7 STAGES OF DEMENTIA: IS IT TIME FOR MEMORY CARE?

7 STAGES OF DEMENTIA: IS IT TIME FOR MEMORY CARE?

If you think a loved one is starting to suffer from dementia, it is important to get them evaluated by a doctor. Below are the 7 stages of dementia according to the Reisberg Global Deterioration Scale. 

Stage 1 (No Cognitive Decline): No subjective complaints of memory deficit. No memory deficit evident in the clinical interview.

Stage 2 (Age Associated Memory Impairment): Subjective complaints of memory deficit, most frequently in following areas: (a) forgetting where one has placed familiar objects; (b) forgetting names one formerly knew well. No objective evidence of memory deficit on clinical interview. No objective deficits in employment or social situations. Appropriate concern with respect to symptomatology.

Stage 3 (Mild Cognitive Impairment): Earliest clear-cut deficits. Manifestations in more than one of the following areas: (a) patient may have gotten lost when traveling to an unfamiliar location; (b) coworkers become aware of patient’s relatively poor performance; (c) word and name finding deficit becomes evident to intimates; (d) patient may read a passage or a book and retain relatively little material; (e) patient may demonstrate decreased facility in remembering names upon introduction to new people; (f) patient may have lost or misplaced an object of value; (g) concentration deficit may be evident on clinical testing. Objective evidence of memory deficit obtained only with an intensive interview. Decreased performance in demanding employment and social settings. Denial begins to become manifest in patient. Mild to moderate anxiety accompanies symptoms.

Stage 4 (Mild Dementia): Clear-cut deficit on careful clinical interview. Deficit manifest in following areas: (a) decreased knowledge of current and recent events; (b) may exhibit some deficit in memory of ones personal history; (c) concentration deficit elicited on serial subtractions; (d) decreased ability to travel, handle finances, etc. Frequently no deficit in following areas: (a) orientation to time and place; (b) recognition of familiar persons and faces; (c) ability to travel to familiar locations. Inability to perform complex tasks. Denial is dominant defense mechanism. Flattening of affect and withdrawal from challenging situations frequently occur.

Stage 5 (Moderate Dementia): Patient can no longer survive without some assistance. Patient is unable during interview to recall a major relevant aspect of their current lives, e.g., an address or telephone number of many years, the names of close family members (such as grandchildren), the name of the high school or college from which they graduated. Frequently some disorientation to time (date, day of week, season, etc.) or to place. An educated person may have difficulty counting back from 40 by 4s or from 20 by 2s. Persons at this stage retain knowledge of many major facts regarding themselves and others. They invariably know their own names and generally know their spouses’ and children’s names. They require no assistance with toileting and eating, but may have some difficulty choosing the proper clothing to wear.

Stage 6 (Moderately Severe Dementia): May occasionally forget the name of the spouse upon whom they are entirely dependent for survival. Will be largely unaware of all recent events and experiences in their lives. Retain some knowledge of their past lives but this is very sketchy. Generally unaware of their surroundings, the year, the season, etc. May have difficulty counting from 10, both backward and, sometimes, forward. Will require some assistance with activities of daily living, e.g., may become incontinent, will require travel assistance but occasionally will be able to travel to familiar locations. Diurnal rhythm frequently disturbed. Almost always recall their own name. Frequently continue to be able to distinguish familiar from unfamiliar persons in their environment. Personality and emotional changes occur. These are quite variable and include: (a) delusional behavior, e.g., patients may accuse their spouse of being an impostor, may talk to imaginary figures in the environment, or to their own reflection in the mirror; (b) obsessive symptoms, e.g., person may continually repeat simple cleaning activities; (c) anxiety symptoms, agitation, and even previously nonexistent violent behavior may occur; (d) cognitive abulla, i.e., loss of willpower because an individual cannot carry a thought long enough to determine a purposeful course of action.

Stage 7 (Severe Dementia): All verbal abilities are lost over the course of this stage. Frequently there is no speech at all -only unintelligible utterances and rare emergence of seemingly forgotten words and phrases. Incontinent of urine, requires assistance toileting and feeding. Basic psychomotor skills, e.g., ability to walk, are lost with the progression of this stage. The brain appears to no longer be able to tell the body what to do. Generalized rigidity and developmental neurologic reflexes are frequently present.

WHEN IS IT TIME FOR MEMORY CARE? 

If the doctor finds signs of dementia, they may suggest a Memory Care Facility like Alba Court Residences. The reason why is, as the dementia progresses, it may become challenging to provide the full support your family member needs at home. It is a challenge for anyone who does not have all the tools needed to handle the hurdles that arise. 

It may be time for memory care if:

1. Your loved one starts becoming overly agitated and aggressive due to dementia. 

2. They are having a hard time managing their own daily hygiene. 

3. They are having trouble sticking to sleep schedules.

4. They start wandering and you are concerned about their safety. 

5. The home is not suitable to keep your loved one from falls or accidents.

6. Medications are becoming harder to keep track of.

7. They start losing weight and need help managing their nutrition. 

8. You as a caregiver, start feeling burnout and are concerned about your own physical and mental health. 

If you are concerned about any of the above items, please reach out to Beverly Robinson at 386-847-3022. She will be happy to provide support and a plan of action that fits all of the needs of your loved one. 

If you are struggling with talking to your family members about your loved one’s care and letting them know it is becoming too much, you may want to check out a caregiver’s support group or Alzheimer’s support group to help you realize that you are not selfish or uncaring it is simply the best route of action for your whole family.