What are the 7 stages of Dementia?
Dementia is a progressive condition that affects memory, thinking, and behaviour, and it can be difficult to know what to expect as it advances. Understanding how dementia progresses can help families better prepare and provide the right care at each stage. One of the most recognised ways to measure this progression is the Global Deterioration Scale (GDS), also known as the Reisberg Scale. This scale divides dementia into seven stages, from no impairment at the early stages to severe cognitive decline in the later stages.
Here we explore the seven stages of dementia, detailing the key changes at each stage, how long they typically last, and the types of care that may be needed.
Stage 1: No Cognitive Decline
At this stage, there are no signs of memory loss or cognitive decline. The individual functions completely normally, and medical evaluations wouldn’t show any evidence of dementia. This stage is often referred to as the "pre-dementia" phase, and it can last for many years, even decades, with no noticeable issues.
In terms of management, there’s no need for specialised care at this point. However, maintaining a healthy lifestyle with regular exercise, a balanced diet, and mental stimulation can help reduce the risk of future cognitive decline. Regular check-ups with a healthcare provider may also help detect any early signs of memory changes.
Stage 2: Very Mild Cognitive Decline
In stage 2, individuals may start to notice small lapses in memory that are often attributed to normal ageing. This might include forgetting where they placed everyday items, such as keys or glasses, or struggling to recall names of acquaintances. These symptoms are subtle and typically don’t interfere with daily life.
This stage can last several years, with symptoms remaining mild. There's no immediate need for dementia-specific care, but it’s important for families to stay aware of any further changes in memory or behaviour. Engaging in mentally stimulating activities, such as puzzles, reading, and socialising, can help keep the brain active.
Stage 3: Mild Cognitive Decline (Early Dementia)
By stage 3, the signs of dementia become more apparent, both to the individual and those around them. Memory problems become more frequent, and the person may struggle with planning and organising tasks. They might find it difficult to recall recent events or conversations and may become easily confused when faced with complex decisions. This stage can last between two and seven years.
At this point, it’s helpful to introduce some gentle support into their daily routine, such as memory aids, calendars, and medication reminders. Staying socially engaged is still important, and families should consider preparing for more comprehensive care as the condition progresses. It’s also a good time to start discussing future care plans, even though the person may still be mostly independent.
Stage 4: Moderate Cognitive Decline
Stage 4 marks the early stages of dementia, where forgetfulness and confusion become more pronounced. Individuals may struggle with short-term memory, such as remembering recent events or appointments, and they might have difficulty managing their finances or preparing meals. At this stage, they may also become more withdrawn, especially in social situations, as their confidence decreases.
This stage can last around two years. Regular support from a family member or professional carer can help with daily tasks. It’s important to maintain a consistent routine, as familiar surroundings and habits can reduce anxiety. Encouraging activities that stimulate the brain, such as listening to music or completing simple puzzles, can also be beneficial. Families should stay closely involved to provide reassurance and emotional support.
Stage 5: Moderately Severe Cognitive Decline
In stage 5, dementia symptoms become more severe. Individuals often require assistance with everyday tasks such as dressing, bathing, and managing medications. They may forget important personal information, like their address or phone number, and might confuse dates and locations. It’s common for people in this stage to experience disorientation, and they may become anxious or upset in unfamiliar environments.
Stage 5 typically lasts one to two years. Live-in care may become necessary, as the person requires regular support and supervision. Carers can help with personal care, nutrition, and maintaining a safe home environment. Ensuring the person’s surroundings are familiar and comforting can help reduce confusion and agitation. Memory aids, such as photo albums or labelled household items, can also be useful.
Stage 6: Severe Cognitive Decline
By stage 6, individuals experience significant memory loss and require help with most daily activities. They may forget the names of close family members, struggle with speech, and lose awareness of time and place. Mobility may also become affected, and there’s a greater risk of falls or accidents. It’s during this stage that many people experience “sundowning,” a phenomenon where confusion and agitation increase in the late afternoon or evening.
Stage 6 can last around one to two-and-a-half years. Full-time care is often essential at this stage. A live-in carer or nurse can provide constant support, helping with personal care, ensuring proper nutrition, and maintaining the person’s safety. It’s important to create a calm and predictable environment to help reduce feelings of distress, and sensory activities, such as listening to music or a gentle hand massage, can bring comfort.
Stage 7: Very Severe Cognitive Decline
Stage 7 is the final stage of dementia, often referred to as late-stage or advanced dementia. Individuals lose the ability to communicate coherently and may only be able to say a few words. They will need full assistance with everyday tasks, including eating, dressing, and moving around. Many people become bed bound as their physical health declines, and they are highly vulnerable to infections such as pneumonia.
This stage can last from one to two-and-a-half years. Palliative or end-of-life care becomes the focus, ensuring the individual remains comfortable and free from pain. Carers play a crucial role in managing healthcare needs, monitoring for signs of discomfort, and providing emotional support to both the individual and their family.
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Sundowning in Dementia
Sundowning is a common symptom in the middle to later stages of dementia, particularly stage 6. It refers to increased confusion, agitation, and restlessness that tends to worsen during the late afternoon or evening. This change in behaviour can be distressing for both the person with dementia and their caregivers. Creating a calm, well-lit environment and maintaining a consistent routine can help ease the symptoms of sundowning. Additionally, ensuring the person is not overly tired during the day and limiting stimulants like caffeine can make a significant difference.
How long does each stage last?
The chart below provides a helpful overview of the different stages of dementia, their expected duration, and life expectancy. While each person's experience with dementia is unique, this can give families a general understanding of how the disease may progress over time, in addition to the information above.
Supporting your loved one through every stage
When it comes to caring for a loved one living with dementia, the comfort and familiarity of home can make all the difference. At Consultus Care and Nursing, we offer compassionate and highly personalised live-in care that allows your loved one to stay in the place they know best - surrounded by their memories and routines. This is particularly comforting for a person navigating the symptoms of dementia. This tailored approach not only helps reduce confusion and anxiety, but it also enhances quality of life for both the individual and their family.
Our highly skilled carers are experienced in managing the complexities of dementia care, from early-stage support to advanced care needs. They provide assistance with daily tasks like medication management, meal preparation, and personal care, all while offering companionship and emotional support. Our carers are carefully matched to your loved one, ensuring that they build a trusting and understanding relationship that promotes dignity and respect.
Dementia care at home means your loved one can continue living safely and comfortably in their own home, avoiding the disruptions that often come with moving to a residential care setting. It also allows family members to stay closely involved in their care, providing peace of mind knowing that their loved one is in the hands of trained professionals.
At Consultus, we take pride in our holistic approach to dementia care. From developing a bespoke care plan that evolves as your loved one’s needs change to offering 24/7 live-in care, we are dedicated to helping families navigate the challenges of dementia with sensitivity and expert support.
Learn more about our tailored dementia care at home services and how we can help your family maintain the best quality of life possible for your loved one.
