Stage 4 dementia is a moderate stage where memory loss and daily challenges become more noticeable. With the right support, a calm routine, and compassionate care, the person can still enjoy comfort, dignity, and meaningful moments every day.

At Stage 4, you may notice:

• Forgetting recent conversations
• Difficulty managing daily tasks (cooking, planning, finances)
• Needing gentle guidance or reminders
• Increased confusion in new places
• Emotional sensitivity or frustration
• Slower thinking or trouble making decisions
• Mild problems with sleep or late-day agitation

The person may still recognise loved ones and respond well to familiar music, routines, and reassurance.

Routine brings security.

• Same time for waking, eating, bathing, and sleeping
• Short, manageable activities
• Avoid sudden changes in schedule

Predictability helps reduce anxiety and confusion.

Use:

• Short, gentle sentences
• Slow, calm speaking
• Visual cues (point, show, gesture)
• Soothing tone of voice
• Reassuring phrases: “You’re safe”, “I’m right here”

Avoid correcting or arguing. Support, don’t challenge.

The person may need help with:

• Dressing
• Bathing
• Preparing meals
• Medication management
• Organising their day

Let them do what they can, and step in when they need help.

Stage 4 requires a safer, calmer environment:

• Remove clutter and trip hazards
• Use night lights
• Install grab bars if needed
• Keep kitchen use supervised
• Label rooms, drawers, and important items
• Store medication safely

A safe home reduces accidents and stress.

Emotions at Stage 4 can be fragile. Support them by:

• Offering gentle reassurance
• Allowing quiet breaks
• Avoiding overstimulation (noise, crowds, busy TV)
• Using calming lighting
• Offering comfort with soft touch or a warm drink

Your calmness becomes their calmness.

Tools that still help at Stage 4:

• Large digital day clock
• Visual cue cards
• Simple lists or reminders
• Colour-coded storage
• Familiar music playlists
• Photo memory wall

These support orientation and reduce repeated questions.

One of the strongest tools for Stage 4.

Helps with:

• Mood
• Anxiety
• Sundowning
• Attention
• Sleep
• Emotional connection

Use:

• Morning gentle music
• Midday familiar favourites
• Afternoon anti-sundowning playlist
• Evening soothing music
• Night-time sleep playlist

(If you want, I’ll make the one-click Stage 4 playlist.)

Choose simple, calming, enjoyable activities:

• Folding towels
• Sorting objects by colour
• Looking at photo albums
• Listening to familiar music
• Watching nature videos
• Painting or colouring
• Short walks or light stretching

Avoid tasks with too many steps.

Help by:

• Offering small meals throughout the day
• Using easy-grip utensils
• Encouraging fluids every 1–2 hours
• Minimising distractions during meals
• Sitting together to create a calm mealtime

Nutrition helps maintain energy and mood.

Improve sleep by:

• Reducing bright light in the evening
• Soft anti-sundowning music
• Warm, calm bedtime routine
• Comfortable room temperature
• Limiting caffeine and long naps

A gentle evening rhythm reduces night-time confusion.

Caring for someone in Stage 4 can be emotional and tiring.
Remember:

• You’re not alone
• Take breaks when you can
• Ask for help
• Look after your own wellbeing
• Celebrate small moments of connection

Your love, patience, and presence make the biggest difference.