Caring for someone with dementia—or even just trying to understand it—can feel overwhelming at times. Dementia isn’t just about forgetfulness; it’s a gradual journey that affects memory, emotions, and even physical health. The more you know about the different stages of dementia, the better prepared you’ll be to support your loved one (and yourself!) through the changes.

When my grandmother started showing signs of memory loss, we brushed it off as normal aging. She'd forget where she left her glasses or tell the same story twice at dinner. But as time went on, the little slips turned into bigger challenges—forgetting how to make her famous mashed potatoes or getting confused about where she was. Looking back, I wish we had understood the stages of dementia earlier so we could have been better prepared.

In this blog, we’ll walk through the seven stages of dementia in a way that’s easy to understand, with real-life insights along the way. Whether you're just starting to notice small changes or you're deep in the caregiving journey, I hope this helps you feel less alone.

Stage 1: No Problems Yet

At this stage, there aren’t any memory issues or noticeable changes. Everything seems normal, and life carries on as usual.

I remember sitting with my grandmother at her kitchen table during this time, chatting about what was going on in our lives.

There was no sign of what was coming. If only we could freeze those moments in time.

No Cognitive Decline (Normal)

• Symptoms:
  • No memory issues or other signs of dementia.
  • Individuals function normally in all areas of life.
• Health Changes:
  • Brain health appears normal.
  • No noticeable changes in behavior or abilities.

 

Stage 2: A Little Forgetful
This is the stage where people might start forgetting small things, like where they left their keys or someone’s name. Honestly, it’s easy to confuse this with normal aging because it’s super subtle.

At first, my grandma would joke about her forgetfulness. “Guess my brain’s just getting old!” she’d laugh when she'd forget something trivial. We laughed too, not realizing it was the beginning of something bigger.

Very Mild Cognitive Decline (Age-Associated Forgetfulness)

• Symptoms:
  • Slight forgetfulness, such as misplacing objects or forgetting names.
  • These lapses are often attributed to normal aging.
• Health Changes:
  • Minimal to no impact on daily life or independence.
  • No noticeable physical or behavioral health changes.

 

Stage 3: Mild Memory Issues
This is where changes become a little clearer. You might notice someone having trouble organizing their day, losing track of conversations, or forgetting important dates. Family and friends usually start picking up on these changes, even if the person themselves doesn’t see it.

With my grandma, I believe this is when the post it notes started popping up all over their house. I thought it was a little strange, but didn't contribute it to anything sinister.

Mild Cognitive Decline (Early-Stage Dementia Possible)

• Symptoms:
  • Increased forgetfulness (e.g., forgetting recent conversations or appointments).
  • Difficulty finding the right words.
  • Trouble concentrating or organizing tasks.
  • Family and friends may notice subtle changes.
• Health Changes:
  • May begin to feel anxious, frustrated, or embarrassed about memory lapses.
  • Can still function independently but with increased effort.

 

Stage 4: Struggling with Complex Tasks
Here’s where things get a bit trickier. Tasks like managing bills, planning a trip, or keeping up with appointments might become overwhelming. People might start withdrawing from social situations because they’re aware of their struggles.

We used to always have Thanksgiving at my grandparent's house.  Suddenly she just couldn't handle the complexities of making a meal with so many moving parts. It was heartbreaking to see, and I'm sure she felt embarrassed. The following year, my mom made everything and brought it over to my grandparent's house. Warming up food is far simpler.

Moderate Cognitive Decline (Early-Stage Dementia)

• Symptoms:
  • Difficulty performing complex tasks, such as managing finances or planning events.
  • Forgetting personal history and recent events.
  • Withdrawal from social or challenging situations.
• Health Changes:
  • Noticeable changes in personality (e.g., mood swings or irritability).
  • May require assistance with some daily tasks, but personal care remains intact.

 

Stage 5: Trouble with Daily Life
By this stage, memory gaps are pretty noticeable. Someone might forget their address or the day of the week, and they’ll need help with basic daily things, like choosing what to wear or remembering routines. While they’ll still know their loved ones, confusion about time and place becomes more common.

My grandma went out to go somewhere and got lost. She couldn't no longer navigate the neighborhood they had lived in since my dad was a boy. My grandfather went out and saved her, but it was then that it became more obvious it was more than just the usual forgetfulness of aging.

Moderately Severe Cognitive Decline (Moderate Dementia)

• Symptoms:
  • Significant memory gaps, such as forgetting their address, phone number, or the date.
  • Confusion about time or place.
  • Difficulty dressing appropriately or selecting proper clothing.
• Health Changes:
  • Increased dependence on caregivers for daily activities.
  • May experience confusion or frustration, leading to mood disturbances.

 

Stage 6: Big Changes in Independence
At this point, a person will need help with nearly everything—dressing, eating, bathing, and so on. Memory loss becomes severe, and they might not always recognize close family. It’s also common to see mood changes, like agitation or suspicion, and sometimes they’ll wander or get lost. 

At one point, I was cleaning my grandparent's home once a week. Grandma would follow me around, watching. Mom asked one time, after she had misplaced something, if she though either of us grandchildren would steal, and she adamantly denied she thought we would. It was at this point we decided the 3rd non-existent child "Jennifer" was the center of the missing items.

She was suspicious, even if she wouldn't voice it.

Severe Cognitive Decline (Moderately Severe Dementia)

• Symptoms:
  • Significant memory loss, including forgetting the names of close family members.
  • Inability to perform basic tasks like dressing, bathing, or toileting without help.
  • Increased risk of wandering or becoming lost.
  • Behavioral changes, including paranoia, aggression, or delusions.
• Health Changes:
  • Physical decline begins, including trouble walking or maintaining balance.
  • Sleep disturbances and incontinence become common.

 

Stage 7: Full-Time Care Needed
This is the final stage, where the person loses the ability to communicate or do basic movements like walking or even sitting up. They’ll need constant care for all aspects of daily life. It’s a hard stage but keeping them comfortable and loved makes all the difference.

Near the end, she ended up being placed in a very good nursing home. As difficult as a decision as it was, she would no longer bear weight and needed more care than we could provide at home

Very Severe Cognitive Decline (Severe Dementia)

• Symptoms:
  • Loss of ability to communicate verbally (limited to a few words or none at all).
  • Loss of physical abilities, such as walking, sitting, or swallowing.
  • Complete dependence on caregivers for all aspects of care.
• Health Changes:
  • Profound physical decline, including muscle rigidity and weight loss.
  • Increased vulnerability to infections, such as pneumonia.
  • End-of-life care is often required.

                                     

A Few Things to Keep in Mind
Everyone moves through these stages differently—some faster, some slower.
The type of dementia (like Alzheimer’s or vascular dementia) can change how these stages look.
If you're caring for someone with dementia, take care of yourself too. It’s a lot, and having support is so important.

You’re not alone in this.

Alzheimer's Association has many great resources

Questions:

1. How has understanding the stages of dementia helped you better connect with or care for your loved one?
2. What do you think is the most overlooked sign of dementia or Alzheimer's?
3. What stage do you find the most challenging to understand or cope with, and why?

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