Three Stages of Dementia, What to Expect.

The three stages of dementia provides a structure for understanding how your loved one may change and what you can expect.

Dementia is an umbrella term that covers many types of diseases that all result in a decrease in memory, the ability to think and reason and the ability for a person to care for herself.

Different dementias have different symptoms and progress in different ways. The three stages of dementia is a simple way of looking at the progress of a complex group of diseases.

Dementia Stage 1:
The person becomes aware that she is not thinking and remembering as she did in the past. At this stage, she is pretty good at covering up gaps and lapses in memory. Family members and others may see a troubling lapse once in a while but will likely attribute it to the person having a bad day or the normal memory changes that occur with aging. Tools such as making notes, using a written calendar and keeping lists can help her stay on track.

Actions to take:

  • At this stage you may not really be aware of your family member's memory issues. If you are concerned or she expresses concern about her memory to you, encourage her to discuss her concerns with her doctor. Early diagnosis can result in treatment that enhances your family member's quality of life.
  • Suggest and support the use of memory aids like making notes to help your family member remain independent.
  • Begin discussion about aging issues such as where she would want to live if she could not live independently, her end of life preferences and legal, financial and medical paperwork.

Dementia Stage 2:
At this stage memory lapses and confusion become more obvious and the person can no longer hide her memory gaps from family and friends. Her short term memory is very impaired and she may ask a lot of repetitive questions and be anxious about when events are happening. Her ability to manage her day-to-day life is affected. A formerly neat person may become messy. Hobbies that previously provided enjoyment may be abandoned. She may withdraw socially, finding that she is uncomfortable in group situations. Friends may drift away when your family member can no longer participate and respond as she did before.

Actions to take:

  • Encourage your family member to discuss her condition with her doctor if she has not already been diagnosed.
  • Make sure your family member has completed her legal and medical paperwork to allow someone else to act on her behalf if she becomes incapacitated.
  • Regularly visit your family member or hire someone to check in with her to make sure that she is eating well, taking medications, that her environment is safe and that she has opportunities to connect with others socially.
  • Watch for signs that your family member cannot handle day-to-day responsibilities like paying bills, shopping or cooking and be prepared to provide support.
  • Investigate long term care options that are appropriate for your family member.
  • Focus on managing your stress. Create a support team for your family member.

Dementia Stage 3:
At this stage, your family member is highly impaired by her dementia. It is obvious to anyone speaking to her for more than a few minutes that something is wrong with her ability to think. Her dementia may also limit her ability to communicate. Your family member requires daily supervision if not constant supervision to make sure that she is safe. She needs assistance with the activities of daily living such as bathing and dressing and can no longer live independently.

Actions to take:

  • Your family member's ability to communicate may be significantly impaired at this stage, observe what is normal behavior for your loved one and interpret changed behavior as possible signs of illness or pain.
  • Step fully into your role as an advocate for your family member by representing her best interests at doctor visits and with any long term care providers that you use.
  • Continue to focus on managing your stress. Work with a support group or coach or counselor to take care of yourself.
  • Individuals in the end stages of dementia may qualify for hospice support. Discuss this option with your family member's doctor.
The stages of dementia as outlined above are guidelines to help you put your family member's condition and behavior into context and to let you know what you might expect as her illness progresses.

Each person will progress differently through their illness based on the type of dementia she has and her overall physical condition.

Other illnesses can tax the your loved one's system and make her progress through the stages of dementia more quickly. Illnesses that would be relatively minor in a younger person such as a urinary tract infection, can cause a dramatic decline in her ability to function.

Leave the Three Stages of Dementia page and Return to the Understanding Dementia Home Page