There has not been a time where I haven’t asked a client, “What stage of dementia is your loved one in?” It’s a loaded gun question. Each stage of dementia will mean something different to each person. In this series, I will demystify the stages of dementia and explain what each one entails.
There are so many websites defining the stages differently that they confuse even me – a trained Alzheimer’s and dementia care consultant. Many websites include detailed sets and subsets, but it’s important for caregivers to stay focused on the general facts without getting too wrapped up in the details. The details of each stage will vary from person to person.
As I stated in Alzheimer’s Disease and Other Dementias: The Caregiver’s Complete Survival Guide, “Stages of dementia are not set in stone. Every person is different and therefore each stage of dementia will be different for everybody.” The stages of dementia will differ due to their particular type of dementia, their environment, and their relationship with the caregiver.
In the most basic breakdown, there are 3 stages of dementia: mild, moderate and severe. In this section of the series, we’ll focus on the mild or early stage of dementia – where your loved one stands in this stage, what’s to come, and what is required of you as a caregiver.
What does the mild stage entail?
Even when a person has early onset dementia – no matter what age, they will exhibit behaviors and characteristics of mild dementia. Changes in behavior, personality, and memory are what bring them into diagnosis. Early onset is unexpected – it’s no different then early onset puberty or menopause. These are things we expect to happen later in life, but sometimes we’re taken by surprise.
In a nutshell, early dementia is sometimes referred to as mild cognitive impairment (MCI). With any form of cognitive impairment, your loved one will lose the ability to process information. Your loved one will be having problems with memory, language, perception, judgment and reasoning.
It’s important to know that not all people who are diagnosed with MCI or mild dementia go on to develop Alzheimer’s disease or other forms of dementia. Some people can remain stable for years, some return to normal, and then there are those who will progress into the next stages. Who this happens to, or why – even doctors don’t know.
What should caregivers expect?
Preparing for the future is difficult. But if you are transitioning into the role of caregiver, one of the best things you can do for yourself and your loved one is to educate yourself. Education and a strong team in place will help you through this time. Every family situation is different and presents unique situations. As a certified Geriatric Care Manager, therapist, and certified family mediator I am trained to guide families to their best solution.
Below are some warning signs of mild dementia to look for:
- Difficulty remembering names of new people, places and things.
- Losing or misplacing common items (keys, remote control, phone, etc.).
- Forgetting recent conversations or appointments.
- Sudden panic/anxiety in a situation they could handle prior.
- Getting lost in recent surroundings.
- Now having problems performing usual tasks (computer, card games, meal preparation, banking, etc.).
- Not being able to handle more than one task at a time.
- Personality changes (loss of previous social skills).
- Inappropriate behavior or responses.
- Difficulty with planning future events.
Often times, the stage of dementia is measured by a test called the Mini Mental Status Exam or MMSE given by a doctor. This is a 30-question examination composed of questions regarding time and place, recall, reading, comprehension, math and visual spatial. The amount of questions answered correctly determines the MMSE score.
The MMSE score for mild dementia is 29-21. These numbers give a lot of leeway. They can also give family members a false sense of confidence that things are not as bad as they appear. Of course, this test is not set in stone, it’s a simple procedure used to gauge where a person is on this scale. However, it’s not proven. We can all get a day, season, or county wrong especially when under pressure. The person administering the test and how certain words are presented can also have an effect on the results.
How long will the mild stage of dementia last?
Besides being asked the common warning signs or symptoms, I’m often asked “How long will this stage last?” Unfortunately, nobody truly knows.
With proper planning and guidance, I’ve seen many cases where clients remain independent with only a little help from loved ones. Others, due to their environment, genes, personal or emotional history – the decline, can occur at a faster pace.
The stage titles of dementia, although not set in stone, are used as guidelines for caregivers to better understand where their loved ones are in their dementia journey. But each person could have a different experience in a particular stage. Stay tuned for the next section of this series on the moderate stage of dementia.
Photo courtesy of Michael Swan