Middle-stage symptoms of Alzheimer’s and how to spot them

The middle stages of Alzheimer's are typically the longest and can last for many years. As the condition progresses, the person with Alzheimer's will require a greater level of care. During this time, it's important to get the support you need as a caregiver.

During this period, damage to the brain can make it difficult to express thoughts and perform routine tasks. You may notice the person with Alzheimer's jumbling words, having trouble dressing, getting frustrated or angry, or acting in unexpected ways, such as refusing to bathe.

Here are some of the behaviours you are likely to see if you or a loved one are in this stage…

Being forgetful of events or personal history

A person with Alzheimer's disease may not remember familiar people, places or things. They may also become confused about the location of home or the passage of time. Situations involving memory loss and confusion are extremely difficult for caregivers and families, and require much patience and understanding.

Showing an increased tendency to walk about and become lost

Alzheimer’s disease causes people to lose their ability to recognize familiar places and faces. It’s common for a person living with Alzheimer's to walk about or become lost or confused about their location.

Six in 10 people living with Alzheimer's will go out for a walk but get lost and confused at least once; many do so repeatedly. Although common, walking about can be dangerous — even life-threatening — and the stress of this risk weighs heavily on caregivers and family.

Experiencing changes in sleep patterns

Individuals may feel very drowsy during the day and then be unable to sleep at night. They may become restless or agitated in the late afternoon or early evening, an experience often called “sundowning.”

Conversely, many people with Alzheimer’s wake up more often and stay awake longer during the night. Brain wave studies show decreases in both dreaming and non-dreaming sleep stages. Those who cannot sleep may walk about, be unable to lie still, or yell or call out, disrupting the sleep of their caregivers.

Feeling moody or withdrawn

As Alzheimer's progresses, it becomes more likely that a person will become withdrawn, but this doesn’t mean that this withdrawal is caused directly by the Alzheimer's. A person with dementia is much more likely to become withdrawn because they feel isolated or bored.

Many people with Alzheimer's spend much of their time alone or, even if they are with others, there may not be much conversation between them. A person with Alzheimer's may find it difficult to initiate a conversation or an activity themselves. When no one else does anything to engage their attention the person has no choice but to retreat into their own thoughts.

Requiring help with daily care needs

People with Alzheimer's need help with various activities for many reasons. They may not remember how to do them, they may have movement disorders and poor coordination, and they may have lost interest in doing things, or may not understand why something needs to be done. They may not be able to understand instructions when someone tries to help them. As Alzheimer's disease is a progressive disorder, they need more assistance as their condition worsens.

Having trouble controlling their bladder and bowels

A person with Alzheimer's is more likely to have accidents, incontinence or difficulties using the toilet than a person of the same age who doesn't have Alzheimer's. This can be distressing for the person living with Alzheimer's and those who care for them.

For some people, incontinence develops because messages between the brain and the bladder or bowel don't work properly.

While these changes are difficult for everyone involved, resources are available to help both you and the person with dementia as the disease progresses. There will be challenging days, but there also will be good days.