Middle Stages Of Dementia

Middle Stages of dementia what to expect

The middle stages of dementia can be the most difficult of the three stages of dementia to deal with so far.

This is the stage where:

• Loss of memory continues to worsen
• Substantial changes in personality begin to emerge
• An increased need of assistance to help in carrying out their day-to-day normal functions.

This is the beginning of requiring total assistance from the care giver.

These changes will increase the day- to- day challenges and stressors for both the care giver and the individual suffering from dementia. Remember, based on the type of dementia will determine which of these signs and symptoms you will see.

Mental Changes

• Large gaps in memory and decline in thought processes. Short-term memory is a problem. This means the ability to recall things, such as something that happened five minutes ago is lost. Repetitive questions, repetitive stories are not uncommon. They are not aware of loss of memory.
• Unable to recall current address. Or to retrieve telephone numbers, where they worked or where they went to school.
• Becomes increasingly confused about the season of the year, day of the week, even the year. May believe that it is some time in the past.
• Can still recall own name and their spouse and children’s and other family member’s names.
• Is still able to identify familiar faces from unfamiliar ones.
• Unable to dress appropriately without cueing, or verbal assistance
• Attention spans are shorter
• Language becomes difficult. Word finding problems increase. If a second language was learned, many revert back to their mother language ... and loose the ability to retrieve the second language.
• Sundowning starts to occur. There is a disturbance in the sleep and waking cycles. Confusion increases as the day goes on, generally, late in afternoon or early evening.
• May experience delusions or hallucinations. May have periods of anxiousness.. fear of something; become suspicious of others and or paranoid. May start to see and hear things that are not there.
• Loss of inhibitions may occur. Socially inappropriate behaviors, such as undressing, sexually inappropriate behaviors and comments.
• Unusual behaviors. This may be exhibited as... compulsive hoarding, hiding things, going through garbage, stealing things, goes through others belongings. May develop repetitive behaviors.

Personality Changes

• This is the stage where personality changes are substantial. This becomes very difficult, as a caregiver, as they may be accused of stealing money or taking things.
• May become suspicious, paranoid, argumentative and accusatory.
• Begins to wander, become restless. Agitation and irritability are common. Becomes frustrated, anxious and angry if cannot express needs. May become physical or verbally
• Becomes socially isolated to self. Becomes more and more dependent on the caregiver.

Behavior Problems

• Wandering
• Insomnia, Sundowning or increased confusion in afternoon or evening
• Physical outbursts
• Verbal outbursts
• Suspicious
• Paranoia
• Hoarding
• Hiding things
• Increased disorientation
• Short attention span
• Pacing

Changes in Abilities to Function

• Will require more assistance with dressing, bathing and eating.
• Will require total assistance with toileting. Incontinence of bowel and bladder.
• Wanders and will become lost.
• Erratic sleep schedule and short attention span not conducive to a good appetite. May need finger foods and high calorie drinks to maintain weight.
• Unable to be responsible for self or other responsibilities.

Caregiver’s Role

• This is a very difficult and challenging time for the caregiver. It is important that a caregiver take time for himself or herself. This is to manage their caregiver stress.
• Mirror communication skills. Meaning, if the individual with dementia speaks in one or two words. Respond the same, with one or two words. That may be all they are able to express and understand.
• A regular routine is very important at this time. Limit distractions. Provide a calm environment when there is an increase in confusion.
• Develop a regular toileting schedule. Take to the bathroom every 2-3 hours to try and manage incontinence.
• Utilize touch and music to promote calm and try to soothe.
• Managing weight at this level is difficult. Nutrition may be finger foods given while they are on the run. Some have a difficult time sitting for more than a few seconds at a time. High calorie nutrition drinks may be encouraged.

As you can see from my description of the progressive stages of dementia this is a terrible disease. It is a difficult role to be in for a caregiver and it will most likely require the help of others.

If you are a family caregiver do not hesitate to ask for help from others.

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