Progression of dementia
Although everyone experiences dementia in their own individual way, it can be helpful to think of the progression of dementia as a series of stages.This page outlines the characteristics of early, middle and late stage Alzheimer's disease, and briefly looks at other forms of dementia.
Alzheimer's disease
Alzheimer's disease is a progressive illness. This means that the structure and chemistry of the brain become increasingly damaged over time. The person's ability to remember, understand, communicate and reason will gradually decline.Looking at Alzheimer's disease as a series of three stages can be a useful way of understanding the changes that occur over time. But it is important to realise that this view of Alzheimer's can only provide a rough guide to the course of the disease.
- Some symptoms may appear earlier or later than indicated here, or not at all.
- The stages may overlap - the person with Alzheimer's may need help with one task, but may be able to manage another activity on their own.
- Some symptoms, such as wandering, may appear at one stage and then vanish, while others such as memory loss will worsen over time.
Early stage
Alzheimer's disease usually begins gradually with very minor changes in the person's abilities or behaviour. At the time such signs are often mistakenly attributed to stress or bereavement or, in older people, to the normal process of ageing. It is often only when looking back that we realise that these signs were probably the beginnings of the dementia.Loss of short term memory is a common early sign. The person with Alzheimer's may forget about recent conversations or events. They may repeat themselves. They may be slower at grasping new ideas or lose the thread of what is being said. The person with Alzheimer's may sometimes be confused. They may show poor judgment or find it harder to take decisions. Other symptoms may include a loss of interest in other people or activities, a readiness to blame others for 'stealing' mislaid items and an unwillingness to try out new things or adapt to change.
If you are caring for someone with Alzheimer's disease there's a lot you can do in the early stages to help the person you are caring for maintain their independence. It may be tempting to do things for them, but a person with dementia is more likely to retain their sense of self-worth if they are given the chance to do things for themselves, with support if necessary.
People with dementia may also be anxious and agitated. They may experience distress over their failure to manage tasks. They may be in need of reassurance. Try to talk to the person you are caring for, and give them as much emotional support as you can.
Middle stage
As Alzheimer's disease progresses the changes become more marked. The person will need more support to help them manage their day-to-day living. They may need frequent reminders or help to eat, wash, dress and use the toilet.The person is likely to become increasingly forgetful, particularly of names, and may sometimes repeat the same question or phrase over and over because of the decline in their short term memory. They may also fail to read more
