If your older loved one is living with dementia, you will likely notice a decline in their cognitive understanding as the condition progresses. Their doctor may have even communicated with you and your family about what stage of cognitive impairment your loved one is facing. There are 7 levels of dementia, which will be described below.
What is Dementia?
Dementia is a progressive loss of cognitive function. It is often caused by the cumulative weakening of nerve cells in the brain, or as a result of diseases like Alzheimer’s. The memory loss and cognitive decline caused by dementia can impair your loved one’s ability to think clearly and act safely in their daily life. They may not be able to care for themselves and manage daily tasks such as hygiene care and meal preparation. As a result, many individuals with dementia require daily care.
Dementia Diagnosis
No test can confirm a dementia diagnosis. Rather, the diagnosis will likely come from a culmination of tests and observations from medical professionals. Often, this can require cognitive tests, bloodwork, neurological tests, brain scans, and even psychiatric evaluations to make an accurate diagnosis. These tests can also rule out a variety of other causes of cognitive decline. When a diagnosis is made, your loved one’s doctor may assign a level to their cognitive impairment. Below, we will list the stages of dementia.
Stage 1: No Impairment
Most individuals are classified at stage one. There are no symptoms of cognitive impairment. The overall mental acuity of an individual at stage one is healthy.
Stage 2: Subjective Memory Loss
Most people over the age of 65 may experience minor memory loss or cognitive hiccups. Age-related memory loss is commonly associated with stage 2. This may be indicated by minor forgetfulness, such as being unable to recall a name during a conversation. Your loved one may seem a bit forgetful, but this is fairly common at an advanced age. In otherwise healthy individuals, stage 2 can last 15 or more years after age 65.
Stage 3: Mild Cognitive Impairment
Stage 3 is where symptoms of dementia can become more noticeable in daily life. It may not cause major impacts on your loved one’s daily life, but it may be more noticeable to friends and family. They may seem more forgetful than usual. Your loved one might repeat the same question a few times in a conversation. They may find more difficulty in concentrating or staying focused. You may also notice them getting lost more easily when driving, even to commonly visited places. For most doctors, Mild Cognitive Impairment is not a cause for a dementia diagnosis. But it may be an indicator that dementia may be on the horizon for the individual. For otherwise healthy people, this stage can last about 7 years.
Stage 4: Moderate Cognitive Decline – Early Dementia
Stage 4 is generally regarded as Early Dementia. Signs of cognitive decline are often apparent. Signs of stage 4 dementia should warrant a consultation with a doctor. These symptoms can include:
- Social withdrawal/reclusivity
- Mood swings
- Occasional non-responsiveness
- Difficulty with common tasks
- Denial of symptoms
Individuals at Stage 4 can often recall their own name, their current address, and other basic information. They may be able to recall current events or discuss the current weather. But they may have a hard time recalling memories or discussing past events. During stage 4, individuals may still be able to care for themselves regularly, but may forget some tasks. While some people can live independently at this stage, there can be a greater risk for potential injury or danger if they become forgetful while cooking or doing other daily tasks. At this stage, a dementia diagnosis will likely be made.
Stage 5: Moderately Severe Cognitive Decline – Moderate Dementia
When an individual is considered at stage 5, they will likely need help with most daily tasks, including dressing, bathing, or eating. They will likely need in-home care or to be moved to a memory care facility. They may not be able to recall personal details or current events. It may be hard for them to remember major events in their life. At stage 5, individuals face reduced mental acuity. They may have difficulty with basic problem-solving or tasks that require a level of focus.
Stage 6: Severe Cognitive Decline
Stage 6 of dementia is where severe mental and cognitive decline occurs. Your loved one may have difficulties with sleeping, paranoia, and symptoms of anxiety. They may have significant trouble recognizing loved ones, including spouses or their children.
Some doctors will subcategorize stage six into levels from A through E. As their dementia progresses, they move through the subcategories. Further stages will indicate levels of decline, often marked by the individual’s inability to care for themselves in certain capacities. Note that these stages are often determined by individuals who are otherwise healthy for their age. Those with other co-morbidities or disabilities may not be able to perform these tasks at earlier points.
In stage 6a, the individual may wear the same clothes every day unless assisted. For Stage 6b, they may be completely unable to bathe themselves without assistance. Stages 6c to 6e are often associated with the ability to use the bathroom properly. For stage 6c, the individual may not understand what to do with toilet paper after using the bathroom. 6d is defined by urinary incontinence, with fecal incontinence marked by 6e.
Stage 7: Severe Dementia
At this stage, the individual will likely need assistance at every level of care to continue to survive. Their ability to speak has likely declined to a small vocabulary of words. For some people, they may be limited to about 6 intelligible words. At this stage, their ambulatory ability is often entirely compromised. This will cause most individuals to need a wheelchair at this stage. While someone can survive many years in stage 7, they are likely to succumb to other health conditions within a few years. Bodily decline and atrophy, in addition to co-morbid conditions, lead to eventual death. Otherwise healthy individuals with stage 7 dementia will continue to slowly lose bodily control and function. Late-stage 7 individuals may not be able to smile or even hold up their head on their own accord.
What Causes Dementia to Progress?
Generally, age is a major factor in the progression of dementia. But several factors can affect your loved one’s progression through the stages of dementia. These factors can positively or negatively impact their time through each stage. There is no exact science for calculating stage progression, as it is generally unique from person to person. Compounding factors may include:
- Onset age
- Type(s) of dementia
- Genetics
- Overall physical health
- Co-morbidities
- Medication side-effects
- Strokes
- Infections
- Daily care support
- Emotional fortitude
In-Home Care for People With Dementia
If your loved one is living with dementia, in-home care support can make a big difference in their overall quality of life. A certified home health aide can assist your loved one with their daily care needs. From daily meal preparation to hygiene care, a home health aide can help your loved one in the comfort of their home. As cognitive decline progresses, familiar surroundings can help minimize confusion and ease stress. Safe Harbor Home Healthcare has a long history of assisting those living with dementia in their daily lives.
Safe Harbor Healthcare Services does not provide medical, healthcare, or financial advice via articles. This material has been prepared for informational purposes only. It is not intended to provide and should not be relied on for advice.
Safe Harbor Healthcare Services has provided excellent home care on Staten Island since 1967. Our services help older and disabled individuals live safely and independently while giving their families the peace of mind they need. For more information, contact us or call (718)-979-6900.
