The Progression of Dementia: How Can Caregivers Recognize the Signs?

Progression of DementiaI was helping my friend move into town recently, and for two days, we were unable to put the bed together because he had misplaced the special screws in the packing process. They were somewhere among the diverse piles of boxes. He was sure he’d stashed them in a safe place, but that fact didn’t make him feel any better during those two days of wondering and turning around and then wondering again.

I think it’s a common experience for most of us, but it’s typically something that leaves us determined never to make that mistake again. I’ll always leave the keys on the hook by the door, so I don’t ever have to wonder, we might reason. But for our loved ones with dementia, those plans and determinations seem out of reach. That experience of even one forgetful day may seem to be without a foreseeable end. Their memories and connections, and even access to their own expression, seem to get further away.

The progression of dementia tends to be different for each individual, but there are certain signs and symptoms that can clue us into its onset. As caregivers, we can help to support aging adults logistically—by helping them reconnect to life and to memories—and emotionally because it can often feel as if they are losing their own connection with themselves.

How Can You Recognize the Early Signs of Dementia?

One of the primary symptoms of dementia is memory loss—especially a disruption in short-term memories—but the signs can take on many different shapes. In general, it’s good to keep in mind that even the early stages of dementia can begin to upset an aging adult’s daily life, so if you can approach the situation with compassionate observance, you will probably notice some changes and new challenges in your loved one’s life. In this list, we’ve included a wide range of signs and symptoms of dementia to look for.

Memory

  • Older adults experiencing dementia progression may be able to recall long-term memories from the past but have difficulty with recent memories.
  • They may forget where they left something or what their reason was for coming into a room.
  • They may have trouble keeping track of events and activities they were planning to be a part of and remembering people they haven’t known for very long.

Communication

  • In addition to general confusion and memory loss, older adults with dementia may have trouble finding the words to express themselves. They may have a sense of exactly what they want to say but language itself becomes a barrier.
  • They may forget people’s names and have difficulty reading and participating in other tasks that require them to make sense of words—including carrying on conversations, watching TV, or following along with other stories.

Concentration

  • Tasks that have been a part of an older adult’s regular routine may become too much for them if they require extended concentration or focus on narrow details.
  • Similarly, it can be hard to learn new things. Even step-by-step processes can be overwhelming.

Reasoning

  • You may notice aging adults with dementia making decisions that seem uncharacteristic for them due to inhibitions in their otherwise familiar judgment.
  • These unexpected actions may arise as atypical social behavior and even comments that lack the sensitivity or understanding they used to exhibit.
  • Their unusual actions may also appear as making poor financial decisions or neglecting to prioritize certain responsibilities and even self-care.

Confusion

  • Impaired memory, barriers to expression, inability to concentrate, and altered judgment can all lead to an overwhelmed feeling and confusion for our aging loved ones.
  • They may even find themselves dissociating and feeling out of touch with their own identities and strong connections they’ve had throughout their lives.
  • They may experience spatial disorientation, whether they are trying to recall directions for previously traveled routes or they are trying to get their bearings in their own home or another familiar place.

Mood

  • It is also possible for an older adult’s moods to become irregular—either as a result of the increasing imbalances in their brain or as a result of the other frustrating symptoms they are now experiencing.
  • Some of the moods they might express include depression, fear, anxiety, suspicion, irritability, withdrawal, and changeability.
  • You may also notice them losing interest in things they used to love doing or connecting with. This can result in increasing isolation and further exaggerated mood shifts.

For older adults experiencing these changes, they may be losing touch with who they’ve known themselves to be for their whole lives. So, on top of the stated challenges, they may feel even more helpless and lost when they don’t have the reassurance of their own sense of self. This is where it becomes incredibly important for us to offer a patient and compassionate space for them to evolve. These changes may be frustrating for everyone involved, but they don’t have to mean certain deterioration in quality of life.

Our blog offers helpful resources and advice about the importance of holistic home care for those with dementia, creative ways to approach compassionate communication, memory exercises to keep aging adults engaged, mindfulness meditation practices, and other activities that will invite loved ones to be present in the moment.

What Can You Expect from the Progression of Dementia?

You may recognize early signs here and there months or years before dementia has really set in for an aging loved one. As we’ve explored, there are many different characteristics and changes that can show up with dementia, and the progression can take on a unique course for each individual. As a caregiver, the more open you are to observing and being close to an aging adult, the more you’ll be able to understand the progression and offer compassionate support. Being able to recognize signs and their progression means that you can be on the lookout in any given day for changes in their behavior, mood, and personal challenges. Here, you’ll find a daily notes printout to help you stay connected and keep track of your observations.

Because dementia is a symptom of damage and degeneration in the brain, the aging adult will likely continue to experience cognitive decline. The progression of dementia depends on the condition that contributes to this decline. Alzheimer’s continues to be the most common contributor to dementia and tends to progress relatively slowly.

After a stroke or other traumatic event, patients may experience dementia’s progression, and the rate of change could be fast or slow. Because there isn’t a predictable pattern for the timeline and stages of dementia, your involvement and careful observations are critical to promoting their positive quality of life, now and moving forward.

In the later stages of dementia, it may take a greater toll on the individual’s physical and overall health. They may need to rely even more on a caregiver’s attention and support. All of the above symptoms may become more pronounced. The aging adult may also experience greater barriers to mobility, eating, and attending to other everyday needs and habits. It becomes even more important that they can feel comfortable, accepted, and appreciated by those around them.

A Caregiver’s Role During the Progression of Dementia

Every day that you spend together represents a significant step along your aging loved one’s path and your own evolution. Together, you can refine and strengthen your working and living relationship. You may be challenging them to continue exercising their memory and concentration—and their ability to connect in the present moment. Meanwhile, your own ability to connect with them and respond in proactive and supportive ways will transform along the way.

For more help and advice on caring for loved ones with dementia, reach out to Institute on Aging. We are committed to our own evolution as advocates for aging with grace and dignity. Here, you’ll find home care resources, as well as other programs and services for caregivers, aging adults, and their families.

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Institute on Aging

Committed to offering thoughtful discussions and resources to older adults, their families, and their caregivers.

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