Arming caregivers with knowledge about the progression of dementia helps in the creation of an individualized care plan. In addition, person-centered dementia care is better served when caregivers are able to recognize behaviors and communication issues that are common through the three stages of dementia.

Early Stage (Mild)
■ Cannot find the right words to name things or to complete thoughts;
■ Scrambles sequence of events when relating a story;
■ Speaks of past events as if they are currently taking place;
■ Cannot remember what was just said;
■ Has difficulty following directions;
■ Short-term memory is affected, may repeat questions and stories;
■ Makes multiple phone calls to a family member to ask about appointments, people, and places;
■ Becomes suspicious and makes paranoid or accusatory statements; and
■ Becomes defensive if corrected or if his “reality” is challenged.

Middle Stage
■ Confused if someone talks fast or uses slang,
or if someone uses abstract ideas or offers too many thoughts or choices;
■ Needs more time to respond to others or to join conversations;
■ Becomes frustrated if more than one person talks at the same time;
■  Begins to use substitute words or uses unorganized sentences;
■ Is often reduced to yes/no responses out of fear of making mistakes “in public;”
■ Makes inappropriate, odd, or impolite statements (dementia erases lines not crossed in “polite company”);
■ Repeats questions and stories;
■ Sings frequently or speaks in rhyme; and
■ Is prone to fabricate forgotten details.

Late Stage (Severe)
■ Speaks one to six words a day;
■ Uses words that make no sense, or may just be sounds;
■ Repeats what’s been said rather than responding to speaker;
■ Responds to nonverbal communication: music, sound, touch, and visual stimulation; and
■ Communicates needs nonverbally through behaviors, facial expression, and sounds.

Source: “Guide To Living With Dementia,”