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Managing Middle-stage Dementia with Compassion





As we’ve previously discussed, dementia is a debilitating disease that affects our senior loved ones in a variety of ways. In this article however, we’ll be taking a look at the transition from early stage dementia, to middle stage dementia.  


Before we begin, it’s important to understand that a foundational aspect of dementia is its variability. Dementia affects individuals in different ways and with varying severity. So, while it’d be nice to find a clear demarcation between early stage and middle stage, the truth is dementia is best understood as a gradual continuum rather than distinct stages.


Some factors to keep in mind:


Range of Individual Differences


  • Each person's journey with dementia is unique

  • Rate of progression varies significantly between individuals

  • Different types of dementia progress in different patterns

  • Existing health conditions can impact progression

  • Age of onset affects progression patterns


Overlapping Symptoms


  • Many symptoms exist simultaneously across stages

  • Some early stage symptoms persist into middle stage

  • New symptoms emerge gradually, not suddenly

  • Symptoms may fluctuate day to day

  • "Good days" and "bad days" can occur in any stage



"Your word is a lamp for my feet,
a light on my path."

Psalms 119:105




Middle Stage Dementia


Middle stage dementia represents a significant turning point in the progression of the condition. Typically lasting between two to four years, this stage brings noticeable changes across multiple areas of cognition and behavior.


When the Familiar Becomes Unfamiliar


In the middle stage of dementia, issues with memory and cognition become more pronounced. Many individuals find it increasingly challenging to recognize family or close friends, sometimes mistaking them for strangers. Retaining new information also becomes more difficult, often leading to repetitive questioning.


Decrease in Language Abilities

Language abilities typically decline further at this stage. Finding the right words may become problematic, and people may lose their train of thought mid-sentence. It also becomes harder for them to follow conversations.


Changes to Space and Time


Orientation difficulties intensify as well. A person may become confused about the time of day, such as getting up and dressed in the middle of the night, or may struggle to recognize familiar places, even their own home.


Emotional Unbalance and Paranoia 


Symptoms of apathy, depression, and anxiety frequently persist into this stage. Many individuals also develop strong, often unfounded beliefs, such as feeling that others intend to harm them or cannot be trusted. Delusions of theft or infidelity are also common.


Visual and Auditory Hallucinations 


Some may begin to experience hallucinations, seeing or hearing things that aren’t present. Hallucinations are more typical in the middle stage of Alzheimer’s than vascular dementia, while visual hallucinations can appear earlier in dementia with Lewy bodies.



"Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, 'I will try again tomorrow.'"
Mary Anne Radmacher


Compassionate Caregiving for Middle Stage Dementia


In-home caregivers play a vital role in supporting seniors with dementia, offering not just assistance but also companionship and understanding. As mentioned, dementia can be a challenging journey for not just the individual but their loved ones as well. Caregivers are trained to navigate these complexities with compassion and patience and help establish routines for all parties involved. 



Personalized Care 


One of the most significant ways in-home caregivers help is by providing personalized care tailored to each senior's unique needs. They create structured routines that can bring comfort and familiarity, helping to reduce anxiety associated with memory loss. Additionally, caregivers engage seniors in meaningful activities that stimulate cognitive function while also promoting emotional well-being.





Establishing Routines


  • Caregivers can help by helping to establish and maintain a daily schedule. Consistent routines provide structure, which reduces confusion and anxiety for the person with dementia. 


  • They can also help to simplify tasks by breaking them down into smaller steps, offering gentle guidance along the way, which can make everyday activities more manageable.


Supporting Memory and Orientation


  • Using visual cues like labeling doors, cupboards, and important areas (such as the bathroom) can make navigation easier and improve orientation.


  • Keeping a large, clear clock and calendar visible helps them stay oriented to time and date, which can minimize disorientation.


Facilitate Communication


  • Using simple language and short sentences can make communication clearer. Caregivers can help by avoiding complex explanations and speaking slowly.


  • Listening patiently and allowing time for the person to express themselves helps them feel understood, even if they struggle to find the right words.













Support System for All


In-home caregivers serve as a crucial support system for the individual as well as the families affected by dementia. They offer respite for family members who may feel overwhelmed by the demands of caregiving. By taking on daily tasks such as meal preparation, medication management, and personal care, they allow families to focus on spending quality time together without the stress of constant supervision.




Dementia is a debilitating disease that affects not only the individual but families and friends as well. It’s not an easy task and doesn't have to be taken on alone.


Here at Christian Companions Houston, we understand just how difficult and overwhelming caring for someone struggling with dementia can be. That’s why we offer compassionate and caring assistance meant to shoulder some of the heavier burdens so you can focus on spending quality time with your loved one. 


If you or a loved one could benefit from our wonderful services, please do not hesitate to reach out today!

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