12 Warning Signs That Dementia Is Progressing, and What to Do Next

Recognizing the Shift and Responding With Confidence and Compassion

In this blog we will discuss, dementia getting worse, dementia progression, late stage Alzheimer’s signs

“I can’t tell if this is just a bad day—or if something is really changing.”

Caring for someone with dementia often means living in the grey. One day they’re cheerful and talkative. The next, they seem distant, confused, or withdrawn.

You start asking yourself:

• Is this normal?

• Are we moving into a new stage?

• Do we need to change how we’re doing things?

  
  

In this blog, we’ll walk you through 12 clear signs that dementia is getting worse—and what you can do next to stay one step ahead.

Signs Dementia is Progressing

🧠 1. Increased Confusion With Familiar People or Places

They may begin forgetting the names of close family, misplacing where they are, or mistaking current events for the past.

💬 “Why are we at your house? I live here, don’t I?”

This suggests short-term memory and orientation are declining, especially in mid-to-late stages.

📅 2. Loss of Sense of Time and Sequence

Struggling with time of day, season, or even year is common—but if they can’t follow a simple daily routine or repeatedly mix up past and present, it may indicate deeper cognitive disconnection.

🧍‍♂️ 3. Difficulty Walking or Increased Falls

Dementia progression can affect the part of the brain that controls balance and coordination.

If your loved one:

• Moves slower

• Shuffles or freezes when walking

• Has trouble getting up from chairs

• Experiences more falls

…it’s time to assess their physical safety and fall prevention plan.

🗣️ 4. Changes in Language or Word-Finding

If they:

• Stop mid-sentence

• Substitute the wrong words

• Struggle to express needs

• Speak less overall

…it may indicate language processing is declining.

This often happens subtly—but grows more obvious over time.

🍽️ 5. Not Eating, Drinking, or Swallowing Normally

Weight loss, choking, or refusing food and water can stem from reduced appetite, confusion, or physical difficulty swallowing.

Left unchecked, this can lead to dehydration, UTIs, and infections that worsen cognition further.

🧼 6. Neglecting Personal Hygiene

Your loved one might stop:

• Brushing teeth

• Bathing

• Changing clothes

• Using the toilet properly

This isn’t laziness—it’s a sign they may no longer understand why or how to complete these tasks.

💬 7. Frequent Repetition or Shadowing

As memory worsens, they may ask the same question every few minutes or follow you from room to room.

While repetitive behavior is common early on, increased intensity can signal mid-stage progression.

🚪 8. Wandering or Attempting to Leave

If your loved one tries to exit the house at night, “go home” (when they’re already home), or suddenly leaves familiar places, this signals serious disorientation and flight risk.

This behavior can emerge suddenly—and escalate quickly.

😟 9. Paranoia, Delusions, or Hallucinations

Accusing family members of stealing, seeing people who aren’t there, or becoming fearful without clear cause may indicate more advanced cognitive changes.

This stage often requires behavioral care support and medication reassessment.

😶 10. Emotional Flatness or Sudden Mood Swings

You might notice:

• A blank expression

• Less interest in once-loved activities

• Angry outbursts without cause

• Tearfulness or agitation

As dementia progresses, emotional regulation becomes harder, and they may lose the ability to interpret or express feelings clearly.

🛏️ 11. Sleep Changes and Sundowning

• Restlessness in the evening

• Night waking or confusion

• Sleeping all day or flipped sleep cycles

These signs point to circadian disruption, common in moderate-to-late dementia.

🧍‍♀️ 12. Increased Dependence for Daily Living Tasks

When your loved one needs help with:

• Toileting

• Feeding

• Walking

• Getting dressed

• Taking medication

…it’s a strong indicator they’ve reached a new care threshold.

This is often when families begin considering facility care or structured home support.

What to Do When You See These Signs

✅ 1. Start Tracking Behaviors and Patterns

Use a daily log to note:

• Changes in behavior

• Sleep patterns

• Food and fluid intake

• Accidents or falls

• New medical symptoms

This helps doctors, nurses, and care teams make smarter, faster decisions.

✅ 2. Schedule a Medical Reassessment

Behavioral changes can be caused by:

• Infections (like UTIs)

• Medication side effects

• Pain they can’t explain

• Emotional distress

A dementia-savvy provider can assess whether these symptoms are part of progression—or something treatable.

✅ 3. Adjust the Care Plan

This might mean:

• More caregiver hours

• Nurse visits for medication and symptom tracking

• Adding calming routines or activities

• Considering if at-home care is still safe and sustainable

💡 Not sure what’s next? A Nestcare nurse can help you build a step-by-step plan without jumping to drastic decisions.

✅ 4. Use Calming Tools Like Nest Care Cards

Progression can bring new stress—for both of you.

Nest Care Cards are designed to:

• Help redirect agitation

• Create structure

• Bring emotional connection back into tough moments

And they require no prep, no pressure, just presence.

Recognizing that dementia is getting worse is hard—emotionally, mentally, and practically.

But you don’t have to face it with fear.You can meet it with clarity, compassion, and support.

We’re here to walk with you, every step of the way.