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Emerald Gem State: Early to Mid-Stage Dementia

As the journey of dementia progresses, we move from the Diamond to an Emerald stage, which means the changes your loved one living with Dementia is experiencing are now much more visible to others. They may misplace important things and accuse others of taking them, they can lose their ability to comprehend situations and they may not be able to recognize their flaws or loss of abilities.

The easiest way to determine if your loved one is in the Emerald stage is if they travel in time. This is often called a "time hop," where Emeralds lose their personal timeline of places and roles, which means they can think they are in a different time and place in their life, especially later in the day or if there are stresses.

For example, an Emerald can become agitated at 3 pm, wanting to meet the school bus down the road to pick up their children after school. In reality these children are now in their 40's and 50's and now in the position of caring for their mother who is living with dementia. Similarly, a wife who has been married to her husband for 50 years cannot recognize him at certain times of the day, because the husband she is looking for is the man in their wedding picture instead of the 70-year-old man who is in her house. They may even insist that they need to go home even though they have lived in the same house for 30 years with their husband or wife. The home they are looking for is the home they grew up in.

Emeralds will be making mistakes in their personal care, not bathing, not changing clothes, and sometimes not wearing enough clothes. They most definitely feel like they do not need any help and will resent being treated like a child if you try to help them. Their emotions get out of control rapidly, either angry or sad, but often in the early evening when they are getting tired. Emeralds also have the ability to fill in the blank spots with false memories or lies, that actually register as being the truth to them.

If the characteristics listed above remind you of someone, your loved one may be in the Emerald stage of dementia. Here are tips to help:

  1. When they are lost in time, accept that moment, stay calm, and go with the flow. Get connected and listen and try to identify where they are time wise and how you can meet them in order to share stories and memories.

  2. If they don't remember your name, let it go, relax, be a friend and not a family member. Tell them you are someone who loves them.

  3. If they are asking to go home and they are home, don't use reality orientation or argue. Validate their need to go home and be emotionally supportive. For example "you need to go home" or "tell me about your mother growing up and the farm"

  4. If words are a problem, use more examples of their "home" they are thinking of.

  5. When you want them to do something use visual cues first. Show them and then do it alongside them. Be a Care Partner and not a Care Giver.

  6. You must establish a relationship with an Emerald before immersing yourself. Use the mindset "Greet before you Treat" when helping someone living with dementia.

  7. Think before you speak, limit how many words you use, slow your speech down for them and wait for responses instead of overwhelming them.

  8. Give your Emerald a chance to help you with language and storytelling to help develop speech skills with prompts such as "tell me more about..." and "could you help me with?"

  9. Build a daily routine and schedule, this provides structure and rhythm for the day, but if something is not working be flexible and willing to let it go.

  10. Many Emeralds have a wonderful sense of humor, try and tap into the humor that your Emerald can relate to and enjoy. Life is better if we can laugh and smile.

  11. An Emerald needs to feel needed and wanted. So let them feel that they still matter and that they make a difference in the world. Share tasks and chores to help them feel productive and constructive.

For more information about Emeralds or how to care for your loved one living with dementia, please visit or on Facebook at

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