Mid-Stage Dementia

The behaviors people associate most frequently with Alzheimer’s disease are those that appear in the mid-stages of the disease. It is important to remember that not all people experience all of the behaviors, but it is also important to be aware of them so that if they occur you are prepared to deal with them. Some of the typical challenging behaviors include anger, suspicion, repetition, wandering, fear of bathing, eating problems, hoarding, inappropriate sexual behavior, hitting, shouting, increased need for help with dressing, difficulty recalling words, loss of the ability to read, perform basic arithmetic, writing, and general loss of coordination.

The most important task in this stage of the illness is helping keep the person safe. It is always important to provide opportunities for the person with dementia to maintain maximum independence, but that is within the constraints of providing a safe environment. A person may fight relinquishing their car keys because of their desire to remain independent but risking their lives or others in the public because they can’t drive safely, isn’t permissible. The same applies to cooking or lighting the fireplace. Although the person with dementia may prefer to do these tasks on their own, it is irresponsible to turn these tasks over without supervision and risk burning down the house.

Another factor to reassess during mid stage disease is the ability to independently remain living at home. Although most people express the desire to remain living in their homes, irrespective of their illness, this isn’t always possible. Here is another place where an ongoing safety assessment is required. At some point in the development of the disease, an individual may no longer be capable of living safely on their own. Sometimes it’s sufficient to bring in long-term care services; in other cases it’s necessary to use residential services. Each situation is unique. There isn’t one right way to manage a long-term illness. The sooner you have discussions about these issues with the care recipient, the greater the probability that you will provide safe care that honors the wishes of your loved one to the maximum extent possible.