The 3 Stages of Alzheimer's: What To Expect and What To Do

If you or someone you love has been recently diagnosed with Alzheimer’s disease, it’s normal to feel overwhelmed. You may be dealing with a mix of emotions: shock, fear, sadness, or uncertainty about the future. Understanding what to expect and planning can bring a sense of control and peace of mind.

Alzheimer’s typically progresses through three stages:

1. Early (mild)
2. Middle (moderate)
3. Late (severe)

Here’s what you can expect in each stage and how to prepare.

1. Early Stage (Mild) Alzheimer’s

In the early stage, a person may:

• Struggle with memory
• Repeat themselves often
• Get lost in familiar places
• Misplace items or put them in strange places
• Have difficulty managing money or paying bills
• Forget to take medication
• Take longer to complete everyday tasks

At this point, most people can still live independently and participate in social activities, but they might start needing help with more complex tasks like driving, work responsibilities, or managing medications.

Symptoms are often most noticeable to close family and friends. Getting a diagnosis early opens the door for better long-term planning and care. Some research shows that lifestyle changes like regular exercise, a Mediterranean-style diet, and staying socially and mentally active may help maintain quality of life for longer.

There are also FDA-approved medications that may temporarily help with memory and thinking, though they don’t stop the disease’s progression. 

Research into disease-modifying treatments is ongoing, and joining a clinical trial could be worth exploring.

This is also the ideal time to start planning legal, financial, and healthcare decisions. Having these conversations early can help loved ones feel more confident and supported down the road.

2. Middle Stage (Moderate) Alzheimer’s

In this stage, you might notice:

• More severe memory loss and confusion
• Trouble recognizing friends or family
• Difficulty learning new things or handling new situations
• Trouble completing tasks with multiple steps
• Mood or behavioral changes
• Forgetting common words or objects
• Wandering

Symptoms are now more noticeable and impactful. A person may still recall important aspects of their life, but will likely need help with daily activities. They may no longer be safe to drive or handle finances independently.

Caregivers should start learning more about how to manage behavior changes and seek support for themselves, too. Caregiver burnout is real, and finding a support system can make all the difference.

3. Late Stage (Severe) Alzheimer’s

In the final stage of the disease, people may:

• Stop communicating
• Sleep more frequently
• Lose weight
• Struggle with swallowing
• Have incontinence

This is the most advanced – and often the shortest – stage of Alzheimer’s. At this point, 24/7 care is typically needed. The plans made earlier in the disease can now help guide care, easing some of the pressure on family and caregivers.

Even if verbal communication is no longer possible, connection is still important. Simple things like holding a hand, listening to music, or flipping through old photos can bring comfort and show love.

Just as in the middle stage, caregiver support is essential. Seeking help is not only okay- it’s necessary for everyone’s well-being.

[Related: Alzheimer’s Association – Late-Stage Caregiving]