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Progression of dementia

Dementia is a progressive disease, which means that the person’s ability to communicate and engage in activities will decline over time. Every person with dementia has different symptoms and along with their own individual lifestyle, there are many variables that can affect the ‘speed’ of how the dementia develops, making the rate of this progression difficult to predict. Sometimes it can happen over a matter of months, or for others their abilities can deteriorate over a period of years. For those caring for someone with dementia, they might also note daily changes – like the first time they are disorientated in a familiar place, or forget their partner's or children’s name.

Stages of dementia

Dementia is sometimes classified into three stages although it is important to note that not all of these features will be present in every person, nor will every person go through every stage. However it remains a useful description of the general progression of dementia.

  1. Early dementia
  2. Moderate dementia
  3. Advanced dementia

Stage 1: Early dementia

Early dementia causes gradual changes in behavior, often only noticed in retrospect once a formal diagnosis has been discussed. Changes in behavior could include:

  • Unwillingness to try new things/inability to adapt to change
  • Taking longer to do routine jobs
  • Loss of interest in hobbies and activities
  • Irritability and sensitivity
  • Poor judgement decisions
  • Increased self-centeredness and a lack of concern the feelings of others
  • Difficulty maintaining conversation, including repetition or losing their train of thought
  • Difficulty handling money.

Stage 2: Moderate dementia

Moderate dementia is when independent living can be risky, and usually requires some supervision. Symptoms of moderate dementia include:

  • Forgetting to eat
  • Neglect of personal hygiene
  • Seeing or hearing things that are not there
  • Becoming easily lost if away from familiar environments
  • Forgetting about recent events and/or names of family and friends
  • Feeling easily upset and distressed through frustration
  • Forgetting saucepans and kettles on the stove, leaving gas unlit
  • Inappropriate behaviour e.g. going outdoors in nightwear

Stage 3: Advanced dementia

Severe or advanced dementia is when the person needs continual supervision, and often requires specialist care in a dementia unit. The person will need help to shower and use the toilet, and their speech will decline to the point where they can no longer be understood. They may exhibit behaviours such as:

  • Inability to recognise family and friends, or even everyday objects
  • Inability to locate their own room and bed
  • Difficulty remembering what happened in the last few minutes
  • Difficulty walking, eventually perhaps becoming confined to a wheelchair
  • Restlessness, perhaps looking for a long-dead relative or consumed with going over a particular event from their life
  • Incontinence
  • Feeling disturbed at night and restless at sundown

It is important to remember that some abilities do remain – like the sense of touch and hearing and the capability of responding to emotion. There are still many opportunities to have positive interactions with a person who has stage 3 dementia (or any stage) and we can help you make the most of your life with them in it.