The stages of dementia

Mar 8, 2022

When a person is diagnosed with dementia, they and/or their relatives may wish to know how progressed their dementia is. Questions about the stages of dementia may be asked during a person’s diagnosis, or be explored through post-diagnostic support groups offered via Memory Clinics or through other providers such as charities.

 

How many stages of dementia are there?

When thinking about dementia https://ena.co.uk/homecare-services/dementia-care-services-at-home/, it’s important to remember that ‘dementia’ is an umbrella term for the numerous different types of dementia. Each type of dementia presents differently and no two people will experience their type of dementia in the same way, therefore accuracy around defining the stage of a person’s dementia can be really difficult.

 

In the US, the 7-stages of dementia are often referred to. In this model, preclinical stages and MCI (Mild Cognitive Impairment) are included, but crucially it really only describes the progression of very typical Alzheimer’s disease. It isn’t applicable for any other type of dementia.

The 7-stages of dementia model also doesn’t allow for the individual variation that we know happens for every person living with Alzheimer’s disease, and it is especially unreliable when thinking about progression in a person with younger onset Alzheimer’s disease or an older person with multiple long-term conditions alongside their Alzheimer’s.

In the UK, the 3-stages of dementia model is more commonly referred to for reasons that include:

  • It starts at diagnosis (unlike the 7-stage model, that describes diagnosis as stage 4).
  • It’s more applicable to different types of dementia.
  • It’s easier to understand and is accessible for the wider population.

 

What is the 3-stage model of dementia progression?

The language used to describe the 3-stages of dementia varies. You may see or hear terms that include:

  • Early/Mild
  • Middle/Moderate
  • Late/Severe/Palliative

In the early/mild stage of dementia a person may have:

  • Memory problems, particularly if the person has Alzheimer’s disease.
  • Experience changes in their mood or emotions.
  • Struggle with communication and language.
  • Find orientation (even in otherwise familiar places) difficult.
  • Struggle to run their diary, home and/or finances.
  • Find problem-solving difficult.
  • Have difficulties judging distances or other issues related to perception.

In the middle/moderate stage of dementia a person may find that:

  • Early stage symptoms have become more pronounced.
  • Paranoia and hallucinations begin or become more intense (hallucinations are particularly associated with dementia with Lewy bodies).
  • Changed behaviour is often experienced, including repetition, verbal distress, restlessness, disturbed sleeping and/or losing inhibitions.
  • Physical health problems may become more obvious, such as issues with continence and falls https://ena.co.uk/news/reducing-the-risk-of-falls-in-the-home/

In the late/severe/palliative stage of dementia a person may:

  • Have a significant deterioration in their physical health, including immobility, incontinence and/or swallowing problems (dysphagia).
  • Have limited communication and experience more intense changed behaviour, delusions and/or hallucinations.
  • Continue to struggle with their mood, with emotions being significantly affected, manifesting in extremes such as being very apathetic or very tearful. 
  • Not recognise loved ones and/or themselves, and live in a different (usually earlier life) reality.

 

Important considerations when thinking about the stage of a person’s dementia

First and foremost, stages of dementia are just a guide. Stages can overlap, and symptoms can appear (and disappear) in a different order. It’s possible that a person may appear to be in one stage, then appear to progress into another, and then appear to be back to an earlier stage. This is because a characteristic of most types of dementia is good days and bad days, and many factors can influence how cognitively alert a person is and how able they are to participate in daily life at any given time. 

If a person has an infection, a mental health problem like depression (this may be linked to changes in the weather and the seasons), a lack of sleep, a change in their environment, an inpatient hospital stay, a change of care provider, or another health problem/accident (for example a stroke, fall etc) their dementia may appear to have progressed or have permanently progressed.

Conversely, if a person has appropriate stimulation/occupation and activity during the day, is well-rested https://ena.co.uk/news/sleeping-better-when-you-have-dementia/, has good physical and mental health, is in a settled/familiar/dementia friendly environment https://ena.co.uk/news/creating-a-dementia-friendly-home/, is taking medication to improve their dementia symptoms (if this is appropriate for their type of dementia), and has familiar and continuous care provision the progression of their dementia may stabilise or slow down temporarily.

Ultimately, for a person with dementia and their family, it’s important to live in the moment rather than focusing too heavily on the stage of the person’s dementia.

 

How live-in care can support a person throughout their dementia

Our live-in dementia care is the ideal way to provide appropriate support for a person throughout their life with dementia https://ena.co.uk/news/why-dementia-care-is-so-much-better-at-home/. We can provide everything from companionship https://ena.co.uk/types-of-care/live-in-companionship-care/ and low-level support in the earlier stages of a person’s dementia, through to more comprehensive care as a person’s dementia progresses, include support with personal care, medication, mobility, continence https://ena.co.uk/news/coping-with-incontinence/, nutrition and hydration https://ena.co.uk/news/how-our-live-in-carers-can-support-your-nutrition-and-hydration/, communication https://ena.co.uk/news/positive-ways-to-communicate-with-a-person-who-has-dementia/ and social engagement. In the latter stages of a person’s dementia, we can provide more intensive support, including complex care https://ena.co.uk/homecare-services/complex-care/ and end-of-life care https://ena.co.uk/homecare-services/end-of-life-care/

We focus on supporting a person’s independence, choice and control https://ena.co.uk/news/maximising-independence-choice-and-control/, and work side-by-side with the person to help them achieve their maximum.

Find out more about how ENA Care Group could support you or your family by calling 0800 4334 413

or emailing .