Moderate dementia

Moderate dementia is the stage in which cognitive symptoms become apparentespecially for the caregiver, sometimes also for the patient.

At this stage of the disease the caregiver notices the appearance of memory and attention disorders of the patient as well as difficulties in temporal-spatial orientation or difficulties in performing certain daily activities (Caregivers state: “he doesn’t judge properly, he doesn’t do things properly, he does them halfway, he forgets where he puts certain objects and then he looks for them for hours and because of this he gets angry and becomes verbally aggressive. He doesn’t know what date we are, he barely knows the town he lives in and maybe the year we are, that’s all. He has days when he sits unkempt, goes to bed in the same clothes he wears all day.”

On the other hand, some patients tend to deny these issues, blaming the symptoms on a poorer mood or a single episode of memory and attention decline. However, there are also patients who are aware of these memory losses that are becoming more and more frequent and affect their daily life, telling the doctor “I forget, doctor, I forget more and more often. Sometimes I forget why I went into the room or forget where I put something 5 minutes ago. I’m not me anymore, I can’t concentrate on doing things right.”

At this stage of the disease the patient is no longer 100% independent, he needs supervision and support in carrying out certain daily activities.

Severe dementia

Severe dementia is the most advanced stage of the disease and caring for patients at home is becoming increasingly difficult.

Severe dementia is the most advanced stage of the disease and caring for patients at home is becoming increasingly difficult. Due to severe cognitive decline, patients no longer have the capacity for judgment and reasoning, they no longer understand what their caregivers or others around them communicate ( “Stop judging, doctor, he doesn’t understand anything I say, it’s like he’s in another world”), they are temporally and spatially disoriented, they do not recognize close people ( “He doesn’t know I’m his daughter anymore, he calls me a different name when he sees me.”) become psychomotorally agitated and even aggressive, perform dangerous activities for themselves and others (“He wanted to light a fire and set the blanket on fire, lucky I was in the next room”).

Although from the outside it looks like a fairly easy decision to make, as a parent it is a very difficult time. On the one hand, you want your mother or father to stay at home, in their own backyard where they have lived their whole lives, but on the other hand you are aware that the best option for proper care would be to be admitted to a specialised centre.

Some caregivers decide to be the day-to-day caregivers themselves, and this decision can be really challenging. It’s a good feeling to be able to care for those who gave you life and raised you, but at the same time it’s difficult to watch them progressively deteriorate without the ability to stop that decline.

Caregivers of patients with severe dementia may also experience different mental states, ranging from feelings of guilt such as “I could have done more for my parents, maybe if I’d gone to the doctor earlier it wouldn’t have ended up like this”, “I abandoned my parents at the asylum”to states of tension and exhaustion and “I can’t go on at this pace, with sleepless nights and so many problems arising daily” or feelings of resignation “We’re all going to end up like this, sooner or later…”.

At this stage of the disease the patient requires continuous monitoring and support.

The clinical picture of patients with severe dementia consists of: