Dementia - through all its stages

People with dementia differ in the patterns of problems they experience and in the speed with which their abilities deteriorate. Their abilities may change from day to day, or even within the same day. What is certain is that the person’s abilities will deteriorate - sometimes rapidly over a few months; in other cases, more slowly, over a number of years.

Phases of the disease
Features of dementia are commonly classified into three stages or phases. It is important to remember that not all of these features will be present in every person, nor will every person go through every stage. However, it remains a useful description of the progression of dementia.

Early dementia
Often this phase is only apparent in hindsight. At the time it may be missed, or put down to old age or overwork. The onset of dementia is very gradual, and it is often impossible to identify the exact time it began. During the early phase of dementia, the person may:

• Appear more apathetic, with less sparkle.
• Lose interest in hobbies or activities.
• Be unwilling to try new things.
• Be unable to adapt to change.
• Show poor judgement and make poor decisions.
• Be slower to grasp complex ideas and take longer with routine jobs.
• Blame others for ‘stealing’ lost items.
• Become more self-centred and less concerned with others and their feelings.
• Become more forgetful of details of recent events.
• Be more likely to repeat themselves or lose the thread of their conversation.
• Be more irritable or upset if they fail at something.
• Have difficulty handling money.

• Be very forgetful of recent events. Memory for the distant past seems better, but some details may be forgotten or confused.
• Be confused regarding time and place.
• Become lost if away from familiar surroundings.
• Forget names of family or friends, or confuse one family member with another.
• Forget saucepans and kettles on the stove. May leave gas unlit.
• Wander around streets, perhaps at night, sometimes becoming lost.
• Behave inappropriately - for example, going outdoors in their nightwear.
• See or hear things that are not there.
• Become very repetitive.
• Be neglectful of hygiene or eating.
• Become angry, upset or distressed through frustration.

• Be unable to remember - for even a few minutes - that they have had, for example, a meal.
• Lose their ability to understand or use speech.
• Be incontinent.
• Show no recognition of friends and family.
• Need help with eating, washing, bathing, using the toilet or dressing.
• Fail to recognise everyday objects.
• Be disturbed at night.
• Be restless, perhaps looking for a long dead relative.
• Be aggressive, especially when feeling threatened or closed in.
• Have difficulty walking, eventually perhaps becoming confined to a wheelchair.
• Have uncontrolled movements.

• Your doctor
• Your local community health service
• Your local council
• The Cognitive Dementia and Memory Service (CDAMS) clinic
• Alzheimer’s Australia Vic, National Dementia Helpline Tel. 1800 100 500
• Carer Support and Respite Coordination Centre Tel. 1800 059 059
• Carers Resource Centres Tel. 1800 242 636
• Aged Care Assessment Services - contact your regional Department of Human Services office
• The Aged Care Information line Tel. 1800 500 853

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