Common Signs and Symptoms of the Stages of Dementia Early Stage. Typical duration – 2 to 4 years. Onset often insidious, difficult to identify much as being wrong. This stage covers lead-up to and diagnosis of early dementia. Largely independent in all Activities of Daily Living (ADL`s) and Instrumental Activities of Daily Living (IADL`s) Symptom Example Short term memory loss (S.T.M) STM loss affects job performance. The person may not be sure what they have just been asked to do. Paying bills 2 or 3 times.

Advanced Stage. This last stage sees progressive global neurological deterioration and is characterised by needing full assistance in ADL’s and IADL`s. Typical duration – 1 to 2 years. Symptom Example STM and LTM are both severely affected. They forget their spouse’s or care giver’s names. Global cognitive decline. Loss of personality and emotional changes. Disorientation to time and place They are largely unaware of their past life and their surroundings. Topographical memory problems and spatial perceptual problems. Spatial awareness and their sense of geography are affected so they become unable to find their way around their own house. Speech severely affected Phonology or production of sound affected. Syntax severely affected. Sentence structure poor. Incomplete sentences. Communication may make no sense. Mood Disturbance Anxiety, agitation and violent behaviors may occur. Emotionally disinhibited and labile or apathetic. Hallucinations and delusions Common in this stage Diurnal rhythm disturbed. May be up all night, can`t differentiate between night and day. Weight loss occurs Despite a good diet Paratonia Increased muscle tone evident on quick movements. Gives the illusion of resisting care. Incontinence Doubly incontinent by the end of this stage. Gait Disturbance Evidence of wide-based, unsteady gait or slow shuffling gait. Eventually leading to client being bedbound Windows of Lucidity Even at this late stage there can be windows of lucidity , where the client makes sense, or remembers people or life events for brief periods. End Stage. Dementia is fatal and in this last, terminal phase, clients die from complications of overwhelming brain cell death. Degeneration is so bad that the brain can no longer tell the body what to do. They are totally dependent in all ADL`s and IADL`s. They require 24 hour nursing care. Duration – Days to 6-12 months Symptom Example The loss of psychomotor skills. They lose the ability to dress, toilet or walk independently, they are now mostly bedbound and they will lose even their ability for head control. Verbal abilities are lost. Have extremely limited vocabulary, usually less than 5 words. There may be no speech at all, only grunts. They lose the ability for facial expression and can no longer smile. Extreme Confusion. Individuals in this stage display no recognition of family, and offer little or no response to the surrounding environment. Total Incontinence. Susceptible to infections and dehydration They have had at least one of the following medical complications occurring within the previous 3 months; dehydration, pneumonia, urosepsis. Exhibit marked weight loss Refusal/inability to consume adequate calories despite encouragement by staff. Weight loss despite adequate calories….

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