Keep in mind that these stages are general guidelines that help people understand dementia’s progression, and that some professionals do not use them as disease guideposts. I am applying them to the dementia that is occurring in my family. Another family may not have anywhere near the same experience.
By the time stage five of dementia begins, a person is experiencing more and more cognitive decline. Remembering time, dates, locations, current address, and other bits of information is difficult. Math and reading abilities continue to diminish. At this point our family member, who had never belonged to less than two book clubs in her adult life, gave up book clubs, though she listens if read to. Moreover remembering to get to meals, dressing, and undressing were becoming more and more difficult. Showering details, especially understanding how to use the faucets and hand shower required help.
Many physicians give their patients the Mini-Mental State Examination (MMSE), a short evaluation that measures cognitive functioning, and the results can provide a snapshot of a person’s dementia progression. Our family member had been given this short evaluation right after the stroke and did just fine, but that was about 20 months ago. Her current physician did not offer to do it, nor did we think to request it. More up-to-date MMSE results would have helped us a lot had the new doctor suggested repeating this test in recent months.
My husband and I are now fully aware of the dementia as it relentlessly encroaches into our parent’s life and into ours. We find ourselves in stage six. When our parent began to look upset and worried all of the time we began to think about what to do next. She was frail, confused about time of day, and befuddled about almost every task. After many meals she thought it was evening and tried to go to bed. Within a short time she needed support with every single ADL.
After looking at residential memory units, we decided to hire caregiving assistants from the time she wakes up until the time she gets in bed. Mother is not a wanderer at this point so this gives us some flexibility. Staying put requires minimal change in our parent’s life and will work — for the time being — so she can remain in the familiar environment or assisted living facility with the aides. One of us tries to visit most days. She still enjoys being read to, though for shorter periods.
Stage seven? We’re not there yet, but I know it is the final stage of the disease.