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Stages of the disease

Early stage dementia
This phase may only be apparent in retrospect. At the time it may be missed or put down to ‘overwork’, ‘laziness’ or ‘old age’. The start of dementia is very gradual and it is usually impossible to identify the precise moment it starts. The person may:

  • Be apathetic
  • Show less interest in hobbies or activities
  • Be unwilling to try new things
  • Find adapting to change difficult
  • Become less good at making decisions or plans
  • Be slower to grasp complex ideas
  • Blame others for ‘stealing’ mislaid items
  • Become more self-centred and less concerned about others and their feelings
  • Forget details of recent events
  • Be more likely to repeat himself or herself, or lose his or her train of thought
  • Become irritable or upset if he or she fails at something

Middle stage dementia

Here the problems are more apparent and disabling. The person may:

  • Be very forgetful of recent events – memory of the distant past generally seems better, but some details may be forgotten or confused
  • Be confused regarding time and place
  • Become very clinging
  • Rapidly become lost if not in familiar surroundings
  • Forget names of friends or family, or confuse one family member for another
  • Forget about the saucepans on the stove or kettles boiling and may leave the gas on whilst it’s unlit
  • Walk around streets, perhaps at night, sometimes becoming lost
  • Behave in ways that may seem odd – for example, going out in nightwear
  • See or hear things that are not there
  • Become repetitive
  • Neglect hygiene or eating, perhaps claiming to have bathed or eaten when that’s not the case
  • Become angry, upset or distressed very rapidly

Late stage dementia

Here people are more disabled and need a great deal of help. They may:

  • Be unable to find their way around
  • Be unable to remember for even a few minutes that they have, for example, just had a meal
  • Constantly repeat one or more phrases or sounds
  • Be incontinent of urine and/or faeces
  • Show no recognition of friends and relatives
  • Need help or supervision with dressing, feeding, washing, bathing and using the toilet
  • Undress at the wrong time or in public
  • Fail to recognise everyday objects
  • Have difficulty communicating or understanding what is said
  • Be disturbed at night
  • Be restless, perhaps looking for a long-dead relative or for a small child now grown up
  • Be aggressive, especially when feeling threatened or closed in
  • Make involuntary movements
  • Have difficulty walking