Dementia is a progressive condition where symptoms worsen over time because of damage to the person’s brain. To determine how far a person’s dementia has progressed, health professionals sometimes discuss dementia in terms of ‘stages’. Defining these stages can help to ensure that the right treatment and care is provided, together with aiding communication between healthcare providers, caregivers, family and friends.
A broad way of looking at dementia progression and understanding the changes that can occur over time, is using a series of three stages, ‘early’, ‘middle’ and ‘late’.
Most people in the early stages of dementia live very independently. Their symptoms, such as memory loss will be noticeable but mild and will have an impact on some of their day-to-day activities.
People in the mid-stages of dementia will experience moderate to severe cognitive decline. This will mean that they will gradually need more help to carry out most daily activities. Memory loss will be very noticeable and their behaviour and personality can change, with anxiety, agitation or depression being common.
In the later stages of dementia, people become increasingly frail and may struggle to do many of the things that they used to. Concentrating, planning and organising may also be very difficult and they can become increasingly disorientated. They are likely to experience significant memory loss and as such, become frustrated and upset with people that they do not remember, including themselves when looking in a mirror for example. However, being around people that they know, even if they do not recognise them, can cause them to have positive feelings of happiness and safety, so it is important to keep in touch with familiar people. Similarly, people in the late stages can still get enjoyment from past hobbies, interests and activities.
Speed of progression
The speed at which dementia worsens varies widely from person-to-person and can depend on a number of other factors including the type of dementia. Alzheimer’s disease, for example, seems to have the slowest progression on average, while people who develop symptoms before the age of 65 often have a faster progression. Poor health can also contribute to faster deterioration, such as in people who have had strokes, have a heart condition or diabetes.
The seven stages of dementia
The stages of dementia can be defined further using the Global Deterioration Scale for Assessment of Primary Degenerative Dementia (GDS). This scale divides the progression of dementia and the changes that will occur, into seven stages. It is important to note that the GDS is most relevant for people with Alzheimer’s disease, as some other types of dementia such as frontotemporal dementia do not always include memory loss.
No dementia – Stage one – No cognitive decline
A person is mentally healthy with no memory loss i.e. someone without dementia.
No dementia – Stage two – Very mild cognitive decline
Normal forgetfulness associated with ageing occurs, symptoms of dementia are not evident.
No dementia – Stage three – Mild cognitive decline
Increased forgetfulness and slight difficulty concentrating. People may get disorientated and have difficulty finding the right word. The average duration at this stage is 7 years before onset of dementia.
Early stage – Stage four – Moderate cognitive decline
Difficulty concentrating, managing finances and traveling alone to new locations. Decreased memory of recent events and trouble completing complex tasks accurately. People may find socialising difficult and may withdraw from this as a result. Average duration is 2 years.
Mid-stage – Stage five – Moderately severe cognitive decline
Now with major memory deficiencies, people need assistance to complete most daily tasks. Memory loss is more prominent. Average duration is 1.5 years.
Mid-stage – Stage six – Severe cognitive decline (middle dementia)
Many people can only remember some details of earlier life and require extensive assistance in carrying out everyday tasks. Incontinence is present at this stage and their ability to speak declines. Personality changes can also occur, such as delusions, agitation, compulsions and anxiety. Average duration is 2.5 years.
Late stage – Stage seven – Very severe cognitive decline (late dementia)
At this stage, people have no ability to speak or communicate and can often lose the ability to walk. This will mean that help will be required with most activities e.g. eating and using the toilet. Average duration is 2.5 years.
At which stage should you use a home monitoring system?
TextCare should be installed in a person’s home when they are in the early stages of dementia, or between stages two and three. Using TextCare at this early stage helps to ensure that normal routines can be established, so that any abnormalities in behaviour can be identified as the dementia progresses. It will also allow the person being monitored to get used to seeing the system around their home and to understand how it works. When someone is in the late stages or stage seven of dementia, a TextCare home monitoring system may not be suitable, as their care needs can be too great.
If you would like to discuss using a TextCare home monitoring system for someone living with dementia, please contact a member of our friendly team here.
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