Stages of Dementia

Lesson Outline

The changes to the brain that result in the signs and symptoms of dementia can be described in three stages: mild, moderate, and severe. These are sometimes also referred to as early-, middle- and late- or advanced stages.

People in the mild or early stage of dementia may notice subtle changes to their memory or thinking skills. They can do most of the things that they are required to do day-to-day from a functional point of view, but they're not able to live independently without the help of others.

During the moderate stage of dementia, the person will require more help with the Instrumental Activities of Daily Living (IADL). These are the things a person does every day to take care of themselves and their home, such as:

• using the telephone, including answering and calling others
• shopping for groceries on their own
• planning, heating, and serving their meals
• managing medications, including refilling them when needed and taking them correctly
• cleaning their house or apartment
• getting around on their own, either by car, taxi, or public transportation; or on foot
• managing money and paying bills

In general, in the moderate stage, a person's ability to complete the basic Activities of Daily Living (ADL), which are essential self-care tasks, such as bathing, dressing, eating by one's self, and moving around their house or apartment independently, are still intact.

In the severe stage, many areas of the brain are affected, and a person's level of function both cognitively and functionally becomes much worse. A person's care needs are very high at this stage, with issues such as incontinence and changes in mood and behaviours creating challenges for many caregivers. In the most advanced stages, eating and swallowing problems often lead to complications such as malnutrition, weakness, or aspiration pneumonia.

It's important to have an advanced care plan in place to help guide care decisions that are aligned with what the person with dementia would want when they are no longer capable of making independent decisions.