The 7 Stages of Dementia: A Guide for Caregivers

Caring for someone with dementia can be a difficult, stressful process and a tough balance. On the one hand, you want to help them maintain as much independence as possible; on the other hand, you want to make sure they’re safe and receive the care they require.

Alzheimer’s disease and other types of dementia are often slow-progressing. It can take years before the symptoms of dementia fully develop and significantly impact the person’s life. It can take even longer until they are no longer able to care for themselves and require full-time services. Fortunately, early detection of dementia symptoms followed by treatment may be able to help slow down the disease’s progression and may help your loved one retain their memory and cognitive abilities longer.

This slow process can make it difficult for caregivers to fully understand their roles and what memory care services their senior loved ones require. This guide takes a closer look at the seven stages of dementia and what you can expect at each stage. It also provides tips for how to care for seniors struggling with memory loss issues.

According to the World Health Organization, as of 2023, 55 million people across the globe face some form of dementia. As a loved one or caregiver, it’s important to understand how dementia can progress over time. Dr. Barry Reisberg developed the Global Deterioration Scale (GDS), which is used for clinicians and in care settings. Caregivers can also learn about GDS to better understand how dementia affects their loved one. This chart breaks down the progression of dementia into seven different stages, from no cognitive decline to very severe dementia.

Use the graphic below only as a guide. It details the symptoms and management options for each stage of dementia. These details can help caregivers better gauge the severity of their loved one’s dementia. With the help of a doctor, they could better understand what type of care and supportive services they may require.

Early-stage dementia covers the first three stages. Seniors at this level are able to maintain their independence and can continue with their normal activities. Unless the person exhibits other health issues, they usually require little or no supportive care during this stage.

The person may experience moments of mild memory loss. For example, they may not be able to remember the names of people and places that were once familiar, though they should have no problem remembering close family members or major details of their lives.

At first, it can be difficult to detect any signs or symptoms of dementia during these early stages. However, as your loved one progresses through early-stage dementia, some memory issues and cognitive decline may be noticeable to those close to the person. For example, co-workers may notice a decline in performance at work.

Some signs of early-stage dementia include:

• Increased forgetfulness
• Forgetting people’s names they once knew
• Difficulty concentrating
• Reduced performance at work
• Misplacing important items
• Trouble finding the right words
• May get lost traveling to unfamiliar locations
• Difficulty retaining new information

The fourth, fifth and sixth stages correspond to mild and moderate dementia. During this period, both memory loss and cognitive decline worsen. Signs of decline are also more noticeable to family members, co-workers and medical staff.

Your loved one may become disoriented, even in familiar spaces, and have more difficulty remembering people’s names and major life details. Seniors experiencing this stage of dementia may show signs of increased anxiety and agitation, and become unable to perform complex tasks. 

As your loved one progresses through this period, they may require some assistance with activities of daily living. Creating a secure living environment may also be necessary.

Signs of middle-stage dementia include:

• Noticeable memory loss
• Difficulty remembering major events and close family members
• Forgets basic personal information, such as address or phone number
• May need some assistance with activities of daily living
• Difficulty counting backward
• Reduced ability to travel or handle finances
• May become anxious, aggressive or angry
• May experience incontinence

Late-stage dementia, also referred to as severe dementia, covers the seventh stage of dementia. By the time a senior reaches this stage of dementia, they may no longer be able to recognize or communicate with family members. They can no longer care for themselves and require 24/7 supervision as well as help with all activities of daily living, including eating, mobility and hygiene. It may appear as if the brain is no longer communicating with the body, as the senior continues to lose motor and verbal skills.

Signs of late-stage dementia include:

• Inability to speak coherently
• Loss of motor skills
• No longer able to recognize close family members
• Requires assistance with all activities of daily living
• May require mobility support
• Frequently or consistently disoriented
• Loss of bladder control
• Requires assistance with feeding

The life expectancy for someone with dementia varies significantly depending on numerous factors, including the person’s age, overall health, lifestyle habits and treatment plan. For example, dementia in a person who is over 80 years old may progress faster than someone in their 60s.

A major factor that determines life expectancy is the type of dementia. Below is a look at the average life expectancy for the major types of dementia.

• Alzheimer’s disease: According to the Alzheimer’s Association, the average life expectancy for a person diagnosed with Alzheimer’s is between four and eight years. However, in some cases, a person with Alzheimer’s can live for up to 20 years, depending on other factors.
• Vascular dementia: The average life expectancy for those with a vascular dementia diagnosis is five years. This number is lower than many other forms of dementia due to the other health concerns it causes. For example, this type of dementia causes a decrease in blood flow to the brain, which can trigger heart attacks and strokes.
• Lewy body dementia: Lewy body dementia impacts more than a million people across the country. The average life expectancy for someone with Lewy body dementia is five to eight years, but can range as high as 20 years.
• Frontotemporal dementia: The life expectancy for a person diagnosed with frontotemporal dementia can range from 2 to 20 years, but the average is 7 to 13 years after the symptoms start.

As a caregiver, it’s critical you take steps to minimize the stress and difficulty of caring for someone with dementia. Below is a look at five tips to keep in mind as you continue to care for a loved one struggling with dementia.

Taking care of a senior with dementia can be extremely stressful. Don’t be afraid to ask for help when necessary. For example, ask other family members to fill in so you can take breaks and vacations. If family isn’t an option, look into respite care.

As soon as you believe your loved one has dementia, it’s time to take action. Take steps to create a safe living environment by removing area rugs, decluttering the space and installing safety bars and door alarms. Check the home environment frequently and address any safety or security concerns.

Seniors struggling with dementia can respond well to familiar things, including their daily schedule. Do your best to keep the same daily routine, including waking, eating, dressing, bathing, TV time and bedtime.

Seniors with memory loss issues can experience frequent episodes of confusion and disorientation, which can make them agitated and angry. Arguing with them when they’re in that mental state may only make things worse. Instead, do your best to remain calm and to shift the conversation towards another subject.

Living with dementia can be scary and confusing for those with the condition. You can do a lot to minimize these feelings by ensuring your senior has several familiar items nearby, such as photos, a special blanket or personal mementos. These items can calm your loved one down and help them feel safe.

Memory care options for seniors living with dementia range from in-home care services to full-time skilled nursing services at a memory care unit. As a caregiver, it’s important to understand your options, so you can get an idea of which setting is best for your loved one. A healthcare professional can help recommend specific services based on the patient’s health. Below is a detailed look at the three most common memory care options along with a list of pros and cons for each care type.

Studies show that 80% of people struggling with Alzheimer’s Disease receive some form of in-home care services. This care option allows seniors to remain living in their homes or the home of a loved one. This type of care typically includes a combination of caregiver support by family members and home or home health care services. Typically, family members coordinate care and medical services, and transport seniors to and from medical appointments.

Seniors with memory loss issues who don’t require around-the-clock skilled nursing services may be able to safely live at a memory care unit within an assisted living community. These communities allow seniors to maintain some level of independence while ensuring a safe and secure environment. These facilities usually have enclosed outdoor areas and doors with alarms to keep seniors with memory impairment from leaving the facility.

Services at dedicated memory care communities are the most expensive option for seniors with dementia. However, these communities are specifically designed to care for seniors with significant memory loss issues and cognitive decline. These facilities are completely secure and provide around-the-clock skilled nursing care.

Understanding your loved one’s memory care options can help you determine which care solution is best for your family. It’s equally important to talk to your loved one’s physician and other medical providers and ask for their recommendations.

Check out the Caring.com memory care directory to learn more about the memory care options in your specific location. This guide provides answers to some of the most important questions about dementia care and breaks down care options by city and state.