Early, Middle & Late Stage Alzheimer’s Disease & the Caregiver’s Role in Each Stage

Alzheimer’s disease (AD) is progressive, meaning as time passes, symptoms of the disease get worse. The typical changes over time in dementia are described as “stages” – read more about the stages of dementia. The amount of care and assistance that a person with Alzheimer’s disease needs varies by stage.

Early Stage Alzheimer’s

In the early stage of AD, which is also referred to as mild Alzheimer’s, inflicted individuals generally are still able to function on their own. However, many people in this stage of Alzheimer’s disease do have memory-related problems, such as needing help finding a lost set of keys, not remembering an old friend’s name, and forgetting something that was just read. There may also be some difficulty with tasks that take organization and / or planning, such as managing finances and keeping track of what medications to take, the dosage, and when to take them.
Caregivers of persons in the earlier stages of dementia support and help the person with dementia, and thus, are sometimes called care partners rather than caregivers. During early stage Alzheimer’s, it is important for caregivers and persons with AD to discuss legal and financial issues and care options for when the dementia progresses.

Moderate Stage Alzheimer’s

During the moderate stage of AD, also called middle stage Alzheimer’s, persons have trouble expressing what they are thinking and difficulty performing day-to-day activities. Persons may also experience changes in behavior and personality, such as anxiety, depression, agitation, issues with sleeping, hallucinations and delusions, and verbal outbursts.

Caregivers must help the person with AD with time-consuming or distressing tasks. For example, assistance with activities of daily living, such as bathing, dressing, preparing food and eating, using the bathroom, etc., is needed. Regular supervision to prevent undesirable behaviors, such as wandering, and to ensure the safety and wellbeing of the person with dementia is also required. In addition, caregivers must be prepared to deal with emotional problems and behavioral challenges.

Late Stage Alzheimer’s

People in late stage AD, also called severe Alzheimer’s, often lose the ability to speak, lose control of their bowels and bladders (incontinence), and lose the ability to move around easily. At some point, even swallowing becomes difficult.

At this stage of dementia, persons with AD require around-the-clock care. This can be extremely difficult, and it is common that it is no longer feasible for informal caregivers to provide care for a loved one. Dementia care facilities, also called memory care units, are worth exploring if adequate care cannot be provided at home.

Dementia Support

Support is crucial for caregivers in every stage of Alzheimer’s, as is reassurance they are not alone and that help is available. One’s local Alzheimer’s Association is a good starting place for assistance or support in caregiving during any stage of dementia. One can also call the Alzheimer’s Association 24-hour helpline anytime at 1-800-272-3900. Also, one can visit the section of this website on Finding Support.