Trends in aging: The Emerald Stage of Alzheimer's, dementia

By Wendy McHaney
Jan. 10, 2014 at midnight
Updated Jan. 9, 2014 at 7:10 p.m.

To recap, my columns so far on the stages of dementia, the first two columns discussed normal aging and the early stage of dementia, identifying these stages respectively as sapphire and diamond.

This column highlights early to mid-stage dementia, which we call the emerald stage. We are now entering more complex stages of dementia, and it is necessary to discuss each of these stages in two columns.

An emerald was chosen to represent this stage because of the color green. In a stoplight sequence, green means "go," and emerald's are on the move, as they are moving in time and tend to get lost in a past life, places and roles.

The following are some basic characteristics of an emerald:

Things are not as clear or sharp, becoming vague

Time traveling - getting lost in a past life, places and roles

Think they are fine

Get emotional quickly

Make mistakes and don't realize it

Do something over and over

Ask "What? Where? When?"

Like having choices

Need help but don't know it or like it

Conversation with an emerald can be difficult. Emeralds can be vague in their conversation and have trouble sustaining a conversation for a long period of time without repeating themselves. The following are best practices for communication with an emerald:

Use a friendly, warm and adult tone. Never speak to them like they are a child.

If they ask a question or tell a story multiple times, always treat it as though it is the first time you heard it. To them, it is the first time and you do not want to make them feel foolish or incompetent.

When you want them to accomplish a task, such as taking a shower or washing hands for dinner, do not assume a bossy tone. Instead ask them to "try" the task, such as asking if they would like to try to wash up for supper.

Redirection is a good tool for handling an emerald who is repeating themselves or is lost in time. Often, emeralds will ask to "go home" because they are remembering a former home and believe their current residence is not where they live.

Oftentimes, dementia caregivers will mistakenly use distraction in this scenario, such as suggesting playing a game, but this will only cause an emerald to become agitated as their feelings are not being validated. Instead, start asking questions about or discussing home, such as: Where is home? Didn't you have a vegetable garden? My next column focuses on how environment can impact an emerald and will focus on three key topics: sundowning, watching television and making the bathroom a comfortable place.

If you would like more information about caring for a loved one with Alzheimer's or dementia, Senior Helpers presents a free workshop and support group at Copperfield Village, 501 E. Larkspur, every Thursday morning from 10:15 to 11:15 a.m. beginning in February.

Sources: SH Franchising Senior Gems training materials

Wendy McHaney is a certified senior adviser and the owner and director of operations of Senior Helpers. For more information about Senior Helpers, visit



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