Caring for a family member or friend with dementia can be uniquely challenging and uniquely rewarding. Whether you’re a full-time caregiver or assist your loved one periodically, understanding their needs is essential to supporting their well-being. Take a moment to learn about the stages of dementia and how your loved one’s symptoms should inform your care.
What Are the Stages of Dementia?
Dementia is a progressive condition that affects cognitive function and, in turn, daily activities. Symptoms vary from person to person, but they can be broadly grouped into three categories or stages. Here is a look at these stages and how they influence your loved one’s abilities and needs.
Early Stage
In the early stage of dementia (also called mild stage), a person experiences subtle changes in cognitive function, which may manifest in issues such as forgetfulness, difficulty finding words, mild disorientation, and challenges with planning and organization. Despite these changes, individuals can often maintain most aspects of their daily lives and perform many activities independently, although it may take more time or effort to do so. Research indicates that most dementia cases are undiagnosed; early-stage dementia is especially likely to go undetected because a person can often compensate for and mask their cognitive deficiencies.
Middle Stage
As dementia progresses to the middle stage (also called the moderate stage), symptoms typically become more pronounced and noticeable to family and friends. As cognitive decline progresses, individuals may struggle more with the issues experienced in early-stage dementia, such as memory loss and disorientation, and experience new symptoms, including behavioral changes such as agitation, wandering, and mood swings. Individuals at this stage often require more assistance with daily activities and may need supervision to ensure their safety.
Late Stage
In the late stage of dementia (or severe dementia), individuals experience severe cognitive decline and become increasingly dependent on others for care. Memory loss is a significant issue, and a person may no longer recognize familiar people or places and may forget key information about themselves. Cognitive decline may also lead to more erratic behavior, with increased agitation, aggression, or withdrawal. Individuals with late-stage dementia symptoms may also experience physical decline, leading to challenges with mobility, swallowing, and bladder or bowel control. A person in this stage typically requires round-the-clock care.
Dementia Care at Home: Caring Well for Your Loved One at Every Stage
Consider your loved one’s dementia symptoms and which stage best describes those symptoms. That understanding should inform the way you approach caregiving and will help you feel more confident that you’re assisting your loved one in ways that make sense for them.
Care for Early-Stage Dementia
For a loved one with early-stage dementia, the key is finding the ideal balance of support and independence. Because your loved one can do many things on their own, you’ll want to support their independence as much as possible. However, even if they seem to be behaving “normally” most of the time, they may benefit from assistance with certain tasks and activities (for example, scheduling appointments).
Talk to your loved one about the ways they would appreciate your support, and determine a regular caregiving routine. A set schedule can help decrease anxiety and confusion for both your loved one and you.
In addition to helping with practical tasks, you can support your loved one’s well-being by encouraging mental stimulation through social interaction and activities that promote mental fitness. Something as simple as pulling out a jigsaw puzzle instead of turning on the TV during your visit can be fun and help you enjoy conversation while exercising your brain.
Thinking about the future can be difficult when your loved one’s condition necessitates taking things one day at a time. However, you’ll want to discuss legal and financial matters and your loved one’s care preferences while they’re still able to participate in creating a care plan. By talking through these matters now, you can rest assured you’re honoring your loved one’s wishes when you need to make decisions in the future.
Care for Middle-Stage Dementia
The middle stage can be uniquely challenging in that your loved one may possess a strong desire for independence but also be experiencing episodes of confusion that can affect their safety. Talk with your loved one and their care team to determine the best ways to support their independence while providing appropriate assistance. The balance will likely look different in this stage than it did when dementia first impacted your loved one.
Communication can begin to be more of a challenge at this stage. Whether you’re discussing your loved one’s care or simply enjoying a friendly conversation, you can aid communication by using simple and clear language, hand gestures, and visual cues. Be patient and allow extra time for conversations.
Whether your loved one lives independently or with a caregiver, now is a great time to implement safety precautions to prevent accidents and injuries in the home. For example, you can look for and remove trip hazards, install grab bars in restrooms, and implement technology to stay connected and help your loved one call emergency services if needed.
Care for Late-Stage Dementia
A loved one with late-stage dementia needs more help than ever before but may be resistant as they become less aware of their own cognitive decline. You will likely need to take a more active role in their daily life, but you can prioritize their comfort and dignity when you speak to them. Avoid talking down to them and seek opportunities to maintain their privacy and independence.
Empathy goes a long way in any caregiving relationship, especially in cases of dementia. Be prepared for changes in behavior such as agitation, aggression, or withdrawal, and work with healthcare professionals to develop strategies for managing these behaviors. If your loved one becomes upset, listen as they express their feelings. Their fears or frustrations may be based on inaccurate beliefs, but the feelings are real, so validate your loved one wherever you can and gently redirect them.
If your loved one is experiencing physical decline, be sure to work closely with their medical team to support their physical health. Offer nutritious foods and fluids that are easy to swallow and digest, and monitor for signs of dehydration or malnutrition. You may also want to arrange for an at-home nurse to come regularly for health checks.
As their need for assistance increases, your loved one may require round-the-clock nursing care. At this point, you may want to consider whether at-home care is the best approach. Memory care communities can provide your loved one with the specialized support they need in a homelike setting, and you can still spend time with them. For example, at Brio of Johnston (Iowa’s only certified Dementia "Excellence in Care" Program of Distinction), Executive Director Teresa Krueger explains that “every part of our household, from what's on the walls to the music that's playing to the way we serve meals, is deliberate, and [...] our residents have the opportunity to thrive."
Caring for Yourself as You Care for Your Loved One
No matter what stage your loved one’s symptoms align with, providing dementia care at home can be emotionally and physically demanding. Caregiver burnout is extremely common, but allowing yourself to reach that point benefits neither you nor your loved one. Take steps to invest in your own well-being — both for yourself and to provide the care your loved one needs.
Find individuals or groups you can lean on, such as friends or support groups for caregivers or people impacted by dementia. You can also take advantage of practical support from senior living services to help manage the responsibilities and challenges of caregiving.
Take Advantage of Senior Living Services Designed for Your Loved One’s Needs
Senior living services can lighten your caregiving burden and allow you to focus on enjoying quality time with your loved one. Depending on your loved one’s needs, some services to consider include:
Every individual’s symptoms and needs are different, so choose the service(s) that best fit your and your loved one’s needs, and be ready to reevaluate your care plan regularly.
Want to learn more about senior living services your loved one could benefit from at home? Read The Complete Guide to At-Home Services!
