The Stages of Dementia That You Need to Know

Both Alzheimer’s and Dementia are progressive conditions, which means that symptoms worsen over time as the disease progresses. This article serves to educate loved ones of those diagnosed with dementia or Alzheimer’s disease on what to expect as the disease progresses. 


Despite Alzheimer’s and dementia being terms that are used interchangeably, they both are different conditions and have some important distinctions between the two conditions. Dementia is an umbrella term that is used to describe several conditions, including Alzheimer’s. Since dementia is more than mere forgetfulness, there is specific criteria that someone must struggle with. In order to be diagnosed with dementia, a patient must have trouble with at least two of these cognitive areas:


  • Memory
  • Communication and Speech
  • Focus and Concentration
  • Reasoning and Judgement 
  • Visual Perception (including having trouble detecting movement, differentiating between colors, or even experiencing hallucinations)


The tools that professionals use to determine which stage of dementia a person is experiencing is simply a guide that gives the caregivers and medical support team a rough outline of what family members and professional caregivers alike can expect and when they can expect it. Some symptoms may surface later than others, some may appear in a different order than predicting and some may not appear at all.

Every person is different and dementia is a condition that manifests itself uniquely from case-to-case. As a result, the speed at which dementia progresses can vary widely. The average person diagnosed with Alzheimer’s disease lives 4 to 8 years post-diagnosis, but this is not a standard. Some patients can live as long as 20 years.


What Is the GDS and How Does It Measure Progression of Dementia?


As time progresses, the symptoms that a person experiences will become more and more obvious. There are several scales to measure the progression of dementia, but the most common is the Global Deterioration Scale for Assessment of Primary Degenerative Dementia (GDS). 

You may have heard it referred to as the Reisberg Scale. The GDS emphasizes seven different stages of memory-related conditions that correlate with four categories: 


  • No Alzheimer’s
  • Mild Alzheimer's
  • Moderate Alzheimer’s
  • Severe Alzheimer’s


Stages 1-3: No Dementia


Stage 1


In the first stage of dementia, there aren’t any signs of dementia and the person functions normally. People without a dementia diagnosis are considered stage 1. There aren't any signs or symptoms, no visible memory loss, no behavioral problems or anything else that would indicate the onset of dementia.


Stage 2

At this point, the disease begins to progress into stage 2. This is known as ‘very mild cognitive decline.’ In this stage, people can expect to experience normal forgetfulness attributed to the normal signs of aging. At this stage, caregivers may start to notice an elevated level of forgetfulness, but the symptoms of dementia still aren’t readily apparent to medical professionals or the person’s loved ones.

In this early stage, caregiving should be focused around finding a balance between independence and assistance. If you’re in doubt, assume your loved one can accomplish tasks on their own unless there’s a risk of safety.

Stage 3


The last stage in category 1 is mild cognitive decline. This is the point where loved ones may begin to notice the signs of cognitive decline as their family member begins to experience increased forgetfulness, a decrease in performance at work, speech difficulty, and difficulty focusing on everyday tasks. This stage is known in the medical world as ‘mild cognitive impairment’ and it’s crucial that caregivers are trained to recognize the signs of this stage for early diagnosis and intervention.

The Symptoms of Mild Cognitive Impairment


  • A decrease in overall work performance.
  • Increased memory loss
  • Trouble concentrating, problem solving, or managing complex tasks
  • Driving difficulties
  • Verbal repetition


Stage 4: Early-Stage Dementia


The clinical definition of early-stage dementia only has a single stage- stage four. This is categorized as moderate cognitive decline. This stage can last an average of two years and cognitive issues are clearly detected in a medical interview and exam.


 People that are in this stage of the disease will have difficulty concentrating, forget recent events, and have difficulty managing finances as well as traveling to new locations. Additionally, they may begin to experience difficulty socializing and may begin to withdraw from friends and family.

In this stage, caregivers should make an orchestrated effort to actively engage with the person suffering from dementia. Caregivers take on a more involved role at this stage and moving forward as the disease progresses, they’ll continue to have an involved role in the patient’s life. 


As a caregiver, you should create a daily care plan and make adjustments to schedules as needed to provide the necessary care while seeking physical and emotional support from other caregivers.


Symptoms of Early-Stage Dementia


  • Misplacing items
  • Forgetting recent conversations and events
  • Struggling to find the words they need in conversation
  • Losing track of the day, date, and time
  • Loss of interest in other people
  • Unwilling to try new things
  • Increased feelings of anxiety, depression, irritability, or depression
  • Trouble remembering names when meeting new people
  • Increased difficulty planning or organizing


Stages 5-6: Mid-Stage Dementia


This category is comprised of two stages: Stage 5, which is moderately severe cognitive decline and Stage 6, severe cognitive decline (also known as middle dementia.)


Stage 5


Mid-stage dementia lasts an average of 4 years and means that the person living with the disease now needs assistance to complete the activities of daily life. At this point, signs and symptoms of dementia are very easy to identify. Short-term memory will be mostly lost- allowing confusion and forgetfulness to be more pronounced as the person suffering goes through their day-to-day life. 


Stage 6


It’s at this stage that your loved one may start forgetting the names of close loved ones and have little memory of recent events. Communication is hampered and becomes extremely difficult while delusions, compulsions, anxiety and agitation may occur.

Symptoms of Mid-Stage Dementia


  • Problems sleeping 
  • Confusing day and night
  • Behaving inappropriately in social settings
  • Wandering or getting lost
  • Trouble with perception
  • Delusions or hallucinations
  • Increased irritability and aggression
  • Unable to recall personal history, address, or phone number
  • Changes in sleeping patterns


Stage 7: Late-Stage Dementia


This is the final category of dementia and only includes one stage. Stage 7, also known as very severe cognitive decline lasts, on average, 2.5 years. If your loved one is in this stage, they typically have lost the ability to speak or communicate and will need assistance with most activities- including walking. At this stage, caregivers should focus on providing comfort and improving quality of life as much as possible. Care options may exceed what you or your family may feel you can provide at home because around-the-clock care will be needed.

Symptoms of Late-Stage Dementia


  • Difficulty eating and swallowing
  • Considerable changes in weight (either loss or gain)
  • Incontinence
  • Gradual loss of speech
  • Restlessness
  • Angry outbursts from confusion
  • Increasingly vulnerable to infections.

    Situations like this are always difficult but if you have a quality support system combined with quality memory care, you can make it through! If one or both of your parents need memory care in Beaverton or the Portland metro area in Oregon, contact Laurel Parc at Bethany Village to arrange a tour of the best possible care to suit their needs. Reach out to us today at (503) 533-7979 to ask any questions or arrange a visit.

Assisted Living vs Independent Living: Know The Difference

Taking care of an elderly parent is hard work. It is also sometimes difficult to tell what sort of care your elderly parent needs. This article will focus on the similarities and differences of assisted living vs independent living. Once you understand the differences between these facilities, you will be able to make the best decision regarding your loved one’s care.

Assisted Living vs Independent Living: What You Need to Know

Assisted care facilities are generally for adults who struggle with completing daily tasks on their own. Adults at such facilities have the freedom to live independently. However, they also get support for a wide range of basic care needs. Some examples of services provided for residents are as follows:

  • Housekeeping services
  • Maintenance services
  • Meal preparation
  • Laundry services
  • Transportation
  • Medication management

Keep in mind that not every assisted living facility will offer all of the above services. However, the best programs will offer as many of the above services as possible, and most of these services will be included in the monthly rent. Before committing to a care home, ask which amenities are offered. Compare this list of offered amenities with a list of the services your loved one requires.

At most assisted care facilities, your loved one will also be invited to participate in extracurricular activities. Some care homes take residents on day trips and plan social activities in which residents can participate. Light exercise programs and sports might also be offered.

Assisted Living vs Independent Living Facilities

While assisted living homes are designed for those who need help with daily tasks, independent living facilities are designed for adults who are able to live alone but still want access to assistance. Such facilities offer residents convenient access to health care, food, entertainment and other services. Most independent living programs provide minimal assistance for seniors. However, most of these programs do offer housekeeping, meal programs and laundry services, though these amenities may not be included in the rental amount.

Before deciding on a care home for your loved one, sit down with him or her. Make a list of their needs and wants. Then, tour some possible facilities. Be sure to ultimately choose the one that gives you the best quality and the most amenities for your money. You will also want to consider things such as size and location. For instance, would your loved one be happy in a larger facility or a smaller one? Does it matter if you choose one in a large or a small city?

Make a list of questions you want to ask the staff before you go in to tour each facility. Ask for brochures and website names, just in case there are some programs offered that you’d like to read more about later. If possible, arrange to meet some of the residents at each facility. Meeting residents allows you to probe for further information about the quality of services offered.

Though weighing the options of assisted living vs independent living might seem stressful at first, you can make the appropriate decision if you plan ahead. Speak with your loved one about the services he or she desires most, tour facilities together. Don’t hesitate to ask questions of the staff members. Overall, the best decision for your family is one you will make together.

Situations like this are always difficult but if you have a quality support system combined with quality senior living care, you can make it through! If one or both of your parents need assisted living care in Beaverton or the Portland metro area in Oregon, contact Laurel Parc at Bethany Village to arrange a tour of the best possible care to suit their needs. Reach out to us today to ask any questions or arrange a visit.

The Risk Factors of Stroke That You Should Know

So, What Is A Stroke?


Before we take a deep dive into the risk factors behind a stroke that you need to watch for, let’s discuss what a stroke is. A stroke occurs when the blood flow to your brain is stopped for any length of time. This is a medical emergency and it’s urgent to seek medical care.

What Causes a Stroke?


The brain needs a constant supply of oxygen, blood, and nutrients in order to function. If blood supply stops- even for a short time, brain cells begin to die. When you lose brain cells, brain function is lost. When you have a stroke, you may lose the ability to do things that are controlled by the affected part of your brain. A stroke may impact your ability to:


  • Move
  • Speak
  • Eat
  • Think and Remember
  • Control your bowels and bladder
  • Control your emotions
  • Control other bodily functions


Types of Stroke


There are two kinds of stroke:



  • Ischemic stroke. This is the stroke that afflicts the majority of people who have a stroke. It occurs when a major blood vessel in the brain is blocked by either a blood clot or a buildup of fatty deposits and cholesterol.  
  • Hemorrhagic stroke. This is when a blood vessel in your brain bursts and spills blood into nearby tissues. When you have a hemorrhagic stroke, pressure builds up in surrounding brain tissue, causing even more damage and irritation.



Risk Factors For Stroke


Strokes can happen to anyone at any time but your chances of having a stroke increases when you have certain risk factors. You can manage some of the risk factors for stroke through lifestyle, but others are genetic. Here are risk factors that can be managed through intervention:



  • High Blood Pressure. Having a blood pressure reading of 140/90 or higher can damage the blood vessels and arteries that supply blood to the brain. 
  • Heart Disease. Heart disease is the second most important risk factor for stroke and is ultimately the major cause of death among stroke survivors. Heart disease and stroke share many of the same risk factors 
  • Diabetes. People suffering from diabetes are at greater risk for stroke than someone who isn’t diabetic. 
  • Smoking. Smoking will almost double your risk for ischemic stroke. 
  • Birth Control Pills.
  • History of Transient Ischemic Attacks. These are often called mini-strokes and share the same symptomatology as stroke but symptoms don’t last. If you’ve had one or more of these TIAs, you are almost 10 times more likely to have a stroke than someone of the same demographics that hasn’t experienced a transient ischemic attack. 
  • High Red Blood Cell Count. Significant increases in the number of red blood cells causes the blood to thicken and makes clots more likely, raising the risk for stroke. 
  • High Blood Cholesterol and Lipids. High cholesterol levels can help to contribute to the thickening or hardening of the arteries caused by a buildup of plaque. This plaque is deposits of fatty substances, cholesterol, and calcium. Plaque buildup on the inside of the artery walls can decrease the amount of blood flow to your brain. A stroke occurs when the blood supply to the brain is cut off.
  • Lack of Physical Activity.
  • Excessive Alcohol Consumption. Consuming more than 2 drinks a day raises your blood pressure. Binge drinking can lead to a stroke. 
  • Illegal Drugs. IV drug abuse carries a high risk of stroke from blood clots (cerebral embolisms). Cocaine and other stimulants have been closely linked to strokes, heart attacks, and other severe cardiovascular problems. 
  • Abnormal Heart Rhythm. Some forms of heart disease can raise your risk for stroke. Having an irregular heartbeat is both the most powerful and the most treatable heart risk factor of stroke.



Risk Factors for Stroke That You Can’t Change



  • Aging. For each decade of life after the age of 55, your chances for having a stroke more than doubles. 
  • Race. African Americans are at a much higher risk for death and disability from a stroke than caucasians. This is partially tied to the increased chances of high blood pressure in the African-American population. 
  • Gender. Men are most likely to have a stroke, but women are more likely to die from stroke. 
  • History of Prior Stroke. You carry a much higher stroke for having a second stroke after you’ve had one. 
  • Heredity or Genetics. Your chances of stroke are greater when you have a family history of stroke. 



Stroke: The Key Points To Remember


  • Strokes occur when the blood flow to your brain is stopped and are a medical emergency. 
  • Stroke can be caused by a narrowed blood vessel, bleeding, or a blood clot that restricts or blocks blood flow. 
  • Symptoms can onset suddenly. If someone is showing any of the signs of having a stroke, call 911 immediately. 
  • Stroke victims have better chances of recovery when emergency treatment is started right away. 
  • How stroke affects you depends on where the stroke occurs in the brain and how much damage occurs during the event.

Evaluating memory care for a loved one with dementia

Evaluating memory care for a loved one with dementia

It is never easy to witness the decline of an aging loved one, and when that decline is due to dementia, it becomes significantly more painful for the family to cope. These diseases present an ever-changing landscape that demands constant reevaluation. When you believe you have a game plan down, some new medical or behavioral development can completely upend your strategy. Even the most dedicated family can eventually become emotionally spent or find themselves over their heads in terms of their loved one’s care. For these patients, the process of decline will invariably beg the question, “at what point do I surrender his care to professional help?” This is the most challenging question of all, but in truth, memory care services offer tremendous benefits in preserving the safety and dignity of the mentally impaired.

What’s happening to them?

“Dementia” is an umbrella term for a variety of neurological diseases that share some similar characteristics. Alzheimer’s disease is the most common and well-known disorder, but other types of neurological conditions can cause dementia as well, such as chronic strokes, or brain tissue loss. Signs of dementia will be subtle in the beginning and may be either behavioral or cognitive. Mom may suddenly forget the orientation of her home or community or how to use a few common words. Dad may become agitated, paranoid, or fearful over seemingly benign events. As the decline progresses, the cognitive impairments will become more persistent, eventually rendering the person speechless, irrational, or unable to create new memories. The need for care becomes greater, as each stage of the disease removes a little more independence, until ultimately he or she cannot be left alone at all, either because of safety or a complete inability to feed or toilet alone.

What to expect

It is crucial for families to remember that while there are a few medications and therapies available to slow the progression of some types of disorders, the decline will continue. You should not expect that your loved one will ever free themselves from this disease, or that they should “try harder” to get better. Coping with memory disease is a one-way street that requires a coordinated effort of love, understanding, and diligence at every level. There may come a point when in-home care is no longer sustainable or safe, and a specialty facility may be in your loved one’s best interest. As painful as it may be, when Mom can no longer stay home without presenting a danger to herself or you, it is time to consider enlisting the help of a senior care center.

What is a memory care facility?

Memory facilities are often separate units built within an assisted living community or skilled nursing facility. Memory care units are designed entirely to provide a consistent and secure living structure to patients with Alzheimer’s or other cognitive deficits and are staffed with nurses, nursing assistants, and activity directors dedicated to providing a safe, happy, and controlled environment twenty-four hours a day. Unlike what you would typically associate with a nursing home, these are very active living communities designed to allow your loved one to continue to thrive with as much quality as possible while removing the variables of danger that living at home might present.

How to evaluate a memory care facility

Facilities like these hold a great responsibility to a tremendously vulnerable population. Before you consider enrolling your loved one, do your research to be sure that they will be receiving quality care. Visit the facility a few times at different times of day to see how the environment feels. Ask as many questions as you want about safety protocols and resident activities, and make sure you think you are getting consistent and enthusiastic answers. Check with your state’s regulating authority about any violations or complaints against your chosen facility. Last but not least, put an ear out to your local community. Ask for personal recommendations from others who have utilized these facilities for their aged family members.