What To Expect In Stage Five Dementia: Symptoms, Challenges, And Support Strategies
Over 50 million people worldwide currently have dementia, and that number is expected to nearly triple by 2050. Dementia can present many challenges for those affected and for their loved ones and caregivers. As a disease that causes dementia progresses, individuals will typically experience worsening symptoms and increased difficulty with daily activities.
The stages of dementia can vary depending on the individual, the type of dementia they have, and other elements of their health. That said, medical professionals often divide them into phases numbered from one to seven in order of increasing symptom severity over time. Understanding what to expect in stage five dementia according to this scale can help family members and caregivers prepare themselves and plan how to best support their loved one with dementia.
Identifying dementia stages using the Global Deterioration Scale
Dementia symptoms are typically progressive and terminal, gradually worsening until the final stages. A framework like the GDS can help medical providers, caregivers, and loved ones of individuals with dementia understand what to expect for the patient’s condition so they can be equipped to manage symptoms and plan for the future.
Note, however, that the GDS is a broad tool, not a rigid guideline. The symptoms a person with dementia may experience, when they appear, and how long they last can vary. Some people may not experience certain symptoms listed on the GDS at all, or they may appear earlier or later than the guidelines suggest. For more specific information, speak to your loved one’s doctor.
Understanding stage five dementia symptoms
Stage five dementia is identified as “moderate dementia” per the GDS. In this phase of the illness, individuals will usually require some level of assistance in order to care for their daily needs. It may be around a year and a half before the person progresses to the next stage.
Symptoms and challenges of stage five dementia
In stage five dementia, a person may still be able to remember their own name but may have trouble recalling key life details, such as their address, phone number, the school they went to, and some family members’ names. They’re likely to experience some confusion related to the date and time and their physical location. While people in stage five usually don’t yet need assistance eating and using the bathroom, they may need help choosing the right clothing for weather or occasion and completing other daily tasks.
Key challenges often faced by those past the first four stages of dementia
One significant challenge for many individuals in stage five dementia is the loss of independence. Daily activities that they once performed with ease now require support, which can be frustrating and disheartening for both the individual and their caregivers.
Communication can also become more challenging in this stage. People with dementia might start to have trouble finding the right words, following conversations, or understanding complex instructions. These challenges can lead to feelings of isolation and frustration. Emotional and psychological shifts are also common during this stage of symptom progression. Examples may include heightened anxiety, signs of depression, or mood swings.
Care and support strategies for loved ones of those with stage five dementia
Providing support to someone with stage five dementia usually requires a compassionate and flexible approach. Here are several strategies to consider that may be beneficial for both the individual with dementia and their caregivers and loved ones:
Arrange medical check-ups often
It’s usually helpful to get medical check-ups for the person with dementia regularly as their disease progresses. Their doctor can help monitor their overall health and suggest tips for managing emerging symptoms.
Establish a routine
Routines can provide a sense of stability and predictability, which can be comforting for individuals with dementia. Regular schedules for meals, activities, and rest may help reduce confusion and anxiety.
Simplify communication
Using clear, simple language and providing one instruction at a time can help individuals with stage five dementia better understand and follow directions. Maintaining eye contact and using non-verbal cues can also aid in communication.
Promote safety
Ensuring a safe living environment can reduce the risk of accidents and injuries. Removing potential hazards, such as loose rugs or cluttered spaces, can help prevent falls. Installing safety features like bathroom grab bars can also provide added support.
Engage in meaningful activities
Activities that the individual with dementia finds enjoyable and engaging and that match their interests and abilities can provide a sense of purpose and improve quality of life. Listening to music and gardening are two examples.
Provide emotional support
Acknowledging and validating your loved one's feelings may make them feel heard and understood. Offering reassurance, affection, and a listening ear may help alleviate stress and promote emotional well-being.
Each person's journey with dementia is unique. Remaining attentive to their changing symptoms and needs and offering personalized care and support can help promote their overall health and well-being.
Planning for the future
Since dementia symptoms often begin to more significantly interfere with a person’s daily life at this stage, the need to plan for the future can become more apparent. If you haven’t yet covered these topics with or on behalf of your loved one, here are some important factors that may be important to consider as soon as possible:
- Advanced care planning. Discussing preferences for medical care, including decisions about life-sustaining treatments, can give individuals with dementia a sense of control and help ensure their wishes are known and respected going forward.
- Financial planning. Managing finances can become challenging as dementia progresses. It may be necessary to designate a trusted person to handle financial matters and to explore options like power of attorney.
- Long-term care options. Long-term care options, such as assisted living facilities or memory care units, may need to be considered as the individual's needs evolve.
- Legal matters. Creating or updating legal documents such as wills and advanced directives can help ensure the individual's wishes are followed in the event that they are no longer able to make decisions for themselves.
Having these conversations early can significantly reduce stress and offer peace of mind to both the person with dementia and their relatives. As the disease progresses, plans may need to be reviewed and revised. Professional advice from attorneys and financial planners can help ensure informed decision-making.
Support for caregivers and loved ones of those with dementia
Many organizations offer training programs for dementia caregivers, which may help you learn practical skills and techniques for managing challenging behaviors and improving communication with your loved one. Technology can also assist in caregiving tasks, such as medication reminders, safety devices, and apps designed for dementia care.
Looking after your own well-being as a family member and/or caregiver of someone with dementia is important too. It’s common to experience a range of emotions as a loved one goes through the stages of dementia, such as grief, sadness, frustration, and even anger. Taking steps to boost your emotional resilience may help you navigate emotional highs and lows. Helpful techniques may include regular exercise, mindfulness, time with friends, getting plenty of sleep, joining a support group, and taking regular breaks from caregiving by leaning on family and friends or respite care services.
Online therapy as a way to receive support
If you’re looking for additional emotional support as you care for a loved one with an illness like dementia, you might consider meeting with a therapist. They can help you identify and process difficult emotions and identify self-care strategies you may want to add to your routine. For those who don’t have time to locate and then regularly travel to and from a therapist’s office for in-person appointments, online therapy might be more convenient. You can get matched and meet with a licensed provider from home. Research suggests that online therapy can be an effective form of support for family caregivers.
Takeaway
Is dementia the same as cognitive impairment?
Dementia is not the same as mild cognitive impairment, memory lapses, or difficulty with mental function. There are many causes of cognitive decline, and not everyone with cognitive functioning difficulties necessarily has dementia. For example, some mental health conditions can cause memory loss and difficulty with complex tasks. However, if you or a loved one is suddenly experiencing moderately severe cognitive decline or significant personality changes, talk to a professional as soon as possible. Early diagnosis and genetic testing may slow dementia symptoms and potentially prolong the early stages of a loved one’s dementia.
What stage of dementia is memory loss?
Memory loss can begin in early stage dementia but worsen with a person’s cognitive decline. In the beginning, someone may have occasional memory lapses and forget recent events. As dementia progresses into moderate cognitive decline, a person may start to forget how to perform basic tasks, remember personal history, and use problem-solving abilities. As dementia progresses to moderately severe dementia or severe dementia, the individual will start to experience very severe cognitive decline, which leads to the final stage of dementia, also called late stage dementia. In this stage, a person may lose their physical abilities and motor skills to eat, sleep, and breathe well. Difficulty speaking and difficulty sleeping can lead to illness. The last stage of dementia leads to the end of one’s life, often within four to eight years.
What happens when you have dementia and Alzheimer's disease?
Dementia symptoms can be different for everyone and may depend on when symptoms begin, the type of dementia diagnosis someone has, and whether they have received support services during an early stage. According to the Alzheimer’s Association, common symptoms of Alzhimer’s disease include difficulty with problem-solving, language skills, memory, and being able to perform routine tasks, such as paying bills or organizing lifestyle factors, such as self-care and work. Generally, there are considered to be seven dementia stages. However, dementia can also be classified into stages like severe, moderate, and mild dementia. Symptoms that arise before developing dementia and being diagnosed are often referred to as pre-dementia stages.
How long can you live with stage five dementia?
Each person is different for how long they stay in each of the seven dementia stages after they develop dementia. Dementia types like frontotemporal lobe dementia, vascular dementia, and lewy body dementia may have different life expectancies than Alzheimer’s disease for some people. Some people can live for 15 years or longer, even if their life expectancy or prognosis is shorter. Each dementia stage may last a few years.
Some people in a severe or moderate stage may progress much faster, especially without treatment. Other symptoms unrelated to dementia are often the cause of death in those with severe cognitive decline. For example, a study in the National Institute of Health journal shows that people with dementia commonly develop pneumonia. Although pneumonia is not directly associated with age-associated memory impairment, late stages of dementia can cause someone to stop swallowing normally, which can cause buildup of fluid in the lungs.
Are dementia and Alzheimer's disease the same condition?
Dementia is an umbrella term for a group of conditions, including Alzheimer’s disease, Huntington’s disease, Lewy body dementia, frontotemporal lobe dementia, and others. Dementia itself is not a specific illness. Each type of dementia has unique symptoms and a different prognosis for each individual. For example, Huntington’s disease tends to arise earlier in life than other forms and is genetic, meaning someone with the condition has a 50% chance of passing it on to their child if the other parent also has the marker for the condition.
What type of dementia causes memory loss?
All types of dementia can cause memory challenges. The most severe type of memory loss may come with late stages of Alzheimer’s disease. However, since all forms of dementia impact the cognitive functioning areas of the brain, all forms of dementia can have detrimental impacts on memory.
What stage of dementia is associated with severe cognitive impairment?
The final stages of dementia are most frequently associated with severe cognitive impairment. These stages are around the fifth to seventh stage. In the seventh stage, an individual with dementia will be in their final days of life. They may stop being able to eat, sleep, or swallow normally. They may need 24/7 care until they pass.
What is the most aggressive form of dementia?
Creutzfeldt-Jakob disease (CFD) is the most aggressive form of dementia, although very rare. This condition progresses rapidly, often ending in death around eight months after diagnosis. The person with this condition may lose memory much more quickly, and there is no current cure for this condition. Hospice care to make one’s final days more comfortable is often recommended.
What stage do dementia patients become violent?
Not all people with dementia become violent or have agitation as a symptom of their condition. However, this symptom is more likely to occur during the stages of moderate to severe dementia as opposed to the beginning of the disease. However, someone may become agitated if they are unsure what’s happening to them during the early stages, in which they may be more irritable or avoid others to avoid shame.
How can you tell when the end is near with dementia?
There are often signs that someone has entered the final stage of dementia, including a lack of speech, difficulty sleeping, refusing to eat or drink, and laying in bed most of the time. Their muscles may become stiff, and they may have extreme difficulty with motor control. In this time, loved ones may prepare for losing the individual within a few days to months. Talk to the doctor to understand the exact prognosis in your case.
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