Understanding the Stages of Dementia

When should you, an adult child of aging parents, begin to educate yourself about the stages of dementia? Ideally, before any signs of dementia present themselves and before difficult decisions need to be made swiftly. But that could be quite hard to do.

What’s at Stake?

Dementia is a group of conditions involving a decline in mental abilities, such as reasoning and memory, that can significantly interfere with daily life. Alzheimer’s disease, the most common form of dementia, results from the loss of connections between brain cells, and as a result, the brain cells eventually die.

According to the Alzheimer’s Association, one in 10 people aged 65 or older has the disease. Other causes of dementia include Parkinson’s disease, vascular diseases, or chronic drug use.

There is no cure for Alzheimer’s, which eventually leads to failure in bodily systems. This, coupled with advanced aging, often is fatal. However, there are medications that help reduce the symptoms of dementia, and early diagnosis enables caregivers to plan ways to keep their loved ones safe and supervised.

Recognizing the Stages of Dementia

Dementia varies in how it develops. Below is a range of potential symptoms that can serve as a guide toward the possible progression of dementia. The purpose for this list is not to assign labels, but to help identify symptoms of dementia in its different phases. Above all, it is important to recognize as soon as possible that you, the adult child, are witnessing something that is not part of the normal aging process.

• Mild dementia can be characterized by changes in personality, especially changes lasting several months. The senior may eventually become apathetic, taking little interest in subjects, hobbies, and other activities that used to interest them. Also, they often begin to repeat thoughts and ideas while becoming more easily frustrated or impatient. Problems with finding the right words to express oneself, explaining a situation, or asking a question may begin to surface.
• Moderate dementia is marked by more significant changes in personality. The senior may become suspicious of others and exhibit increased agitation. Sleep can be disturbed and daily tasks such as dressing, bathing, balancing a checkbook, or preparing meals (called activities of daily living, or ADLs) become more of a challenge. The senior may dress themselves inappropriately, such as wearing several layers of clothes on a warm day. Memory loss also becomes more pronounced, and items like cell phones may end up in the freezer or car keys in the mailbox.
• Severe dementia increases difficulties with ADLs to the point that the senior may need full-time care for even the most basic needs. The ability to communicate, remember information or control emotions are severely compromised, as well as physical functions like bladder control. Extreme mood swings, profanity, and even violent reactions are possible.

Dementia and Driving

When an adult child suspects his or her parents may be developing dementia, one of the more crucial decisions is determining when the car keys should be relinquished.

Combining slower reaction times, hearing loss, and diminished vision —all part of the normal aging process — with the disorientation and increased aggression of dementia could prove to be a deadly combination when driving.

So, what should the adult child be looking for when it comes to evaluating their senior’s driving competence?

• Are there unexplained dents on the parent’s car?
• Has the garage doorway been damaged recently?
• Have there been recent tickets or accidents?

A driving test might be a good idea. Here are a few things to ask yourself during the drive:

• Does the senior seem to be confused by road signs?
• Do they take wrong turns in areas they should be familiar with?
• Does talking in the car cause them to lose focus on the road and traffic?
• Are they reluctant to let you ride with them? (They may not want to reveal how much their driving skills have deteriorated.)

Testing for Dementia

You do not have to make the diagnosis of dementia alone. Aside from the observations of other family members, your parent’s family physician can administer tests, some taking only a few minutes, to indicate whether a more extensive screening for dementia is warranted.

The Montreal Cognitive Assessment is a widely used test that takes 10 to 12 minutes. The test looks at the senior’s ability to follow verbal commands, think abstractly, use and understand words, and copy a drawing, as well as other cognitive functions often affected by varying stages of dementia.

If you need assistance caring for a senior with dementia, Alzheimer’s, or any other form of memory loss—contact Bethesda. Our memory support neighborhoods in the St. Louis area provide support to caregivers and families of seniors. Contact us or schedule a tour to learn more.