Caregiving In The Early Stages
Although most of your loved ones immediate medical needs can be managed on their own in the early stages, you may need to assist with tasks associated with memory or problem-solving. You may need to remind them of their doctors appointments and to set up the next appointment, along with taking their medications on time and getting refills as needed. You may need to assist them in managing their finances and keeping up with social and work obligations. At times, they may also need help remembering places, people, words, and names. In the early stages, you will want to encourage them to:
- Maintain their independence
- Establish a routine to delay the disease from worsening
Where To Live With Dementia
Eventually, caregiving for someone with dementia wont be appropriate anymore. The needs of a person with progressive dementia become overwhelming, and moving into a full-time residence with trained staff becomes necessary. You should plan for this well before it becomes necessary, by visiting communities and asking the right questions.
Depending on your loved ones stage of illness, different living options are available:
Assisted Living in Early StagesAssisted living residences combine room and board with medical and personal care, and are often sufficient for someone in the early stages of Alzheimers disease or related dementia. Full-time supervision means residents are safe, with living units like private studios or apartments so someone with mild dementia can still feel a sense of independence.
Services offered in assisted living include meals, help with activities of daily living , social activities, and transportation to and from doctors appointments. Before moving in, the residence will assess your loved one to make sure its a good fit.
Memory care residences have physical designs that are appropriate for people with dementia. Someone with Alzheimers, for instance, may become upset when encountering a wall, so memory care buildings have circular hallways. Because people with dementia are prone to wander, memory care residences have increased security and supervision, and special locks on doors.
Did You Know?
Early Symptoms Of Dementia
Although the early signs vary, common early symptoms of dementia include:
- memory problems, particularly remembering recent events
- increasing confusion
- apathy and withdrawal or depression
- loss of ability to do everyday tasks.
Sometimes, people fail to recognise that these symptoms indicate that something is wrong. They may mistakenly assume that such behaviour is a normal part of the ageing process. Symptoms may also develop gradually and go unnoticed for a long time. Also, some people may refuse to act, even when they know something is wrong.
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Dementia Timeline For Deterioration:
Stage 1 Normal Function: No symptoms of memory loss and no evidence of any type of dementia present.
Stage 2 Very Mild Cognitive Decline: the patient may be concerned about mild symptoms of memory loss, but relatives and medical professionals can see no obvious symptoms of dementia during an examination or interview.
Stage 3 Mild Cognitive Decline: symptoms of Alzheimers are now becoming more obvious to other people in contact with the patient. Typical symptoms evident in stage 3 Alzheimers include problems remembering names of people and objects, short term memory issues and losing belongings, difficulties with organization and planning tasks or performing social or work related tasks.
Stage 4 Moderate Cognitive Decline: this is the first stage that is definitively classed as early-stage Alzheimers. Symptoms detected will include short term memory loss, problems performing complex tasks and challenging mental arithmetic, forgetfulness, and changes in personality.
Stage 5 Moderately Severe Cognitive Decline: this is classed as the mid-stage Alzheimers and patients will now show symptoms such as large gaps in memory and greater levels of confusion. They will also be less able to perform easier feats of mental arithmetic, but will still be capable of using the toilet and eating without assistance, although they might need help with some tasks.
Stage : Moderate Changes/mild Dementiaquality Of Life: Very Little Impact
Your loved one will remember all or most of his or her past and will recognize loved ones. You have the ability to make your own healthcare decisions. You may see your loved one:
- Forget familiar words and names of items.
- Forget where things were left, like their eyeglasses or phone.
- Have some trouble with daily tasks such as laundry, cooking and shopping.
- Make more mistakes with driving and feel uncomfortable in unfamiliar places.
- Have trouble Increased trouble with keeping up with finances
- Be unable to find the right words more often
- Increased difficulties with problem solving
How You Can Help:
If you havent already done it, help your loved one plan for when he or she might have severe dementia. Use our tools to create a document that lists care values and priorities at different stages of dementia.
If you have, help the health care team follow your loved ones care preferences.
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What Is The Dementia Timeline For Deterioration
There are many different types of dementia, but Alzheimers is the most common: the disease accounts for between 50% and 80% of all diagnosed cases of dementia. Alzheimers tends to be associated with old people and the vast majority of patients who develop the disease are aged 65 and over, but it can also affect younger patients. So if your relative or friend has been diagnosed with Alzheimers, what is the dementia timeline for deterioration?
Research into Alzheimers has shown that there are seven distinct stages in the progression of the disease, although symptoms will vary between different patients and some people will deteriorate faster than others.
The Progression And Stages Of Dementia
Dementia is progressive. This means symptoms may be relatively mild at first but they get worse with time. Dementia affects everyone differently, however it can be helpful to think of dementia progressing in ‘three stages’.
The progression and stages of dementia
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What Are Early Dementia Signs And Symptoms
Dementia affects each person differently, in varying degrees and at different rates. Individuals usually need to experience two or more symptoms that dramatically interfere with their daily life to receive a diagnosis. However, if you notice one or more signs in someone you love, schedule an appointment with a doctor who can make a complete assessment.
Six early warning symptoms may include:
Care In The Later Stages Of Dementia
There are medicines used in the early stages of dementia that manage some of the behavioural symptoms. In the later stages some of these medicines can do more harm than good causing severe side effects that can increase confusion and frailty. It also becomes harder to diagnose and manage some of the normal illnesses that older people get such as Urinary Tract Infections . UTIs can exaggerate some symptoms of dementia and increase confusion sometimes know as delirium.
Pain is also something that can be present in the later stages of dementia, but can be harder to diagnose if the person isnt able to communicate it. For all of these reasons, its important to stay vigilant when looking after someone with dementia, and to talk to the GP if you are worried about anything.
There are dementia living aids and products that can help you to care for someone living with dementia. Something like a simple dementia clock or personal alarm can make the world of difference to your life and the live of the person you care for.
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Moderate Or Middle Stage
In this stage, individuals with Alzheimers disease are more likely to experience increased confusion, greater memory loss, and worsening judgment. Individuals in this stage of the disease may exhibit confusion about orientation, such as where they are or what day it is. They may also have difficulty recalling personal information, such as their address or phone number or important dates like birthdays or anniversaries. Some individuals may also be at increased risk for wandering. In the other types of dementia, the earlier symptoms will become more pronounced , but the diseases also start to resemble the moderate stage of Alzheimers disease.
During this stage, individuals with dementia are likely to begin to need more assistance. They may need help with some basic daily tasks, such as dressing, bathing, and grooming . You might also notice changes in sleep patterns, as well as in their personality and behavior. For example, individuals with dementia might experience increased paranoia or fear.
Late stage of dementia
Psychological Changes For Dementia Patients
- Changes in mood: Frequent mood swings, increased sensitivity to change, and increased anxiety and agitation.
- Personality changes: Loss of interest in previously enjoyed activities and sometimes completely changed personality and behaviors.
- Hallucinations or paranoia: In later stages of dementia, sufferers may believe that even close friends or family are dangerous or “out to get them”.
- Neglecting safety, personal hygiene, exercise, or nutrition. May display decreased judgement skills involving money, like careless purchases or giving away large sums of money.
- Socially inappropriate behavior: Making rude or explicit sexual comments publicly or to strangers.
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What Are The Stages Of Dementia And How Long Do They Last
The symptoms of dementia occur in 7 stages and are characterised by the cognitive decline a person will experience at each stage:
- Stage 1 no cognitive decline
- Stage 2 very mild cognitive decline
- Stage 3 mild cognitive decline
- Stage 4 moderate cognitive decline
- Stage 5 moderate / severe cognitive decline
- Stage 6 severe cognitive decline
- Stage 7 severe cognitive decline
Stages 1-3 Mild dementia
The first stage of dementia may happen months or a year or more before any symptoms present in a person. During this time a person may not know that dementia is developing. A person will be generally well, living with levels of independence and maintaining their lifestyle.
As the person transitions through mild dementia stages, they may start to show some symptoms:
- Problems with memory for example, not knowing where they put their keys or glasses
- Communication problems struggling to find the right words, or getting lost in sentences
- Issues with planning and organisation
- Concentration issues getting distracted from day-to-day tasks and routines
- Changes in mood and personality may display a lack of motivation for everyday life
- Loosing track of place and time
This stage of dementia is often referred to as early-stage dementia and can last on average 2-4 years.
Stages 4-5 Moderate dementia
Memory issues are more severe during this stage and a person can become confused about who they are or where they are.
Stages 6-7 Severe dementia
What Is The Life Expectancy For Someone With Dementia
This is an incredibly difficult question to answer as there are many influencing factors, including the persons age and gender, the type of dementia and the stage of the condition at diagnosis. The average life expectancy after diagnosis for someone with Alzheimers, the most common form of dementia is 10 years. However, dementia progresses differently in everyone, meaning people can live anywhere from 2 years to 26 years after diagnosis.
The main way in which health care professionals estimate dementia life expectancy is by using the Global Deterioration Scale , also called the Reisberg Scale. It shows the average time someone is expected to live depending on which stage of dementia they are at.
|Stage||Expected Life Expectancy|
|Stage 1: No cognitive decline||N/A|
|Stage 2: Very mild cognitive decline||Unknown|
|Stage 3: Mild cognitive decline||2-7 years|
|Stage 4: Moderate cognitive decline||2 years|
|Stage 5: Moderately severe cognitive decline||1.5 years|
|Stage 6: Severe cognitive decline||2.5 years|
|Stage 7: Very Severe cognitive decline||1.5 to 2.5 years||2.5 years or less|
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What Does Stage 3 Look Like
At this stage, the individual starts showing subtle signs of mild cognitive impairment that may only be noticeable to close friends and family. For example, someone may start repeating questions or telling a story over and over. If the individual is still in the workforce, their ability to perform their job will start to decline. Concentration becomes more difficult, and the person may be unable to perform overly complex tasks like organizing a party or doing their own taxes.
Stage : Severe Cognitive Declinemoderately Severe Dementia
At this stage, the ability to perform basic activities of daily life becomes compromised. Functionally, five successive substages are identifiable. Persons initially in stage 6a, in addition to having lost the ability to choose their clothing without assistance, begin to require assistance in putting on their clothing properly. Unless supervised, the person with Alzheimers disease may put their clothing on backward, they may have difficulty putting their arm in the correct sleeve, or they may dress in the wrong sequence.
The total duration of the stage of moderately severe Alzheimers disease is approximately 2.5 years in otherwise healthy persons.
At approximately the same point in the evolution of AD, but generally just a little later in the temporal sequence, AD persons lose the ability to bathe without assistance . Characteristically, the earliest and most common deficit in bathing is difficulty adjusting the temperature of the bath water. Once the caregiver adjusts the temperature of the bath water, the AD person can still potentially otherwise bathe independently. As this stage evolves, additional deficits occur in bathing and dressing independently. In this 6b substage, AD persons generally develop deficits in other modalities of daily hygiene such as properly brushing their teeth.
Stages 6c, 6d, 6e
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What Does Stage 5 Look Like
In Stage 5, the person with dementia has progressed to the middle stage and can no longer live independently. They can still perform some basic tasks, such as being able to feed themselves, but someone else has to prepare the meals for them. At this stage, problematic behaviors can start to occur, such as confusion, wandering, hallucinations and suspiciousness. The person with dementia will require a full-time caregiver and will become more and more dependent.
How Is Dementia Diagnosed
No single test can determine if your loved one has dementia. A physician will examine several factors to come up with a diagnosis, including a full medical history, physical exam, laboratory tests, and recognizing a pattern of loss of function and skills. With a high-level of certainty, doctors can diagnose a person with dementia, but its more challenging to define the exact type of dementia. Biomarkers can help make an accurate diagnosis of Alzheimers disease, which is included under the umbrella of dementia.
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Why It Is Useful To Know The Stages Of Dementia
A categorization of dementia stage can help inform plans for treatment and care. There is currently no cure for dementia, but there are medications that may help manage or slow some of the symptoms. It can also be important to know the disease stage to determine whether your loved one may be eligible for clinical trials. Understanding the stage of dementia can also help guide care needs as the disease progresses. Typically, in the early stages of dementia, individuals can still function relatively independently. In the middle stages, they will begin to need more assistance with some activities of daily living. Eventually, in the late stage, they will need assistance with all activities of daily living.
During these later stages of dementia, the caregivers goals often shift to focusing on preserving the persons comfort and quality of life. And although individuals may lose the ability to communicate, research suggests that aspects of the person and his or her former self still remain. This means that you may still be able to have meaningful interactions in the later stages of the disease. Suggested ways to do this include playing their favorite music or using their favorite scents anything to foster a connection and bring them joy.
Study Design Setting And Participants
This was a cross-sectional descriptive observational study in two urban health centres in the municipalities of Alcorcón and Villaviciosa de Odón located in the western portion of the Community of Madrid these municipalities have a combined registered population of 43,594 people, of whom 9247 were65years old. For the preparation of the article, the STROBE recommendations were followed .
Between November 1, 2015, and January 31, 2016, patients of all ages with a previous diagnosis of dementia identified with the International Classification of Primary Care code P70 and/or with specific treatment for dementia and/or memantine ) were selected from the electronic health records of the Community of Madrid . Eligible patients had a least one consultation or received PC in 2015 and had a known caregiver who agreed to participate in the study and signed the informed consent form. For patients with professional caregivers, informed consent was also requested from the legal representative of the patient. Informed consent was also requested from the patient himself or herself if considered able to do so at the discretion of the physician responsible. Institutionalized patients and/or patients with previous major mental disorders such as schizophrenia or other psychotic disorders were excluded, as well as those patients whose caregivers presented difficulties with language while conducting the interview and those who refused to participate in the study.
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