What are the different stages of dementia?
There are many different forms of dementia and it presents differently and progresses at different rates in different people. Some people can stay in a state of mild decline for a long period of time, whereas others develop a wide range of symptoms seemingly all at once.
Understanding each stage can help make these transitions a little easier.
Everyone starts at stage 1. There are no symptoms of cognitive impairment and mental function is normal.
This stage can vary between typical age-related memory problems that most elderly people will face (such as forgetting certain dates) or could include some of the early signs of Alzheimer’s disease. Side effects that correspond with this stage include:
- forgetting everyday phrases
- forgetting the location of objects (such as where the house keys are)
Stage 3 is where symptoms of dementia or Alzheimer’s can become more noticeable to friends and family. It won’t have a major impact on your loved one’s day-to-day life, but you may notice these signs:
- Memory loss/forgetfulness
- Verbal repetition
- Less organised
- Less able to concentrate
- Work performance impaired
- Trouble with complex tasks/problem solving
- Difficulty driving
This stage is commonly defined as early onset dementia or Alzheimer’s. Symptoms of cognitive decline are apparent and your loved one should see a healthcare professional. Symptoms include:
- Trouble with routine tasks
- Social withdrawal
Stage 5 is when your loved one is likely to need help with routine tasks such as washing and dressing. They may need a home carer or to move into supported living accommodation. Other symptoms include:
- Memory loss of personal details and current events
- Reduced mental acuity and problem-solving capacity
Also known as middle dementia or moderately severe Alzheimer’s disease, at this stage your loved one will need help for most of the activities of daily living such as going to the toilet or eating. They may also find it difficult to sleep, experience paranoia or delusions, be more anxious and have difficulty recognising loved ones.
Stage 7 is late-stage dementia or severe Alzheimer’s disease. Your loved one is unable to care for themselves, lives with severe motor and communication impairment and may lose the ability to speak or walk.
I’m concerned about someone who may have, or is living with, dementia
There are many reasons why an older person might be experiencing memory loss, including the normal ageing process. However, if you are worried about someone who is becoming increasingly forgetful or has other signs of dementia, encourage them to see their GP. If detected early, in some cases dementia’s progress can be slowed and the person affected may be able to maintain their mental function for longer.
Memory loss is one of the key symptoms of dementia, but other symptoms include:
- changes in personality and mood
- increasing difficulty with tasks and activities that require concentration and planning
- periods of mental confusion
- difficulty finding the right words or not being able to understand conversations as easily.
You could suggest going with them to see the GP to provide support. You could take notes to help them remember what was discussed after the appointment.
It can be difficult raising the issue of memory loss and the possibility of dementia. Someone who has these symptoms may be confused, unaware they have any problems, worried or in denial.
Alzheimer’s Society suggests before talking to the person, consider the following:
- What could be stopping the person from seeing the GP about their memory problems?
- Have they mentioned their memory problems?
- Do they describe their memory problems as a natural part of ageing?
- Could they be scared about what the changes could mean?
- Do they think there won’t be any point in seeking help?
- Are you the right person to speak with them? There might be someone else who they turn to for advice.
- Would they find it reassuring to have someone offer to go to the GP with them?
- When you do talk to them, choose a place that is familiar and non-threatening and allow plenty of time so that your conversation isn’t rushed.
In the early stages, your loved one will be able to manage most of their immediate medical needs but you may need to assist with tasks associated with memory. This could be keeping up with GP and healthcare appointments and helping with financial matters, medications, social and work obligations.
In the early stages, encourage them to:
- maintain their independence
- get involved in activities they enjoy
- express their emotions
- establish a routine – this can possibly help delay the development of the disease
This can be the longest period that you will face as a caregiver, as the symptoms can go on during the majority of your loved one’s later years. You will need to be patient, flexible and understanding as your loved one’s day-to-day functions become more difficult.
As they begin to need more help with basic tasks such as dressing they may get frustrated and angry and sometimes take it out on you. They may act in unusual or unexpected ways. This can be very stressful and worrying. It’s important that you look after your own wellbeing, get support from family, friends and support services.
The later stages will be the most difficult, as your loved one will be very frail and rely on you for most of their daily care. At this stage, encouraging them to eat and sleep will grow increasingly difficult and they may lose the ability to walk steadily. An occupational therapist may be able to help them stay mobile without falling, and speech therapists and nutritionists can support you with their changing speech and eating patterns. Incontinence, severe memory loss and disorientation, immune system problems, repetitive movements and strange or unusual behaviour must all be managed during this stage as well.
Watching a loved one live with dementia is never easy, but with the proper tools and support in place, you can help them navigate their symptoms to live their life to the best they can. Read up on the latest thinking and think about joining a support groups for caregivers where you can share your successes, frustrations, fears and joys with others going through the same thing. Remember, you are not alone!
- Listen to their concerns, even if they don’t make sense, and reassure them that you’re trying to see things from their point of view.
- Create a calm environment. Turn down loud noises, move to a quiet space with softer lighting and a neutral temperature.
- Keep your own body language and tone of voice neutral, calm and reassuring.
- Don’t ask too many questions and keep questions simple and short.
- Ask them what would help right now.
- Before doing something or calling someone else, ask if this is okay with them.
- Remove any triggers that upset them, if you’re aware of these.
- Never put yourself in harm’s way.
It’s okay not to know what to do and it can even be helpful telling the person this. You’re not there to rescue them; explain that you might need to ask for advice from someone else to help you better support them – a crisis team for example.
Remember a crisis is something that is outside of your control, is intensely difficult and could lead to harm. In a crisis you need to get support. There may be underlying reasons for the crisis that need medical attention, like an infection.
Who can help?
- NHS 111
- 999 if in immediate danger
- Local mental health crisis teams
- Social care team
After the crisis
- Take time out to digest what has happened.
- Talk over your thoughts and feelings with someone you trust.
- If it helps, write down your thoughts and feelings – get them out of your head and on paper.
- Access support – IAPT, carers support services.
- When things are calm, think about a future crisis management plan.
Find local dementia support around Doncaster
Please note that the Dementia Directory is currently under review for release in spring 2024. If you would like to discover other groups and activities in your community, please visit the directory page on the Your Life Doncaster website: Directory – Find groups and organisations near you – YourLifeDoncaster
Tel: 01302 812813
The Keep in Mind service is commissioned by City of Doncaster Council in partnership with Age UK and Alzheimer’s Society, Club Doncaster Foundation, Crossroads Care, darts and the Royal Voluntary Service. It offers a range of holistic wellbeing activities for people with dementia and their carers and general advice and support, depending upon specific needs and interests. Once referred into the service, you will receive an expert initial assessment and be allocated a Pathway Coordinator. During the assessment you will be offered financial and practical advice and signposting support. Your Pathway Coordinator will work with you to build a personalised support package and will review this with you every 12 weeks to ensure it is still meeting your needs.
The Keep in Mind service provides the following offers:
- Dementia Cafés
- Activity session for people with Young Onset Dementia
- Singing for Memory group
- Physical activity groups
- Cognitive Stimulation Therapy
- Carers support groups
The service is provided by a partnership between Rotherham, Doncaster and South Humber Healthcare Trust (RDaSH) and Alzheimer’s Society. You can access it if you are concerned about your memory, or that of a loved one. If a diagnosis of dementia follows, the service would support you throughout your journey, as close to your home as possible. Depending on where you are at in your dementia journey, this could be with information and support, holistic support planning, preventing isolation, building support networks, improving coping strategies or higher level of support.
You will be provided with a named dementia advisor who will ensure that you are able to easily access coordinated, timely support whether you have memory concerns, a diagnosis of dementia or are a carer for someone with the condition. The service is provided across the four Doncaster localities in coordination with health and social care.
For those people requiring a higher level of clinical intervention, there will be a registered healthcare professional allocated to the case to work jointly with your dementia advisor to ensure all your care needs are addressed.
Anyone can refer into the service by visiting the webform: https://www.alzheimers.org.uk/dementia-professionals/make-a-referral or by calling 01302 246724, Monday to Friday 8.30am to 6pm (excluding Bank Holidays).
DonMentia is registered Charity raising money for people in Doncaster affected by Dementia. The charity is supported by unpaid volunteers so that all monies raised go where they are much needed.
Backed by a team of experienced and professional trustees, DonMentia’s founder, Eileen Harrington, works tirelessly to support people with dementia and their carers across the Doncaster region.
DonMentia offers the following two grant schemes available for people living with Dementia and their carers:
- Assistance with the cost of short respite breaks and holidays for dementia suffered and their carers
- Assistance with up to 50% of the costs of mobility aids, sensory equipment or travel (taxis to treatment and consultations)
These grants can be accessed by completing an application form at the following link: Grants – DonMentia
If your application is approved, DonMentia will make the grant payment upon proof of receipt for the item(s).
Tel: 07513 206143
We are devoted to Raising Dementia Awareness and, as your local charity, are always coming up with bright and innovative ideas to bring dementia into the public eye.
The DonMentia Forum is held at 1.00pm on the second Wednesday of each month at Scawsby Community Centre – please email for details.
National support organisations
See what national support is available for dementia.