Understanding the Different Stages of Dementia and Appropriate Care Approaches for Each Stage

Medical practitioners frequently discuss the stages of dementia. This is referring to how
Alzheimer’s or dementia affects a person over time. By facilitating communication between doctors
and carers, guidelines that outline the stages assist physicians in deciding on the best treatments.
Mild (“early”), moderate (“middle”), and severe (“late”) phases of dementia are typically thought to exist. Based on the symptoms, a more specific dementia stage is frequently determined.

Knowing how the symptoms alter as the disease progresses will be useful. Alzheimer’s and related
illnesses can induce abrupt changes in a person’s personality and range of physical activities. As
dementia worsens, they will change, stressing out friends and family. Knowing what to expect might
help you get ready for your loved one’s personal, social, and medical requirements.

The stages, according to many accepted scales, are discussed in this page, along with symptoms
unique to each stage. There is also guidance on how to care based on the phase of dementia,
including information on assistive technology and the best kinds of assisted living facilities.

Global Deterioration Scale / Reisberg Scale

“Reisberg Scale” or the more formal "Global Deterioration Scale (GDS) for Assessment of Primary Degenerative Dementia" moniker. Depending on the degree of cognitive deterioration, the GDS breaks into seven stages. Due to the fact that some forms of dementia, such as frontotemporal dementia, may not usually accompany memory loss, this test is mainly pertinent for those with Alzheimer’s disease.

Usually, a person in stages 1-3 does not have adequate signs for dementia identification. A dementia
patient is usually in stage 4 or later when diagnosed. Stages 4 and 5 are referred to as "early
dementia," Stages 6 and 7 as "middle dementia," and Stage 7 as "late dementia.

Stage 1: No Cognitive Decline

Diagnosis: No Dementia
Signs and Symptoms: The first stage of dementia is characterised by normal function and no
memory loss.
Expected Duration of Stage: N/A

Stage 2: Very Mild Cognitive Decline

Diagnosis: No Dementia
Signs and Symptoms: Fails to remember names, loses familiar items, and displays unknown
symptoms from family or medical professionals.
Expected Duration of Stage: Unknown

Stage 3: Mild Cognitive Decline

Diagnosis: No Dementia
Signs and Symptoms: elevated forgetfulness, minor attentional difficulties, reduced productivity at
work, regularly getting lost, has trouble finding the perfect words, Family members start noticing.

Expected Duration of Stage: This phase lasts about two to seven years.

Stage 4: Moderate Cognitive Decline

Diagnosis: Early-stage
Signs and Symptoms: Trouble in focusing, forgetting recent occurrences, is incapable to handle
money, cannot travel independently in foreign locations, difficulty finishing projects, Denies
symptoms, and detachment from family and friends. A doctor can spot cognitive issues.
Expected Duration of Stage: This stage typically lasts two years.

Stage 5: Moderately Severe Cognitive Decline

Diagnosis: Mid-Stage
Signs and Symptoms: Serious memory problems require help with ALDs (dressing, showering, etc.),
forget specifics like an address or contact number, are unaware of the time or date, and are unsure
of their location.
Expected Duration of Stage: This period typically lasts 1.5 years.

Stage 6: Severe Cognitive Decline (Middle Dementia)

Diagnosis: Mid-Stage
Signs and Symptoms: Unable to perform ADLs independently, forgets the names of relatives, forgets
recent occurrences, forgets important historical events. Counting down from ten is challenging.
Speech difficulties, incontinence (lack of bladder function), changes in temperament and emotions,
Imagination, obsessions, and distress
Expected Duration of Stage: The average duration of this stage is 2.5 years.

Stage 7: Very Severe Cognitive Decline (Late Dementia)

Diagnosis: Late-Stage
Signs and Symptoms: Inability to interact or speak, need assistance with the majority of tasks,
decline in motor function, incapable of walking.
Expected Duration of Stage: This period lasts 1.5 to 2.5 years in general.

Unique Care Requirements at Every Phase

Following the initial finding of dementia, a person might not need care support. This will alter as the
disease develops and symptoms increase. While many carers provide daily assistance to family
members, they also employ assistance. There are numerous care alternatives available, including in-
home care, daycare for adults, and nursing facility care. There is financial aid accessible.

Early-Stage Dementia

A person with early-stage dementia may operate fairly autonomously and needs little care. There
may be a requirement for straightforward names and appointment alerts. To help family members

be as autonomous as feasible, carers can also offer support with coping mechanisms. Creating a
daily to-do list and a medicine schedule are a couple of examples of how to do it.
Always keep your safety in mind. Any tasks that can’t be safely completed alone must be given
supervision and support. It’s wise for family members and carers to talk about the future while the
dementia patient is still in this stage. Consider making a long-term care plan and setting up financial
and legal arrangements.

Middle-Stage Dementia

Patients begin to lose their autonomy in the middle stages of dementia. Usually, support is needed
with everyday tasks like bathing, grooming, and dressing. At first, a person may require indications
or cues to carry out these duties. For example, reminders to take a shower or to have their clothes
made up and ready to go to bed. More direct help will eventually be needed, though. Caretakers
must practise patience and establish routines.

Carers must speak slowly and carefully and use non-verbal cues because patients in this phase of
dementia have more trouble conversing. Since people are incapable of driving, transportation is
needed. Additionally, care is required at this stage as it is dangerous to leave the patient
unattended.

Advanced-Stage Dementia

The final phase of dementia necessitates extensive care for the patient. Twenty-four hours a day,
support and monitoring are needed. Patients may need aid with getting in and out of bed,
transitioning from a chair to a bed, or switching postures to prevent bedsores if they are bedridden.
In this period, swallowing becomes a problem. Therefore, carers must ensure that food is soft, like
yogurt and applesauce, sliced into little pieces or pureed.
The person will eventually depend entirely on their caretaker. They are unable to carry out any
independent everyday tasks. Not every family can provide this calibre of care. They might transfer
the patient to a skilled nursing facility or employ a part-time carer.

Stage-by-stage Helpful Technology

Dementia patients can find a variety of tools and technological solutions to make life simpler.

Technology for Early Stages of Dementia

• In the beginning, pillboxes for managing prescriptions were not complicated. But it’s an
  effective way to ensure that the patient takes the correct medication at the appropriate
  time.
• When the patient forgets to switch off the cooker or oven, automatic shut-offs will be
  helpful. It may initially appear that this was an oversight, but starting a task and not finishing
  it is more typical. The patient can make simple errors with turn-offs without fear of
  consequences.
• Through the use of monitors, worried friends or relatives may keep track of if a dementia
  patient has turned off the electronic appliance. Monitors are inexpensive and simple to
  operate. It can be easily connected to your smartphone. Even remotely controlled devices
  can be turned off.
• Key finders or object trackers aid with the unavoidable forgetting that many individuals go
  through in the initial phases. When you push the trigger on the locator, a tiny beeper that is attached to the commonly misplaced object, such as the TV remote or spectacles, chirps a signal.

Tech for Middle-Stage Dementia

• The more advanced your dementia is, the more complicated your medication dispensers
  become. A high-tech dispenser issues an alert and supplies the appropriate dosage when it’s
  time to take particular medications. It is for patients who have passed the intermediate
  stages of the disease.
• Stove knob coverings prohibit the use of the stove. Allowing someone with slightly more
  advanced dementia to cook could put them in danger of starting a fire or other mishap. The
  knobs can also be taken off.
• There are specific features on clocks for dementia sufferers. The words “Morning” or
  “Afternoon”are written over huge, vivid numbers on dementia clocks. One can preserve
  their circadian rhythms and get better sleep by being conscious of the time of day.
• Medical alerts, often referred to as Personal Emergency Response Systems (PERS), are worn
  fastened to clothes or on a lanyard. It features a pushbutton that prompts medical
  assistance. For those who could fall or stray off and get lost, these are helpful. Numerous
  alerts include GPS tracking. Medical alert prices vary, and some come with security service
  memberships.
• A person who is forgetting names and faces in their family may benefit from speaking photo
  albums. Album images include buttons next to them that, when pressed, play recorded
  messages that describe the person or object depicted.

Final Takeaway

Dementia can develop at many different rates. Within three years following diagnosis, a few
individuals survive, while others may live for twenty years or longer. Despite the fact that there is
presently no cure for dementia, there are numerous ways to raise the quality of life for people who
already have the disease. Majorly these interventions focus on the caregiver’s education and
empowerment, the affected person’s emotional support, and a mix of cognitive, behavioural, and
physical interventions. It helps the person develop the mindset and coping mechanisms that will
best enable them to live independently and with comfort.

You may even like to read: Diabetes Homecare services