There are three known stages of dementia progression:
|Stages of dementia||Characteristics|
|Mild stage||• This stage can last from 3-5 years.
• The person is able to live and function independently: work, drive, selfcare.
• In the beginning the symptoms are mild memory interferences, problems with thinking and learning.
• The symptoms are mild attention deficit, when a person cannot follow the conversation, especially in a larger group of people. Person starts avoiding the crowd and is losing interest in things that he/she liked until recently.
• Then they start forgetting things, they become emotionally distant. In a lot of cases they appear sad and numb.
• It continues with memory interferences, when a patient is forgetting and therefore repeats things. When people point that out, the patient sometimes becomes angry and distrustful.
• Complaining over memory interferences: person forgets where he/she puts things, forgets the names he/she knew very well.
• Denial and mild anxiety.
Signs, when there are misfunctions on more than one area:
o The person can easily get lost when traveling at unknown locations.
o Co-workers and people around become suspicious about the problems.
o The person might read a book, watch a movie, see a show and not remember much.
o Not remembering names when meeting new people.
o Losing or misplacing things.
o Clinical testing can show problems with concentration.
The objective indicator of memory loss can be confirmed only with formal tests.
|Moderate stage||• This stage can last from 3-12 years.
• Memory interferences of recent important topics (who is the president, which is the capital city, who is the famous poet, etc.)
• Communication problems (person doesn’t find appropriate words, has troubles with the conversation flow).
• Problems with everyday chores, hygiene, usage of different utensils (kitchen, electrical devices, TV, telephone).
• The person is unable to recall the important information from life, like address or phone number, the names of family members, … Very common occurrence is disorientation for date, day, space, time of the year and backward counting (from 40 or 20).
• The person can recognize family members and has preserved memories from personal history (episodic memory).
• Still able to do some things on his/her own.
• Attention deficit on multiple areas.
• Not able to travel or handle money.
• Not able to do complex tasks.
• Emotional instability and avoidance: denial is a dominant defense mechanism, jealousy, delusions, aggression or apathy, anger, impulsiveness.
• Unable to function on his/her own: the person needs help and cannot live on his/her own anymore.
|Severe stage||• Plaques and tangles are seen on the larger part of the brain.
• The person forgets the names of the relatives. He/she can remember his/her name, but has problems with other family members- don’t distinguish between relatives and strangers.
• Memory fades on the recent events and experiences.
• The person is able to recall only few events and gained knowledge.
• Problems with counting forward and backward with larger numbers than 10.
• Distractions in every day’s rhythm: sleeping disorder.
• Changes in personality and emotional perceiving: the person can have delusional experiences, apathy, obsessive symptoms, fear, loss of appropriate behavior.
• All verbal skills are lost. Often the speech is gone, what is left is mumbling.
• Person needs help with daily chores, getting dressed, being fed, going to the bathroom.
• Loss of psycho- motoric functions: the brain loses the ability to communicate with the body; slowly losing ability to walk.
• In the end the person obtains only vegetative functions.
|Stages of dementia||Measures|
|Mild stage||• The biggest effect on the decrease of cognitive actions are preliminary precaution activities: cognitive exercises (attention, memory, problem solving, etc.), exercises for sensory, physical activities, healthy diet and corresponding lifestyle.
• We have to help the person with the plan for daily chores and activities: diary of activities, taking medicine, finance plan, planning important events, daily plan (meals, free time, etc.).
• Planning the future: legal formalities, conversations about care and staying at the nursing home, etc.
|Moderate stage||• Lead activities with the person so they can strengthen cognitive and other functions.
• Recommended activities are those, that stimulate memory of the past, that strengthen motoric and sensor functions, activities that stimulate all kinds of memory areas (episodic, semantic, implicit-procedural memory).
• Lead activities, that stimulate movement.
• Care for communication and socializing.
|Severe stage||• Complete care.
• Activities that strengthen sensory perception, that are soothing and relaxing.
• Lead activities with the person so they can strengthen cognitive and other functions that are left.