranoia
- Communication skills are severely diminished
- They have a hard time choosing appropriate clothing for the occasion or the season
- Severe difficulty with personal care, eating, dressing, bathing, etc. (ADLs)
- Memory loss is severe
Very Severe Cognitive Decline
Finally, quality of life and providing comfort will be the focus here. Communication may cease altogether. Possibly lasting several years, these final stages include the following:
- Considerable weight loss or weight gain
- Difficulty swallowing/eating
- The person is particularly vulnerable to infections
- Loss of bowel and bladder control
- Physical capabilities decline such as holding their head up, sitting, walking, etc.
- With ADLs, they now need full-time help
- Need assistance with ambulation, walking, etc.
- Physical outbursts, combativeness, disorientation
- The ability to communicate is eventually lost
