There are 3 stages to Alzheimer’s: early-, mid- and late-stage dementia. Below is a summary of what you can expect and what to consider. For more details, steps to take, and tips on your caregiver journey, download this helpful guide by the Dementia Action Collaborative.

Mild or early-stage dementia
With early-stage dementia, your loved one has difficulty accomplishing some activities. Signs can include: However, they may remember stories from long ago or to do familiar things.

During the early stage, you should be an advocate for the correct diagnosis. Learn all you can about the disease and actions you can take, including: Moderate or mid-stage dementia
In this middle stage, confusion becomes more evident. They may: However, they may become increasingly present and “in the moment”.
At the mid-stage, you should develop your network of support, establish routines, and take safety precautions. To start:
Severe or late-stage dementia
In this stage, your loved one is entirely dependent on personal care. They may: At the same time, they may still be attuned to the emotions of others and enjoy companionship.
At the late stage, you should:

Patients with dementia are at greater risk of motor vehicle accidents. If your loved one is diagnosed with dementia, consistent with state law, they should not drive a motor vehicle.

New troubles with driving can be a sign of dementia that requires evaluation. Signs of difficulty may include:

For people in the early stages of dementia, you should start planning and have conversations about how they will get around once they can no longer drive. Preparing them will ease the transition.

Important tip: As things become critical, approach the conversation from an emotional standpoint — not a logical one. Dementia mainly impacts the top portion of the brain that involves logic and reasoning. The emotional brain is still normal so emotional appeals are more likely to be effective. Sit down next to them (not facing them), touch them (hand on knee or back), and start a conversation with something like, “I am worried about you and would like it if you would stop driving. Will you do this for me?”
Explore more tips from the Alzheimer's Association, including how to start the conversation, what to do if doesn’t go well, how to find available transportation options and key warning signs. A variety of public transportation options may be available to patients with dementia, and a social worker can help your family consider your options.

This question requires careful evaluation. Someone in the early stages may be ok to be left alone and you can take steps to create a safe home for them. Read these helpful tips on home safety from the National Institute on Aging.

Their ability to recognize a dangerous situation, like fire, is what’s important to consider. Do they know how to use a phone in an emergency? Are they able to get help? You may want to seek professional guidance if they:

There are steps you can take to minimize the possibility of this happening:

Most people with dementia live in their own homes but need extra help with things like managing finances, cleaning, and errands. Although some people with dementia end up in nursing homes, most do not.

There are some medications available that may help. They don’t work for everyone and not everyone is a candidate. It’s important to understand that while medications may delay memory decline, they’re not a cure. They cannot stop the disease from worsening over time.

There are new medications coming available for Alzheimer’s and mild cognitive impairment. You can ask your doctor whether your loved one may or may not be a good candidate for one of these newer medications.

For in-home Respite care, a professional comes to the house for a few hours or full-time over a brief period. This is typically one person.

Respite care facilities can care for adults during the day or overnight and handle short- and long-term stays. This is a good option if your loved one requires multiple people for care. These facilities can also be a good trial for those considering a move to a higher level of care.

You may also want to consider Palliative care to treat symptoms of Alzheimer’s Disease, such as depression, anxiety, and difficulty sleeping. The care team can teach your family what might trigger behavioral symptoms and how to avoid them.

Explore more resources in Washington State from Community Living Connections.

Contact the Alzheimer’s Association to learn how to manage them or call 1-800-272-3900.

You should also take time to identify what may be triggering challenging behaviors, including: Important tip: Don’t rely solely on logic when communicating with a loved one. An emotion-based approach is more likely to get results. They can sense your emotions and may emulate what you feel. “You’d better put a coat on because it’s cold” may not be as effective as something like, “I’m worried we might get sick. Will you put a coat on for me?”

It depends on what type of insurance your loved one has. You should check their policy. While private insurance and government resources may help cover some expenses, it’s common for individuals and families to have to pay out of pocket for some services. This can include respite, home health, and nursing home care.

You should find out if your loved one has a long-term insurance plan. Carefully review the policy to determine if Alzheimer's is covered, what’s covered, and for how long. The plan may cover skilled nursing homes, assisted living, and licensed home care. Your medical social worker can help advise you based on your insurance coverage. You can also visit the Alzheimer’s Association to learn more.

There are multiple things to consider, including the steps that follow. When a loved one is diagnosed with mild cognitive impairment or dementia, preparing and signing legal forms as soon as possible is important. Dementia will affect the ability to sign legal documents in the future.

Legal planning

You’ll need to address financial and healthcare decisions. Here are some important forms you’ll want to have completed as soon as possible: You can hire a lawyer or attend a free legal clinic by End of Life Washington to prepare these documents for you or do them yourself. You should also download this Dementia Legal Planning Toolkit from the Dementia Action Collaborative. The above planning documents should be completed as soon as possible, updated regularly, and shared with loved ones, doctors, and hospitals.

Durable Power of Attorney

At a minimum, you should complete a Durable Power of Attorney for Healthcare and a Healthcare Directive. This provides a clear opportunity to support the care directions, even when the patient cannot.

Advanced care planning

Making healthcare decisions for yourself or a loved one is complicated. That’s why it’s important to have clear arrangements and preferences. You can change them as needed, but getting plans in place and creating structure now will help you down the road. Here’s a checklist of key actions and considerations^*: ^*Adapted from The National Institute on Aging

Protecting end-of-life choices

This is a challenging topic for everyone, but learning what legal options are available in Washington State will allow for end-of-life planning on the individual’s terms. Here are some important tips: