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Knowing the stages and symptoms of Parkinsons’s disease in older adults may help you to make plans for your older family member’s future. Parkinson’s disease can be particularly difficult for family caregivers and older adults because it varies from one person to the next, making it unpredictable.

This can make it hard to plan for future care or know what to do for symptoms from one day to the next. Although everyone’s experience is different, experts have identified general stages of the disease.

Stages and Symptoms of Parkinson’s Disease in Older Adults

How many stages are there? To add to the confusion of how Parkinson’s disease progresses, how many stages there are depends on which expert you ask. For example, according to WebMD, there are three stages: mild, moderate, and advanced. The Parkinson’s Foundation uses a five-stage model. Your older family member’s doctor may use a different number of stages still.

For the purpose of this article, we will describe the five stages followed by the Parkinson’s Foundation. The five stages of Parkinson’s disease as defined by the Parkinson’s Foundation are:

Stage One -The Subtle Onset

The symptoms during this stage are quite mild. They may be noticeable, but they don’t usually interfere with the older adult’s ability to do their normal daily activities. Symptoms usually occur on just one side of the body. You may notice the senior’s posture or way they walk has changed. There could also be a difference in their facial expressions.

In the initial stage of Parkinson’s disease, symptoms are generally mild and might only affect one side of the body. This stage can be easily overlooked because the signs—like slight tremors or a little stiffness—are often attributed to normal aging or stress. Many people lead their everyday lives without realizing they’ve begun their journey with Parkinson’s (Temple Health).

Stage Two – The Unmistakable Changes

Symptoms are worse and impact both sides of the body. The senior may have tremors, rigid muscles, difficulty walking, and posture changes. Although the older adult can still live alone during this stage, it will take them longer to do daily activities.

Progressing to stage 2, symptoms become more noticeable and start to affect both sides of the body. Activities of daily living may become challenging as stiffness, tremors, and changes in facial expression become more pronounced. Despite these difficulties, individuals at this stage can still maintain their independence, although tasks might take longer to complete.

Stage Three – The Mid-Point

This is the mid-stage of the disease. It is usually identified by a loss of balance and slowed movements. Older adults may fall more often than in the past. Though the older adult might still be completely independent, they will have significant trouble with certain activities, including eating and dressing.

Often considered the mid-stage of Parkinson’s, this phase introduces balance issues and slows movement significantly. Falls become more common due to unsteadiness, especially when turning or if slightly pushed. While independence remains possible, the increased risk of falls and the slowing of movements mark a pivotal point in the disease’s progression.

Stage Four – The Need for Support

The symptoms of Parkinson’s disease are severe enough at this point that the older adult may need help to stand up and will need to use a walker for mobility. Your aging relative will be unable to live alone because they will need assistance with daily activities.

As Parkinson’s progresses to stage 4, the need for assistance becomes evident. Mobility issues may require the use of a walker, and living independently becomes hazardous without help.

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This stage can be particularly challenging, as it requires adjustments not only for the person with Parkinson’s but also for their family and caregivers. It’s a time when support systems become crucial.

Stage Five – The Advanced Stage

At this stage, the older adult will rely on a wheelchair because they will be unable to stand or walk. They could even be bedridden. Some people have hallucinations and delusions during this stage. They will need round-the-clock care.

The most advanced stage of Parkinson’s disease is characterized by severe symptoms that require round-the-clock care. Mobility may be extremely limited or impossible without assistance. In addition to physical challenges, cognitive issues such as dementia may arise. Despite these hurdles, moments of connection and joy are still very much possible with compassionate care and support.

Knowing these stages can make it easier for family caregivers and older adults to decide when it is time to involve senior care. While some families choose to wait until stage three when the older adult needs more help, others involve senior care earlier.

Understanding the stages of Parkinson’s disease is not about predicting the future with precision; it’s about equipping ourselves with knowledge to navigate the journey with grace and strength. Each person’s experience with Parkinson’s is unique, and while the stages provide a framework, they do not dictate the richness or possibilities of a life lived with Parkinson’s.

Remember, you are not alone on this journey. Resources, support groups, and healthcare professionals are there to guide you and your loved ones through each stage, offering expertise and empathy every step of the way. Hiring a senior care provider through an agency during the earlier stages allows the older adult to spend more of their time doing the things they enjoy rather than struggling to do daily activities.

Are you curious too on How Much Does Home Care Services Cost? To answer you, well, that depends on your current situation. The great thing is we actually can give you a free quote according to your current situation. You can try filling out our form here or send us an email at: or drop us a call anytime at (267) 323-1700.



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Joshua Walker, MBA