Mid Stage Dementia: What to Expect

Written by Active Minds on Wednesday the 20th of June 2018.


As dementia progresses, you may start to notice changes in your loved one’s behaviour. This may mean that their condition has started to advance, and they are now in mid-stage dementia. This is often the longest lasting stage, continuing for many years. Whilst it is important to note that many people at this stage of their dementia journey can still enjoy a productive life, you may need to start making slight adjustments to their care to help with changes in their behaviour.

The symptoms of mid-stage dementia vary from person to person, but can be the following:


Whilst one of the common symptoms in the early stages of dementia is poor short-term memory, by the middle stages, long term memory will start to become affected. Similarly, their ability to make decisions can also decline.


Sleep Difficulties

Sleep difficulties may start to affect people with mid-stage dementia. They may struggle to fall asleep, or perhaps their sleeping patterns will start to change. For example, they may continually fall asleep throughout the day but then wake up frequently through the night.


Changes in Behaviours

By the mid stages of dementia, you may start to notice that your loved one is showing marked changes in their behaviour on occasion. This could be increased anger, often caused by frustration at the inability to do things that they used to be able to do, or powerlessness to express their needs coherently. You may notice that they withdraw more, and want to socialise with others less, preferring to retreat into themselves. Similarly, they may start to lose their inhibitions, displaying inappropriate social behaviour.

You may also start to notice that these changes in behaviour occur around the same time of the day, from 4pm onwards. This is sundowning and is often experienced by people with dementia. Symptoms include restlessness, anger and wandering.


Loss of Independence

Your previously independent loved one can start to show signs that they need extra help. They may begin to have difficulty dressing or bathing themselves. Similarly, driving may become too overwhelming for them and so they will need help when they travel.



Some people in the middle stages of dementia can start to experience hallucinations and paranoia. They may believe that they see things in the shadows of a dimly lit room, or start to become convinced that you, or other loved ones, are stealing from them. It’s important that you remember that this is not a personal attack on you, their reaction is out of their control and a symptom of the disease. If appropriate, don’t dismiss their paranoia, try to reassure your loved one that they are ok and that you are there to look after them.

The beginnings of mid-stage dementia can be hard for you and your loved one to cope with. However, it is important that you support your loved one through this transition, and try to spend as much quality time with them as possible, engaging them in meaningful activities and fun pastimes such as Alzheimer’s jigsaws.