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What happens in mid stage dementia?

If the person you’re caring for has been living with dementia for some time, you may find that their condition has progressed. Find out what can happen in the middle or moderate stage of dementia

Could this be you?

You and your loved one had been coping quite well with the early stages of dementia, but recently you’ve noticed:
• They’ve started to mix up day and night.
• When you go out they keep walking off and getting lost.
• They’re not looking after themselves as well as they used to.

If this rings true, it might be that you need to reconsider your daily care plan and make some changes to keep the person with dementia safe and happy during the middle stage of dementia.

Don’t panic

Mid stage dementia is often the longest stage. For people with Alzheimer’s it can last many years so you both have time to adapt and still enjoy life as much as possible.

What’s happening?

Damage to their brain means that the person you’re caring for may now find it increasingly difficult to express themselves verbally or do routine tasks such as dressing or bathing. If they’re still driving, they will need to stop and this, combined with the need for more support with daily life, often results in them losing some of their independence.

Four more signs of mid stage dementia

1. Sleep difficulties
As the illness progresses many people are unable to get a full night’s sleep. But there are ways to help them (and you) sleep and rest more.

2. Distressed response (sometimes referred to as challenging or aggressive behaviour)
This can be very upsetting – particularly if it’s completely out of character. But angry outbursts can often be the result of frustration, and an inability to express their needs. Find out how to help.

3. Hallucinations or paranoia
If your loved one becomes convinced that someone is stealing from them, or spying on them, try not to dismiss it completely. Instead, try to work out what might be leading them to say such things. There’s often quite a logical reason!

4. Incontinence
Having ‘accidents’ because they can’t get to the loo in time can be extremely distressing for someone with mid-stage dementia. However, there are ways you can help them to cope and preserve their dignity.


Everyone’s journey through dementia is unique, and these signs and symptoms of ‘mid stage’ dementia are only meant as a guide. Try not to take them too literally.

Good to know

Although it’s undoubtedly upsetting to see a loved one becoming more confused and perhaps lose some of their independence, it’s also important to note that many people with mid-stage dementia still lead productive and purposeful lives. There are lots of stimulating, meaningful activities they can still enjoy – and some new ones they might want to take up, such as art or music. You could find that life feels better for both of you if you try to focus on what they can still do – rather than what they can’t.