Dementia Progression: Learn the Stages and How to Prepare

How Dementia Progression Unfolds and What Families Can Do to Prepare

Many people approaching the end of their lives need memory care, whether that’s at home or in a specialized care facility. For family caregivers, understanding how dementia progresses, especially at the end-of-life, is absolutely vital. This knowledge is helpful when preparing for dementia care and possibly choosing a hospice provider for your loved one. So, let’s learn more about dementia’s progression, its stages, and how you can support someone with this condition.

Breaking Down the Dementia Progression Stages

Dementia manifests differently depending on the person, but generally speaking, its stages can be categorized using the Global Deterioration Scale (GDS). This tool allows medical professionals to break the condition into specific phases. For family caregivers, knowing what stage your loved one is at can be instrumental in dementia care planning. Here’s a brief overview of the primary stages:

Early Stage (Stage 1-3)

In the early stage, your loved one may still function independently. They may continue to drive, work, and participate in social activities, but memory lapses begin to become more noticeable. During this time, the patient is often aware of their decline, which can lead to frustration and anxiety. However, they may still be able to give input into dementia care planning. Other symptoms common in the early stages include:

• Difficulty coming up with the right word or name
• Trouble remembering names when introduced to new people
• Challenges with performing tasks in social or work settings
• Forgetting material, they’ve just read
• Losing or misplacing a valuable object
• Increasing trouble with planning or organizing

Middle Stage (Stage 4-5)

This is typically the longest stage and can last for many years. As the disease progresses, your loved one will require a greater level of care. The damage to the nerve cells in the brain makes it difficult to express thoughts and perform routine tasks. Be aware of these middle-stage dementia symptoms:

• Forgetfulness of events or personal history
• Feeling moody or withdrawn, especially in socially or mentally challenging situations
• Confusion about where they are or what day it is
• They need help choosing proper clothing for the season or the occasion
• Changes in sleep patterns, such as sleeping during the day and becoming restless at night
• An increased risk of wandering and becoming lost
• Personality and behavioral changes, including suspiciousness and delusions

Late Stage (Stage 6-7)

In the final stage of the disease, individuals lose the ability to respond to their environment, to carry on a conversation, and, eventually, to control movement. They may still say words or phrases, but communicating their pain becomes difficult. Signs that someone has entered the late stages of dementia include:

• Requiring round-the-clock assistance with daily activities and personal care
• Loss of awareness of recent experiences as well as of their surroundings
• Personality or behavioral changes
• Changes in physical abilities, including the ability to walk, sit, and, eventually, swallow
• Vulnerability to infections, especially pneumonia

Getting Started with Dementia Care Planning

No one wants to think about Alzheimer’s or dementia care planning, but preparation is key to helping your loved one live comfortably for as long as possible. As soon as they receive the diagnosis, families can help with:

• Legal and Financial Planning—It’s highly recommended to establish Power of Attorney for finances and healthcare right away. This designates a trusted person to make decisions when the individual with dementia can no longer do so.
• Safety Modifications—Your loved one’s home environment may no longer be safe for them after their dementia progresses. Take care to remove tripping hazards, install grab bars, and consider using GPS tracking for those prone to wandering.
• Building a Care Team—Caregiving is too heavy a burden for one person to carry alone. Early in the progression, identify who is willing to help. This includes family members, professional in-home caregivers, and even adult day care centers.

When to Consider Hospice for Dementia

There’s a misconception that hospice is only for the final days of life. In reality, hospice care can provide immense support for the last six months of life. Hospice for dementia is often recommended when the patient has six months or less to live, as certified by their doctor, and chooses to forego curative treatment. If your loved one is showing a combination of these signs, hospice may be a beneficial form of care:

• The inability to walk without assistance
• Incontinence
• Speaking only a few intelligible words
• Recurring infections (such as UTIs or pneumonia)
• Significant weight loss

Offering Dementia Support to Families

Knowing the dementia progression stages is helpful for caregivers, but it doesn’t make watching a loved one decline any easier. Agape Hospice & Palliative Care is here to help. We offer dementia family support and exceptional patient care in Los Angeles and Orange Counties. Our memory care team has worked with dozens of clients over the years, and we’d be honored to be part of your family’s journey. Contact us for details.