Early Stage
Moderate Stage
Advanced Stage

The rate of deterioration and the symptoms associated with Dementia will differ in each individual. You may find that the person’s abilities will deteriorate rapidly over a period of a few months or in some cases, slowly over a period of years, but it is certain that the person’s abilities will deteriorate as the Dementia progresses.

Dementia is commonly categorised into three stages. It is important to remember that not all of the characteristics associated with each stage will be present in every person, nor will every person go through every stage, however it is a useful guide to determine the progression of dementia.

When caring for the person with Dementia it is vital to remember that although many of their abilities are lost as the disease progresses, the person will always retain their sense of touch, their hearing and their feelings. They will respond to a hug or a gentle pat on the shoulder just as they will feel your anger or dissatisfaction by the tone of your voice or your actions.

Early dementia

The early stages of Dementia are often only apparent in hindsight as the onset of Dementia can be gradual and easily attributed to old age or stress. It is not uncommon to be unable to identify exactly when it began.

You may notice the person displaying unusual behavior such as:

• Becoming apathetic.
• Losing the ability or desire to take part in hobbies or activities, or unwilling to participate in new things.
• Inability to adjust to change.
• Forgetfulness at work, such as regularly forgetting appointments or deadlines.
• Becoming more forgetful of details of recent events.
• Making poor decisions and diminished judgment. People with Dementia will often do or say totally inappropriate things.
• Becoming slow to understand complex tasks and difficulty with everyday tasks and activities such as cooking and driving.
• Blaming others for stealing or losing things they themselves have misplaced or lost.
• Becoming more self-centred and less concerned with others and their feelings.
• Repeating themselves or losing the thread of their conversation.
• Difficulty remembering simple words. People with Dementia often substitute inappropriate words without realising, making them difficult to understand.
• Sudden mood swings with no apparent causes.
• Changes in personality and increased irritability.
• Difficulty handling money.
• Problems remembering familiar places, such as where they live or what year it is.

Moderate Dementia

As the person progresses to the moderate stage, their problems become more apparent and disabling and they will require someone to oversee and provide assistance to them.

You may notice that they are:

• More forgetful of recent events and common activities such as leaving saucepans boiling on the stove or the gas on. Their memory of the distant past is better, but some details may be forgotten or confused.
• Very repetitive.
• Confused as to time and place.
• Forgetful of the names of family and friends, or confusing one family member for another.
• Wandering around the streets, maybe at night and sometimes becoming lost if away from familiar surroundings.
• Behaving inappropriately by doing things like going outside in their nightwear or taking their clothes off in public.
• Seeing or hearing things that are not there.
• Neglecting hygiene and not eating.
• Becoming angry or distressed as a result of frustration.

Advanced Dementia

During the later stages of Dementia the person will require a high degree of care and support with daily living. They will lose the ability to perform basic tasks without assistance, such as feeding and toileting themselves, and they will not respond to their surroundings or to familiar people.

You may notice that they:

• Are losing their ability to understand and to verbally communicate. Their speech becomes jumbled.
• Do not remember – even for a few minutes. For example, they will forget that they have just had a meal or gone to the toilet.
• Do not recognize friends and family.
• Do not recognize common objects.
• Become incontinent.
• Need help with everyday tasks such as eating, washing, showering, dressing and using the toilet.
• Become disturbed at night.
• Become restless. For example, they may be looking for their Mum or Dad who have passed away or wanting to go home, when they are home.
• Become aggressive, particularly if they are feeling threatened or confined.
• Find it difficult to walk and may eventually become confined to a wheelchair.
• Have uncontrolled movements.
• Will become bedridden in the palliative stages.

The information published on this website is cited from the resources noted in the website bibliography.