Dementia is a progressive disease, meaning symptoms cycle through different stages. It can be daunting to learn that you or a loved one has been diagnosed with dementia, but learning about the seven stages of progression can help you feel more confident and prepared for the future.
Understanding the stages of dementia can help determine your loved one’s current status and how this affects their care and support needs. Today, we’ll explore dementia, its stages, and how you can help manage your loved one’s condition.
What Is the Global Deterioration Scale (GDS)?
The Global Deterioration Scale (GDS) has been designed to help professionals categorise types of dementia, namely Alzheimer’s, from no cognitive decline to very severe cognitive decline.
This model comprises seven stages of cognitive decline and is frequently used in caregiving and clinical settings. Despite it being first created in 1982 by Reisberg et al, the GDS is still used as the foundation for many dementia care plans.
Below, we’ll outline the seven stages of dementia and what you can expect during each.
Stage 1: No Cognitive Decline
There are no noticeable symptoms during stage one. Your loved one should be able to function normally and often won’t show any signs of memory loss or cognitive impairment. This stage is often identified in hindsight once it has passed.
How You Can Help Your Loved One
As symptoms aren’t visible, you may not be able to help before the symptoms begin showing. However, certain people may have higher risk factors for developing dementia, so if you and your loved one are worried, you can use this time to plan future care and practical support. Look out for behaviour that could indicate early signs of dementia.
Stage 2: Very Mild Cognitive Decline
Initial symptoms often include subtle memory lapses, such as forgetting familiar names, places and words, or where they’ve put everyday objects. These changes often aren’t detected by loved ones or during medical examinations, and can usually be explained away.
How You Can Help Your Loved One
You may begin to notice your loved one’s memory loss and challenges, meaning this is the optimal time to start or continue planning for the future. Help your loved one get their priorities in order, such as the type of care they want and when they want to enlist the help of professional care.
Stage 3: Mild Cognitive Decline
Symptoms begin to progress and become more noticeable to friends and family members.
Common symptoms include:
- Increased forgetfulness, such as not being able to retrace steps to find a missing item
- More effort is required to remember appointments, manage money and medicines
- Slight difficulty concentrating and paying attention
- Challenges with conversations, finding the right words and names
Stage three typically lasts between 2 and 7 years, although this duration varies among individuals. Your loved one may also start having problems at work.
How You Can Help Your Loved One
You can begin helping your loved one with several tasks to get their affairs in order before their symptoms progress further.
This could include:
- Organising appointments
- Start driving them around
- Paying bills or setting up direct debits
- Helping to put legal and financial documents in order
- Managing medicines by setting alarms and filling pill boxes
You can also help them liaise with their healthcare team to make sure everyone is on the same page and following your loved one’s care preferences.
Stage 4: Moderate Cognitive Decline (Early-Stage Dementia)
Stage four is the most common time when a formal dementia diagnosis is made. This might bring you and your loved ones relief, knowing you have a better idea of what the future holds, but it can also come with feelings of worry, anxiety, or fear.
Common symptoms of stage four dementia include:
- Memory loss
- Forgetting where things were left, such as glasses or their phone
- Trouble managing finances
- Disorientation to time and place
- Difficulty completing tasks, such as laundry, cooking and shopping
- Decreased knowledge of recent events
- Trouble with problem-solving
You may notice your loved one becoming socially withdrawn as they become more aware of their cognitive deficits, which can lead to feelings of self-consciousness and embarrassment. This may lead to loneliness and isolation. Stage four often ranges between 2 and 4 years.
How You Can Help Your Loved One
Your loved one may start to feel more self-conscious about their cognitive deficits, which can lead to negative emotions and feelings. If possible, you should be there for them to offer companionship and emotional support, reducing feelings of isolation and boosting quality of life.
If you’re unable to spend as much time with your loved one as they need, it may be time to consider professional live-in or visiting care.
Stage 5: Moderately Severe Cognitive Decline (Mid-Stage Dementia)
Your loved one may require assistance with daily activities as symptoms progress to stage five. It’s common for individuals to forget personal information, such as their address or phone number, and they may become increasingly confused by the time or location.
More significant dementia symptoms may become present, such as:
- Sundowning: The individual becomes more agitated and confused at night as the sun sets and natural light fades. It increases anxiety, restlessness and disorientation.
- Time-shifting: The individual believes that they are living in an earlier time period, leading to confusion about their current home and loved ones. They may believe they’re in someone else’s house, as they still think they live in their childhood home.
While people with stage five dementia can often still identify close family members, you may notice more pronounced memory gaps.
How You Can Help Your Loved One
Your loved one is likely to recognise you and other close loved ones, as well as some of their past. You can help them by using tools like dementia memory boxes, which help bring positive emotions through happy memories.
Empathy is an incredibly important and useful skill when dealing with someone with dementia. It can help you respond to repeated questions with patience, counter their anxiety with calmness, and allow you to work through the hardships without getting annoyed or frustrated.
Your loved one may also need help with tasks of daily living such as getting dressed, bathing and toileting. If you and your loved one have discussed this previously, you may have decided that you’d prefer a professional carer to take over these responsibilities.
Stage 6: Severe Cognitive Decline
Memory troubles worsen considerably during this stage, and your loved one may begin forgetting the names of their spouses, friends and family members. Individuals often need more help with personal care, such as dressing, bathing and toileting.
You might notice more significant behavioural changes here, too, such as:
- Personality changes
- Delusions
- Compulsions
- Agitation
The severe cognitive decline stage usually lasts around 2.5 years, although certain factors can cause rapid decline in some individuals, including infections, certain medications and frailty.
How You Can Help Your Loved One
You can help your loved one organise live-in or visiting care depending on their needs. While live-in care is often preferred at this stage to ensure your loved one always has professional assistance nearby, visiting care is also suitable if loved ones are able to provide help throughout the day.
Their care plan will need to include:
- Assistance with dressing, toileting and other personal hygiene needs
- Mobility support and steadying
- Symptom monitoring
- Instantaneous support in emergency situations
- Companionship and emotional support
Continue trying to connect with your loved one. Sometimes, connecting in ways other than talking can help, such as reading a story together, participating in complementary therapies, or listening to music.
Stage 7: Very Severe Cognitive Decline (Late-Stage Dementia)
The final stage of dementia is characterised by severe symptoms of cognitive decline.
These may include:
- Loss of verbal and communication skills
- Difficulty or inability to swallow and eat
- Loss of bladder and bowel control
- Inability to recognise family members
- Loss of muscle control
- Inability to walk or sit without assistance
- Disorientation, delirium and hallucinations
Life expectancy at stage seven varies, but many cases range from 1 to 3 years. Your loved one won’t be able to remember their past or recognise loved ones, and they’ll most likely have lost the ability to make healthcare decisions. They will require 24-hour care to assist with daily activities.
How You Can Help Your Loved One
By stage seven, you’ll likely be caring for your loved one full-time or arrange a live-in carer to help. It’s important that you keep showing up for your loved one, even if they don’t recognise you or respond in a way you’d like. Companionship is essential for dementia patients to ensure good mood and quality of life.
Your loved one may experience periods of lucidity, which is a temporary and unexpected return of mental clarity. This moment is brief, but it offers a brief opportunity for communication and awareness with your loved one that you may not experience again.
How Trinity Homecare Can Help
At Trinity, we understand the emotional toll dementia and its stages can have on our clients and their loved ones. Our dementia care is provided by fully trained, compassionate carers with experience in the condition and all seven stages, ensuring your loved one is treated with kindness, empathy and dignity throughout.
The care we provide includes:
- One-to-one support at home
- Completely bespoke live-in care that has been tailored to you
- Specialist care for a number of different circumstances
- Home carers carefully matched to your needs
- CQC rated ‘Outstanding’ live-in care services
Talk to Trinity Homecare Today
If your loved one requires home care, chat with one of our friendly care team today. We offer a free, no-obligation enquiry and assessment service and are happy to offer information and advice to help you find the perfect home care solution.
Call us on 0207 183 4884 in confidence for a free no obligation quotation. If enquiring outside of our opening hours, please complete our online form and we will contact you the next day.
