What stages are there in dementia?
It’s quite common to hear the dementia journey described as a series of ‘stages’ in which different symptoms and challenges can emerge. Find out all the basic information about dementia stages and what they mean
Dementia is a progressive condition which slowly gets worse. The crucial word here though is ‘slowly.’ The dementia journey usually lasts several years – people have been known to live for 20 years with dementia – so having some idea about how and when life might change can be useful for everyone.
Three basic stages of dementia
1. Early – when symptoms are mild and, despite being quite forgetful, most people are still living relatively independently. They might also still be driving or working.
2. Middle – this is the longest stage and can last many years. Forgetfulness and confusion gradually becomes more pronounced, your loved one might also become withdrawn, depressed or moody, and need an increasing amount of help with daily life.
3. Late – most people at this point become increasingly frail, they may not talk or communicate very much and can appear to be in ‘a world of their own.’ They often need round-the-clock care.
BUT whilst this three-stage theory gives a general overview of dementia, it can seem too simplistic for anyone who is living with the condition. Many people therefore find it more useful to see the journey broken down further (see below) and explained in more detail.
The seven stages of dementia
This offers a more clearly defined picture of the whole dementia journey.
1. Normal – no symptoms of dementia or Alzheimer’s are apparent, though changes in the brain might already be occurring – these can happen several years before symptoms emerge.
2. Normal forgetfulness – this involves minor memory problems which can easily be put down to ‘senior moments’ or stress.
3. Mild Decline – loved ones may begin to notice subtle changes and signs that something ‘isn’t right.’ You might be frequently losing your purse, or keys or forgetting appointments. If you seek advice from a doctor at this point you could be told you have Mild Cognitive Impairment. Experts believe this stage can last up to seven years.
4. Moderate Decline – this is when symptoms become clearer to everyone. The person with dementia might find it difficult to manage money or pay bills, or remember what they had for breakfast. If they visit their doctor at this point, and undergo a Mini Mental State Examination (MMSE) it’s likely they will be diagnosed with dementia. The average length of this stage is around two years.
5. Moderately Severe Decline – loved ones may need more help with day-to-day living during this stage. Whilst they can probably still bathe and take care of other personal needs on their own (such as using the loo), they could find it difficult to dress appropriately or be unable to remember simple facts about themselves, such as their address or phone number. However, they usually recognise family and friends and can recall events from decades ago (especially their childhood) with great clarity. On average this stage can last around 1.5 years.
6. Severe Decline – this is the point at which many people with dementia move into care homes or need constant supervision at home. You might need to help them with bathing and they may also become incontinent. You could notice changes in their personality and behaviour – such as anger and aggression – which can be upsetting and difficult to cope with. However, although they might be very confused, they often still know and recognise the people closest to them – which can be some comfort. Experts believe this stage can last, on average 2.5 years.
7. Very Severe Decline – your loved one might not reach this stage, since many people with dementia pass away before it happens, often as a result of other health conditions such as strokes or heart attacks. But if they do get this far, they’ll need round-the-clock care and the support of professional carers (if they haven’t already got this). Whilst this stage can undoubtedly be harrowing for loved ones, it’s important to remember that the person with dementia may not experience it in the same way, since they no longer really understand what’s happening. Providing everyone does their best to keep them comfortable and calm, there’s every chance this stage can end peacefully for them – and for you.
How long do dementia stages last?
It’s very difficult to put a time scale on the illness at this point. However, research shows that if no other medical conditions emerge, this final stage of life can last up to five years.
Good to know
Although these stages of dementia are well documented and researched, it’s best not to dwell too much on the finer details, or think too much about ‘which stage’ you might be at. Everyone’s dementia journey is unique – some people will move slowly through some stages and quicker through others. It’s far more important to make the most of where you are now, and to focus on what you can do, rather than worry about what you may, or may not, be able to do later down the line.