What changes can I expect?
Dementia affects people in different ways and at different times. So, if you are caring for someone who lives with dementia, what changes can you expect?
Some people may experience profound and rapid changes in the early stages of dementia, while for other people the changes can be much more subtle and not become apparent for years.
What are the stages of dementia?
Some of the features of dementia are commonly classified into three stages or phases. It is important to remember that not all of these features will be present in every person, nor will every person go through every stage. Many factors can influence the progression of dementia, including the type of dementia diagnosed. However, it remains a useful description of the general progression of dementia.
- Early dementia
- Moderate dementia
- Advanced dementia
Early dementia
Often this phase is only apparent in hindsight. At the time it may be missed or put down to ageing or overwork. For people under the age of 65, it may be missed because the symptoms can often be mistaken for other more common diagnoses. The onset of dementia is usually very gradual, and it is often impossible to identify the exact time it began. The person may:
- Appear more apathetic, with less sparkle
- Lose interest in hobbies and activities
- Be unwilling to try new things
- Be unable to adapt to change
- Show poor judgement and make poor decisions
- Be slower to grasp complex ideas and take longer with routine jobs
- Blame others for “stealing” lost items
- Become more self-centred and less concerned with others and their feelings
- Become more forgetful of details of recent events
- Be more likely to repeat themselves or lose the thread of their conversation
- Be more irritable or upset if they fail at something
- Have difficulty handling money.
In the early stages of dementia many people find it helpful to get a better understanding of the condition and how they can either live well with the condition or support a loved one.
Dementia Australia can help you learn what is happening, provide emotional support, information, education and counselling. To access these services, please call the National Dementia Helpline on 1800 100 500.
At this stage of the condition, it could also be helpful to make modifications to your home to help the person living with dementia be more comfortable, confident, safe and supported in their environment. For more information on adapting your home, visit our help sheet.
Moderate dementia
At this stage the problems are more apparent and disabling. The person may:
- Be more forgetful of recent events. Memory for the distant past generally seems better, but some details may be forgotten or confused
- Be confused regarding time and place
- Have changes in personality, become disinhibited or become antisocial
- Become lost if away from familiar surroundings
- Forget names of family or friends, or confuse one family member with another
- Forget how to do household activities – for example, leave saucepans and kettles on the stove or leave the gas unlit
- Leave the house at unexpected times and perhaps become lost
- Behave differently than they might have in the past, for example going outdoors in nightwear
- See or hear things that are not there
- Repeat themselves
- Be neglectful of hygiene or eating
- Become angry, upset or distressed through frustration
- Lack insight into the changes occurring.
When a person living with dementia is in this stage of the condition increasing levels of assistance may be required to help the person maintain their functioning in the home and community. If you are a carer you may also be struggling to adjust to the changes in your loved one. Dementia Australia offers counselling, support groups and education to carers and people living with dementia at all stages of the condition. For more information on these services, please call us on 1800 100 500.
Advanced dementia
At this third and final stage, the person will likely need total care or more frequent care and supervision. The person may:
- Be unable to remember occurrences for even a few minutes, for instance forgetting that they have just had a meal
- Lose their ability to understand or use speech
- Become incontinent
- Show no or infrequent recognition of friends and family
- Need help with daily tasks such as eating, washing, bathing, going to the toilet and dressing
- Fail to recognise everyday objects
- Experience sleep disturbances
- Be restless
- Respond in an aggressive way to others, especially when feeling threatened or closed in
- Have difficulty walking, eventually perhaps becoming confined to a wheelchair
- Have uncontrolled movements
- Become immobile
- Have difficulty swallowing.
Most people in the later stages of dementia need total care and usually receive this in a residential facility. In some cases, families and carers will choose to care for the person at home. If you need support at this time in the progression of the condition, we are here to help. Call the us on 1800 100 500.
Want to read more? Check out these articles:
To my family and friends Heather was diagnosed with Alzheimer’s disease four years ago. There’s much she’d like her family and friends to know about living with dementia, and how she’d like to be treated.
How do I cope with the changes of dementia? Experiencing changes may lead to a range of different emotions both for a person living with dementia and family, friends and carers. We explore some ways to process these changes.
How can I live well with dementia? More than two-thirds of people living with dementia live in the community. When supported to live well at home, these people are less likely to enter residential aged care prematurely for a variety of reasons.
How can I plan for the future? Dementia affects people differently. One person may begin to lose the ability to handle money at an early stage, while others may keep these skills much longer. So how do you plan for these changes?
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