Understand the three stages of Alzheimer’s disease and how caregivers can help patients in each of these different stages
Alzheimer’s or Dementia?
Alzheimer’s and dementia are often confused and used interchangeably, but they are different.
Dementia is an umbrella term that refers to a list of different symptoms, one of those being brain and memory function. There are diseases other than Alzheimer’s which can cause dementia. When an individual is diagnosed with dementia, they are being diagnosed with a set of symptoms, without knowing what is specifically causing them. Some forms of dementia are temporary or reversible.
Alzheimer’s disease is a form of dementia that specifically affects parts of the brain that control thought, memory and language. Symptoms of the disease include
impaired thought, speech and confusion. Alzheimer’s is not reversible or curable.
10 signs of Alzheimer’s (www.alz.org) Here are 10 warning signs and symptoms of a person having Alzheimer’s disease. 1. Memory loss that disrupts daily life This is the most common sign. Forgetting information that was recently learned, forgetting important dates or events, asking the same information over and over and relying heavily on memory aids or other people for reminders are all signs of Alzheimer’s. 2. Challenges in planning or solving problems Individuals with Alzheimer’s may have difficulty following a plan or working with numbers. They may be unable to follow a familiar recipe, keep track of monthly bills, or have difficulty concentrating and carrying out simple tasks that didn’t present a problem before. 3. Difficulty completing familiar tasks People with Alzheimer’s may find it hard to complete tasks such as driving to a familiar location, managing a budget, or remembering the rules to a favorite game. 4. Confusing time or place Losing track of dates, seasons and time is a common sign of Alzheimer’s. People with the disease may forget where they are or not know which day of the week it is. They could also have trouble understanding something if it is not happening immediately. 5. Difficulty understanding visual images and spatial relationships Experiencing vision problems can be a sign of Alzheimer’s. Some people may have trouble reading, judging distance and determining colors. 6. Trouble with finding the right words People with Alzheimer’s may have trouble finding the right words. They may call items or people by the wrong name. They might stop in the middle of a sentence and not know how to continue. 7. Misplacing things and losing the ability to retrace their steps Individuals with Alzheimer’s may lose items and be unable to retrace their steps to find them. They might put things in odd places. They may even accuse others of stealing. 8. Decreased or poor judgement Alzheimer’s can affect the decision-making process. Therefore, people with the disease may use poor judgement such as giving money away to telemarketers or solicitors. 9. Withdrawal from activities A person with Alzheimer’s might start to avoid being social and may even withdraw from hobbies, social activities, or work projects. They may have trouble remembering how to complete a favorite hobby or keep up with a favorite sports team. 10. Changes in mood or personality Someone with the disease can become confused, anxious, fearful or depressed. They can get easily upset. The 3 stages of Alzheimer’s (www.alz.org)
STAGE 1 | MILD ALZHEIMER’S (EARLY STAGE)
In the early stages of Alzheimer’s, friends and family may start to notice their loved one experiencing difficulty remembering things such as familiar words or the location of everyday objects. Common symptoms include:
Difficulty finding the right word for something
Forgetting something they just read
Not remembering names of people they were just introduced to
Difficulty performing routine tasks at work or socially
Losing or misplacing objects
Trouble planning or organizing
WHAT CAREGIVERS CAN DO AT THIS STAGE: Since the individual is still independent at this stage, a caregiver’s’ role can be to provide support and companionship. The person with Alzheimer’s may need help with things like:
Appointments
Managing finances
Remembering names or words
Transportation
Planning and organizing
Keeping track of medication It’s important to allow the person to maintain their independence as much as possible and keep communication open for when they do need assistance.
STAGE 2 | MODERATE ALZHEIMER’S DISEASE (MIDDLE STAGE) This is usually the longest stage and individuals can stay in this stage for several years. As the disease progresses, the need and level of care will become greater. People at this stage may start to confuse words, get angry or frustrated or act out in unexpected ways. Symptoms will be more noticeable and include:
Forgetting information such as their own address or telephone number
Feeling moody or withdrawn, especially in socially or mentally challenging situations
Changes in sleep patterns
Forgetting events about their own life
Being confused on what day it is or where they are
Needing assistance picking out clothes that are appropriate for the season or occasion
Urinary and bowel incontinence
Wandering and getting lost
Personality and behavioral changes, including suspiciousness and delusions
WHAT CAREGIVERS CAN DO AT THIS STAGE: Individuals at this stage will require a greater level of care. The person with Alzheimer’s may become frustrated and upset when they have difficulty remembering things and names or trouble with daily activities such as getting dressed. You will most likely have to adjust your daily routine to include more structure for the individual with Alzheimer’s. At this stage caregivers can:
Use a calm voice when responding to questions to help the person from getting upset or frustrated.
Respond to the person’s emotion, instead of the question asked. The individual may need reassurance.
If the individual can still read, write out reminders for them. Practice patience and sensitivity with patients in this stage. They may become increasingly upset or frustrated as they lose more brain function as well as their independence.
STAGE 3 | SEVERE ALZHEIMER’S DISEASE (LATE STAGE) In the final stage of Alzheimer’s, personality changes may occur and individuals need increasing help with daily activities. They may still use words or phrases, but communicating emotion becomes difficult. Symptoms and behaviors at this stage may include:
Changes in physical abilities, including the ability to walk, sit and swallow
Needing assistance with daily personal care
Not knowing their surroundings or recalling recent experiences
Increasingly difficulty communicating
Vulnerability to infections, particularly pneumonia
WHAT CAREGIVERS CAN DO AT THIS STAGE: Intensive, around-the-clock care is usually required at this stage and can last from several weeks to several years. The role of the caregiver is to preserve the quality of life and dignity for the individual. People in this stage will need help with most activities including eating, dressing, and even walking. At this stage, the world is mainly experienced through the senses. Caregivers can connect and help an individual by:
Playing his or her favorite music
Reading excerpts of their favorite books
Looking at old photos with them
Preparing a favorite meal
Brushing the person’s hair
Sitting outside together Although an individual in this stage is unable to communicate, research shows that some core of their self may still remain. Caregivers and loved ones may be able to connect on some level even in this stage of the disease.
Home Care services can greatly help clients with Alzheimer's disease, as well as provide respite for family caregivers. Give us a call at 503-874-4199 to inquire how we can help!
