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Caregiver Training Blog

Degeneration and The Stages of Dementia

DementiaOne of the most difficult aspects of dealing with dementia is its degenerative nature. While its progression often involves common signs and symptoms, everyone’s experience with dementia is different. This can make managing the disease particularly challenging for dementia caregivers who may find its inherent uncertainty stressful. Having a basic understanding of the stages of dementia progression -- keeping in mind that it’s a just a guideline, not a rule -- can help caregivers cope.  

Here’s a closer look at the stages of degenerative dementia aimed at helping caregivers prepare to provide the most compassionate senior care. 

Early Stage Dementia

In the earliest stage of dementia, only mild changes occur. In fact, the early signs of dementia may not be recognizable except in retrospect. People in this stage of the disease may easily forget things, frequently repeat themselves, have difficulty expressing themselves with language and/or following conversations, find new places and situations confusing, struggle with decision making, show poor judgment, lose interest in previously enjoyed activities and people, be reluctant to try new things, and experience feelings of sadness, anxiety, frustration and anger. 

However, individuals in the early stages of dementia can also maintain many basic responsibilities while continuing to engage in daily activities, although they may require more rest.

One note for caregivers? While talking about end-stage care at this point may seem premature, it can be an important part of making sure your aging loved one's voice is heard before he or she loses it -- either literally or figuratively. 

Middle Stage Dementia

The symptoms experienced during the early stage worsen during the next stages of dementia. Seniors in the middle stage of dementia may get lost easily even in familiar places, struggle with bathing and dressing, require reminders about eating and taking medication, need more help with meal preparation and managing their finances, feel agitated and/or restless, confuse time, have trouble sleeping, and believe things are real when they aren’t. 


People living with dementia may find it harder to do things for themselves as the condition progresses. Because of this, they’ll require more assistance with managing the tasks of daily living. At the same time, they may become frustrated and upset about this loss of control. This moderate phase may be especially challenging for caregivers. Your aging loved one’s healthcare team may be able to point you in the direction of resources aimed at connecting caregivers with the information they need to deal with ongoing relationship changes. 

Late Stage Dementia

During the final and most severe stage of dementia’s progression, people experience more significant physical and cognitive decline eventually leading to the need for full-time nursing care. Symptoms of later stage dementia may include difficulty recognizing people, loss of speech, difficulty eating and swallowing, incontinence, and the appearance of restlessness. They may also be more vulnerable to infections and their side effects. 

While people with late stage dementia may be unable to verbally communicate, they may still respond positively to signs of affection, such as a soothing voice, smile, or gentle touch. 


One of the most difficult things about caring for someone with degenerative dementia is its unpredictable timeline. While patients live an average of eight to ten years from the emergence of symptoms,  many variables impact the progression of the disease and life expectancy, including everything from age of diagnosis to the presence of other illnesses. Unfortunately, this can compound the element of uncertainty for caregivers who have no way of knowing which symptoms will emerge and when. Those who are aware of the typical trajectory of the disease, however, can best ready themselves for what's to come. This helpful video from offers more valuable insights into understanding dementia behaviors:


Additionally, mmLearn.org offers a large library of free videos for caregivers of older adults, covering topics pertaining to senior care. Whether you are a healthcare professional or a family caregiver, if you are caring for an older adult we know that you will find mmLearn.org an essential learning and guidance tool for all of your caregiver training needs.  For more information on dementia care, including everything from how to communicate with someone who has Alzheimer's Disease to activities for someone with dementia using Tupperware,  access our database of free online caregiver videos today.