FAST scale · stage 4 of 7
Stage 4 dementia: moderate
Complex tasks need help: money, planning a meal for guests, shopping.
What daily life looks like
Managing money, paying bills, cooking for guests or doing a full shop now need help. The person may know less about recent events and have trouble with dates, but still handles washing, dressing and the toilet on their own, and may be fine in familiar places.
What typically changes next
Next, choosing clothes that suit the day or the weather usually needs help.
Time typically reported at this stage: about 2 years (Reisberg 1988, Alzheimer's disease). An average across many people, never a prediction for one person.
What helps caregivers at this stage
- Take over the complex tasks quietly and leave the simple ones with them; being able to do things matters.
- Keep the daily shape of the day predictable, and keep social contact going.
- Start the life story and calm card now, while the person can tell you what matters to them.
When to talk to a clinician
A sudden change, over days rather than months, is not a stage change. Confusion that appears quickly, new agitation, a fall or a change in eating or continence can be an infection, pain, a medication effect or dehydration, and those are treated. Bring your log and the date you last filled in the checklist.
Frequently asked questions
What is stage 4 dementia?
On the seven-stage FAST scale, stage 4 (moderate) means: Complex tasks need help: money, planning a meal for guests, shopping.
How long does stage 4 dementia last?
Reisberg (1988) reports a typical duration of about 2 years at stage 4 in Alzheimer's disease. That is an average across many people, not a prediction for one person, and other dementias follow different paths.
What comes after stage 4?
Next, choosing clothes that suit the day or the weather usually needs help.
Keep it over time in Anchorly
Anchorly keeps the monthly stage check-in next to the daily log, the sundowning tracker and the life story, and puts the latest stage on the one-page care snapshot for the care team.
Free, no account, works offline. Your loved one's information stays on the phone.
More guides: Health & care · all Adelyons guides