stage: 4

The stage of dementia when 24-hour care becomes unavoidable — and what it looks like before you get there

Twenty-four-hour care typically becomes necessary from stage 5 or 6 of the seven-stage Global Deterioration Scale. At stage 5, the person needs significant help with daily tasks including choosing appropriate clothing, preparing meals, and managing finances. By stage 6, assistance is needed with all personal care including dressing, bathing, and using the toilet. Night-time supervision becomes essential as sleep disturbance, wandering, and disorientation are common. Stage 7 involves total dependence for all activities of daily living, including eating and mobility. The transition to 24-hour care often happens gradually rather than at a single defined moment.