Caring for Someone with Middle-stage Alzheimer’s Disease

As Alzheimer’s disease progresses, you may notice your loved one’s words become mixed up or that they show changes in mood and behavior. They might wander, refuse to bathe, have trouble dressing or act out of character. 

It’s important to remember that the progression of Alzheimer’s disease is not always predictable. There will be difficult days and better days, moments of confusion and moments of joy. At Banner Health, we’re here to provide compassion, education and support throughout your caregiving journey. 

The experts at Banner Alzheimer’s Institute and Banner Sun Health Research Institute, our memory care centers of excellence, can help you understand what to expect during the middle stage of Alzheimer’s and guide you as your caregiving role evolves. 

Understanding the middle stage of Alzheimer’s disease 

The middle stage of Alzheimer’s disease is often the longest and can last for several years. During this time, your loved one may still recognize family and friends but may require more help with daily activities. 

You may notice: 

• Confusion about time or place 
• Increased forgetfulness 
• Difficulty with words and communication 
• Personality or behavior changes 
• Trouble with dressing, bathing or toileting 
• Restlessness, pacing or wandering 
• Disrupted sleep patterns 

As symptoms progress, daily structure and patience become increasingly important. Even though your loved one may need more support, they can still enjoy meaningful moments and activities with your help. 

Your role as a caregiver 

Caregiving during the middle stage requires balance - offering help while encouraging as much independence as possible. Some days, your loved one may seem capable of doing more on their own, while other days may require full assistance. 

Below are strategies to help you care for your loved one safely and compassionately. 

Communication tips 

• Speak slowly and clearly. Use short, simple sentences and maintain eye contact. 
• Focus on emotion, not just words. When your loved one repeats questions, respond to the emotion behind them. They may need reassurance more than information. 
• Avoid arguing or correcting. Redirect the conversation gently and focus on comfort. 
• Monitor for sudden changes. A rapid decline in thinking or communication may indicate delirium caused by infection, dehydration or medication. Contact their provider right away. 

Daily care and routines 

• Encourage independence. Let your loved one do as much as they can on their own. For example, lay out clothing in order and let them dress with guidance. 
• Offer simple choices. Too many options can be overwhelming. Ask, “Would you like to wear your blue shirt or your green shirt?” 
• Be patient with personal care. Loss of privacy can be upsetting. Maintain dignity and use calm reassurance when helping with bathing or toileting. 
• Create a structured routine. Consistent daily schedules help reduce anxiety and confusion. 

Activities that bring comfort and connection 

Physical and social activities can improve mood, reduce restlessness and help maintain abilities. Try to involve your loved one in familiar, low-stress tasks such as: 

• Preparing a simple meal together 
• Listening to favorite music or singing 
• Folding laundry or watering plants 
• Gardening or light household chores 
• Taking a short walk together 

Small successes and shared moments can make a big difference in quality of life for both of you. 

Safety and living environment 

As Alzheimer’s progresses, being left alone may no longer be safe. You may need to adjust your loved one’s living environment or explore care options. 

Consider: 

• Installing locks or alarms to prevent wandering 
• Placing handrails in bathrooms and along hallways 
• Removing tripping hazards and securing loose rugs 
• Moving your loved one in with family or to a memory care community when safety becomes a concern 

Driving and transportation 

Eventually, your loved one may no longer be able to drive safely. 

• Discuss your concerns early, using specific examples. 
• Emphasize your priority is safety, not control. 
• Reassure them that you’ll help arrange transportation when needed. 

Your Banner care team can also provide guidance on driving evaluations and alternative transportation options. 

Support and resources for caregivers 

Caring for someone with Alzheimer’s can be rewarding and exhausting. You are not alone. 

Banner Alzheimer’s Institute and Banner Sun Health Research Institute offer resources to support you, including: 

• Caregiver support groups 
• Educational workshops and events 
• CARE T.I.P.S. (Caregiver Tools, Information, Practical Support) 
• Financial and legal planning guidance 
• 24-hour support lines for urgent questions 

You can also explore our guides to: 

• Caring for a loved one in early-stage Alzheimer’s  
• Caring for a loved one in late-stage Alzheimer’s  

When to reach out for help 

If your loved one becomes increasingly aggressive, confused or unsafe to leave alone, contact their health care provider. Banner’s compassionate memory care experts can help you navigate care transitions and ensure both you and your loved one have the support you need. 

At Banner Health, we’re here with hope, help and healing - every step of the way.