Common stages of dementia

Stages of Dementia

How does dementia progress?

Each person with dementia will have a different experience of the illness, as symptoms can vary from person to person, even within the same type of dementia.

Because of this there is great deal of variability in the progression of dementia. A person's symptoms may fluctuate to some extent from day to day, or even within the same day. Sometimes a noticeable decline can happen quickly and in other cases this will happen over a number of years.

While the information below provides the general progression of dementia, it is important to note that these symptoms and stages will not be present in every person with dementia. For more information, see the progression information under each type of dementia.

Early Stage Dementia

For many people with dementia, the early signs of dementia appear very gradually. It may only be in hindsight that the person with dementia and their loved ones can recognise the symptoms of dementia.

Symptoms of early stage dementia may include:

  • Not being able to recall details of recent events and conversations
  • Become slower to grasp new ideas, or losing the thread of what is being said
  • Taking longer to do routine jobs
  • Difficulty adapting to change and an unwillingness to try new things
  • Losing interest in hobbies and activities
  • Being irritable and easily upset
  • Difficulty finding the right words
  • Showing poor judgment and making poor decisions
  • Blaming others for mislaid items
  • Asking the same questions repeatedly
  • Become disorientated on occasions

Middle Stage Dementia

As dementia progresses, independent living may become more difficult and the person with dementia is likely to need more support. The person may require some assistance with personal care activities such as showering, toileting, and eating. However, with a positive and proactive approach to dementia care, the person with dementia may still be able to live an active and engaged life.

Symptoms of the middle phase of dementia may include:

  • Forgetting to eat
  • Neglecting personal hygiene
  • Hallucinations or delusions
  • Becoming confused about where they are, wandering off, or getting lost if away from familiar environments
  • Forgetting about recent events or the names of family and friends
  • Becoming very easily upset and distressed through frustration
  • Using inappropriate words for everyday objects
  • Living in the past; talking about people and things that happened a long time ago as if they are recent events

Late Stage Dementia

By the time a person reaches the late phase of dementia they will need continual supervision and assistance, either at home or at an aged care facility.

Their speech may deteriorate to the point where they can no longer be understood. Loss of memory may become very pronounced, with the person unable to recognise familiar objects or surroundings or even those closest to them, although there may be sudden flashes of recognition.

This can be a particularly distressing time for the person with dementia and their carers.

By using appropriate dementia communication techniques you can continue to maintain a warm, meaningful relationship with the person. Communicate in a positive manner, use warm facial expressions and appropriate eye contact. Like all of us, it is vital that people with dementia continue to feel a sense of worth, listened to, and loved throughout their life

Symptoms of the late stages of dementia may include:

  • Inability to recognise family and friends or even everyday objects, however the person will still respond positively to a warm, friendly face. They can still show emotion and respond to affection
  • Inability to locate their own room and bed, as their environment becomes less familiar to them
  • Short term memory loss may become more apparent and the person may totally forget recent events such as eating a meal or a recent visitor
  • Continence issues
  • Difficulty eating and swallowing
  • Moving around may also become more difficult

Even though the person seems unable to understand conversation, or have a limited connection to the environment surrounding them, there is a very good chance that they will still respond to affection, a calm soothing voice, music, or stroking a pet.

Many people with end stage dementia move into an aged care facility where care is provided 24 hours a day, and secure wings are made available specifically for people with dementia.

Discussing options about care at the end stage of dementia early after diagnosis allows people living with dementia to have a say in the care they receive.


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