Caring for someone with dementia can be quite challenging. In its early stages, dementia may appear as mild cognitive impairment, characterized by confusion, impaired judgment and forgetfulness. However, as time goes on, your loved one may be affected at a deeper, more concerning level.
Some people with dementia experience personality changes and may become aggressive both verbally and physically. They may display rude, hurtful behaviors, as though they’ve lost their filter for what is appropriate and what is not.
The reasons behind these personality changes can be different for different people. Your loved one may be feeling paranoid or fearful. Or perhaps they simply can no longer contain their impulses. It’s not uncommon for caregivers to say, “This is not the person I knew. She acts so differently now.”
Clearly, dealing with dementia is challenging. Hiring a home care agency that specializes in dementia care will make your journey a bit easier. They will explain how to deal with dementia and teach you the techniques, cues, and strategies that are most useful when caring for dementia patients.
While you and your loved one are coping with dementia, it’s also critically important that you, the caregiver, look after your own needs, as well. Caring for someone with dementia can be very stressful. Dementia is typically unpredictable and that means no two days are ever exactly alike. Be sure you have your own support network and make it a point to rely on dementia resources and professional services, as needed.
Seven Stages of Dementia
Dementia care specialists use “stages” as a way to describe how far someone’s dementia has progressed. These stages are broad, and not everyone fits neatly into one or another. Moreover, sometimes one symptom may be quite pronounced, while others in the same stage are not as noticeable. A dementia care specialist has the specific expertise needed to conduct a comprehensive dementia care needs assessment and create a care plan for a dementia patient.
In its early stages, dementia may appear as mild cognitive impairment, characterized by confusion, impaired judgment and forgetfulness. As it progresses, dementia may diminish someone’s ability to do math, keep a checkbook or pay their bills. They may also fail to recognize common household items or know how to use them.
In the later stages, someone with dementia may no longer be able to recognize personal care items, such as a toothbrush, silverware utensils or the television remote. Some will no longer recognize their home or be able to recite their address or telephone number. They may not be able to accurately say the day, date and time. People in the later stages of dementia should not be left home alone. They require frequent help with activities of daily living, such as taking medication, showering and getting dressed.
To better understand how dementia is staged, take a look at the seven stages of cognitive decline most commonly used for evaluating Alzheimer’s disease, the most common form of dementia. (Note: Alzheimer’s is a terminal illness, and not all people who have dementia will progress to Stage 7.)
|Global Deterioration Scale (CGS) / Reisberg Scale|
|Diagnosis||Stage||Signs and Symptoms||Expected Duration of Stage|
|No Dementia||Stage 1:
No Cognitive Decline
|In this stage, the person functions normally, has no memory loss, and is mentally healthy. People with NO dementia would be considered to be in Stage 1.||N/A|
|No Dementia||Stage 2:
Very Mild Cognitive Decline
|This stage is used to describe normal forgetfulness associated with aging. For example, forgetting names and where familiar objects were left. Symptoms of dementia are not evident to the individual’s loved ones or their physician.||Unknown|
|No Dementia||Stage 3:
Mild Cognitive Decline
|This stage includes increased forgetfulness, slight difficulty concentrating, and decreased work performance. People may get lost more frequently or have difficulty finding the right words. At this stage, a person’s loved ones will begin to notice a cognitive decline.||Average duration of this stage is between 2 years and 7 years.|
Moderate Cognitive Decline
|This stage includes difficulty concentrating, decreased memory of recent events, and difficulties managing finances or traveling alone to new locations. People have trouble completing complex tasks efficiently or accurately and may be in denial about their symptoms. They may also start withdrawing from family or friends because socialization becomes difficult. At this stage, a physician can detect clear cognitive problems during a patient interview and exam.||Average duration of this stage is 2 years.|
Moderately Severe Cognitive Decline
|People in this stage have major memory deficiencies and need some assistance to complete their daily living activities (dressing, bathing, preparing meals, etc.). Memory loss is more prominent and may include major relevant aspects of current lives. For example, people may not remember their address or phone number and may not know the time or day or where they are.||Average duration of this stage is 1.5 years.|
Severe Cognitive Decline (Middle Dementia)
|People in Stage 6 require extensive assistance to carry out their Activities of Daily Living (ADLs). They start to forget names of close family members and have little memory of recent events. Many people can remember only some details of earlier life. Individuals also have difficulty counting down from 10 and finishing tasks. Incontinence (loss of bladder or bowel control) is a problem in this stage. Ability to speak declines. Personality / emotional changes, such as delusions (believing something to be true that is not), compulsions (repeating a simple behavior, such as cleaning), or anxiety and agitation may occur.||Average duration of this stage is 2.5 years|
Very Severe Cognitive Decline (Late Dementia)
|People in this stage have essentially no ability to speak or communicate. They require assistance with most activities (e.g., using the toilet, eating). They often lose psychomotor skills. For example, the ability to walk.||Average duration of this stage is 1.5 to 2.5 years.|
Providing Care Yourself vs. Hiring an Agency
As you start planning for dementia care, you will need to consider the medical, functional, and emotional needs of your loved one. Dementia care is complex, so take the time to consider all of your options, which range from caring for someone with dementia yourself versus hiring a dementia home care agency. It’s important to consider:
- Finances. Taking time off from work to care for your loved one can impact your paycheck. Not only do you need to provide personal care and companionship, but you’ll also be responsible for transportation to and from medical appointments, errands, and social outings.
- Mental Health. As the responsibilities of caring for your loved one mount mental health can be affected, as many family caregivers experience burnout, resentment, depression, and even conflict with other family members.
- Physical Health. Caring for a loved one with dementia can be physically demanding. Your sleeping and eating patterns may be disrupted, and there are physical strains that come along with helping someone with mobility and transportation.
- Time. Dementia care is often 24/7. As a result, you’ll have less time for your own hobbies, social interactions, and general well-being.
- Relationships. When you’re caring for someone with dementia, the relationship between the two of you is bound to change. The quality time that you used to spend together is likely to be replaced by feelings of embarrassment, resentment, guilt, and worry.
- Concerns About Caregivers. An agency that specializes in dementia care will match you with a caregiver and coordinate all aspects of dementia care. Like selecting any service, there are pros and cons to consider before partnering with a home care agency. Make sure to do your due diligence to find an agency and a caregiver that best suit your needs.