Moderate Alzheimer’s, which refers to the middle stages of the disease, often results in people needing help with many daily tasks.

In this stage, thinking and memory continue to deteriorate, but many people will still be somewhat aware of their condition. Common symptoms include problems with cognitive abilities, changes in mood and emotions, behaviours, and physical abilities. Details of these symptoms and some helpful strategies include:


Memory problems are more obvious; less ability to concentrate; confusion – difficulty organizing thoughts or following logic; disorientation to time and place; problems understanding and expressing spoken and written language; difficulty making choices.


  • Use reminders and cues 
  • Offer information when they are struggling 
  • Get their attention, keep eye contact while talking and limit distractions
  • Speak slowly and clearly 
  • Use simple language and repeat if necessary 
  • Stick to concrete rather than abstract ideas 
  • Use physical gestures to reinforce your messages
  • Remember they are not intentionally being difficult 
  • Limit number of choices to one or two
An elderly woman sitting at a kitchen table
A nurse speaks with an elderly couple over coffee at a kitchen table


Mood shifts may include anxiety, suspicion, sadness, depression, frustration, anger, hostility, apathy and agitation; pervading sense of loss or insecurity.


  • Try to identify, acknowledge, and deal with underlying emotions being expressed 
  • Use strategies, keep going with activities which support their independence, and focus on what they can still do 
  • Try remembering the past as a helpful strategy 
  • Reassure and comfort them 
  • Encourage a healthy lifestyle, including physical activity, healthy eating, and familiar and meaningful activities 
  • Avoid disagreeing, arguing or trying to convince them what they believe is untrue or inaccurate


Apprehension, withdrawal or passivity; restlessness; repetitive questioning or actions; delusions; hallucinations; uninhibited behaviour.


  • Remember all behaviour is a form of communication, so try to figure out what they are trying to express 
  • Watch for behaviour changes which may be from physical illness
  • Consider whether the behaviour is mostly annoying or whether it is dangerous or causes anxiety 
  • Identify and avoid situations which trigger uncomfortable reactions
  • Offer choices 
  • Try gentle persuasion 
  • Remain calm, reassure and distract 
  • Learn strategies to prevent wandering 
  • Speak to a doctor about medications that may be able to help
A man with a walking stick walks along the ocean
A young woman helps an older woman pick tomatoes from a bush


Help needed for activities of daily living; changes in sleep/wake patterns; changes in appetite; spatial problems that can affect movement and coordination.


  • Know their preferred tastes and routines 
  • Keep things simple 
  • Adjust scheduled activities to best suit them 
  • Adapt activities to accommodate lost abilities and make the most of remaining ones 
  • Seek home care support 
  • Identify and adapt any potential dangers in the home 
  • Speak with an occupational therapist for advice on routines, activities, and adapting the home to make it as safe and accommodating as possible

Despite your best efforts, caring for someone with Alzheimer’s will likely become more difficult over time as it progresses. Planning for the future is important and your community care supports, including physicians, public health nurses, social workers, and the team at CareGivers are here to help.


*Adapted from Alzheimer Society Canada


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