How Dementia Changes as the Condition Progresses
Dementia is a progressive condition, which means symptoms become more obvious as changes in the brain continue.
Unfortunately, this can make it difficult for families to know whether a new behaviour or difficulty is part of the condition.
This guide explains what can change as dementia progresses and how dementia care homes adapt a resident’s care as their needs increase.
How Does Dementia Change Over Time?
Dementia usually becomes more severe over time as further changes take place in the brain. A person with dementia might start forgetting recent events or struggling with familiar tasks and then gradually need more assistance with personal care and mobility. In later stages, eating and swallowing can also become difficult. However, there is no set timeline for these changes, with dementia progressing differently for each person.
Everyone Experiences Dementia Differently
One of the difficult things for families is not knowing exactly what to expect next. Even when two people have the same type of dementia, their symptoms usually develop differently and one of them could need additional care much sooner than the other.
The type of dementia does give us some indication of the changes that are more likely. For example, memory loss is often particularly noticeable in Alzheimer’s disease. With frontotemporal dementia, changes to behaviour or language can appear earlier, while dementia with Lewy bodies can cause a person’s alertness and confusion to fluctuate throughout the day.
This is why dementia care homes should adapt your loved one’s care plan as their symptoms and needs change over time.
Although dementia progresses over time, a sudden change in your loved one doesn’t necessarily mean their condition has rapidly worsened.
However, any noticeable deterioration over a short period should be taken seriously and assessed promptly, as there may be another medical cause.
Some examples of sudden changes include your loved one becoming far more confused than usual within hours or days. It might not be caused by dementia, but an infection, dehydration or delirium could be responsible, and care homes will ensure the resident receives the right medical attention.
Changes to Expect as Dementia Progresses
The changes in dementia progression are usually subtle at first. Does your loved one now need more reminders during a conversation or take much longer to get dressed, with familiar parts of their daily routine eventually requiring some assistance?
Some signs of dementia progression:
Changes in movement
Physical changes become more noticeable for some residents as dementia advances. Walking slows or becomes less steady as dementia advances. Over time, your loved one might also need assistance getting up from a chair or moving around safely.
Any change in mobility needs to be addressed carefully. Especially if it happens suddenly. An illness or another physical problem could be affecting a resident, so staff shouldn’t automatically assume that dementia is responsible.
Communication
Finding words takes longer, with your loved one losing track halfway through a sentence or using an unexpected word in place of the one they want. Or visibly struggle to follow a fast-moving conversation.
As communication becomes harder, giving your loved one plenty of time to answer helps. And shorter questions and fewer interruptions also make conversations easier to follow.
Everyday tasks
Dementia starts to affect the ability to work through tasks that are familiar – and in the right order.
For instance, your loved one could still be perfectly capable of putting on their own clothes but become confused about which item comes next. A carer can lay the clothes out in order or offer a prompt when they get stuck, allowing them to do as much as they still can for themselves.
Memory and recognition
Recent conversations and events become harder to remember as dementia progresses. Your loved one might repeat a question they asked only a few minutes ago or have no recollection of eating lunch earlier that day.
Recognition changes mean that a familiar face is now difficult to place, particularly as dementia becomes more advanced. It’s upsetting for families, but forgetting a name or relationship does not mean the feelings associated with that person have disappeared.
How Care Homes Adapt Support as Dementia Progresses
As dementia progresses, the support provided in a care home develops with it. Below are some of the ways care teams respond to a resident’s changing needs throughout the progression of dementia:
Prompting with everyday tasks
If a resident who once dressed independently is now forgetting which clothes to put on or what to do next, staff can first introduce prompts and provide more hands-on assistance if necessary.
Changes to communication
Carers can use shorter sentences and give residents more time to process what has been said. They also learn the individual ways a resident communicates when finding the right words becomes difficult, ensuring they can let everyone know what they need.
Additional personal care
Your loved one may reach a point where they need a carer to be with them throughout their personal care routine, including help with washing or getting dressed. Trained carers will step in where needed while continuing to involve the resident in the parts they are still able to manage to maintain dignity and independence.
Support at mealtimes
When a resident starts to need a reminder that it is lunchtime and later requires assistance with eating, care homes will be there to ensure they are nourished at the same times of day. If chewing or swallowing becomes difficult, this should be assessed so their food and drinks can be prepared appropriately.
Responding to changes in behaviour
Restlessness, distress or changes in behaviour sometimes become more frequent as dementia advances. Staff can assess what is happening around the resident and whether there is an underlying cause, such as discomfort or confusion, before deciding how best to respond.
Increasing mobility support
If walking becomes unsteady, care staff will review how the resident currently moves around the home and what assistance they need going forward to avoid accidents and falls. Mobility equipment or specialist input can then be arranged where appropriate. They can also start introducing more dementia-friendly activities to promote mental stimulation or soothing, depending on the stage.
Reviewing the care plan
Changes in a resident’s abilities and care needs are recorded so the team knows what support they now require. Families should also be involved in significant changes to their loved one’s care.
Supporting Your Loved One as Their Dementia Progresses
There is no point at which a family can look at a dementia timeline and know exactly what will happen next.
Your loved one might remain physically independent for a long time while their communication becomes more difficult or need increasing assistance with everyday tasks while still recognising the people closest to them.
Noticing when something has changed and working out what that change means for their care is important. In a specialist dementia care home, staff have the advantage of seeing residents throughout the day, so they can observe when even simple tasks become difficult and a resident starts needing assistance they did not need before.
And remember, if your loved one becomes significantly more confused or unwell over a short period, it should be investigated straight away instead of just being accepted as an inevitable part of their dementia. This is something a dementia care home will be on top of.
As the condition progresses, there will be difficult changes to navigate.
Having the right care in place means those changes can be recognised sooner rather than later, ensuring your loved one can continue to receive the right support for what they are actually experiencing at that stage for dementia.
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