Alzheimer's Disease – Part 2

You can support your loved one with Alzheimer's by learning more about how the condition progresses. There are seven stages in the progression of Alzheimer's and they don't always happen neatly or fit neatly into the seven stages. The symptoms might vary, but they can be a guide and help you plan for your loved one's care. The seven stages include:

Stage 1: Normal Outward Behavior. When your loved one is in this early phase, he/she won't have any symptoms that you can spot. Only a PET scan, an imaging test that shows how the brain is working, can reveal whether he/she has Alzheimer's. As the person moves into the next 6 stages, your loved one with Alzheimer's will see more and more changes in his/her thinking and reasoning.

Stage 2: Very Mild Changes. You still might not notice anything amiss in your loved one's behavior, but he may be picking up on small differences, things that even a doctor doesn't catch. This could include forgetting a word or misplacing objects.

At this stage, subtle symptoms of Alzheimer's don't interfere with the ability to work or live independently. Keep in mind that these symptoms might not be Alzheimer's at all, but simply normal changes from aging.

Stage 3: Mild Decline. It's at this point that you start to notice changes in your loved one's thinking and reasoning, such as:

• Forgets something he just read
• Asks the same question over and over
• Has more and more trouble making plans or organizing
• Can't remember names when meeting new people

You can help by being your loved one's "memory" for him, making sure he pays bills and gets to appointments on time. You can also suggest he/she ease stress by retiring from work and putting legal and financial affairs in order.

Stage 4: Moderate Decline. During this period, the problems in thinking and reasoning that you noticed in stage 3 get more obvious, and new issues appear. Your loved one might:

• Forget details about himself/herself
• Have trouble putting the right date and amount on a check
• Forget what month or season it is
• Have trouble cooking meals or even ordering from a menu

You can help with everyday chores and your loved one's safety. Make sure he/she isn't driving anymore, and that someone isn't trying to take advantage of your loved one financially.

Stage 5: Moderately Severe Decline. Your loved one might start to lose track of where he is and what time it is. He/she might have trouble remembering his/her address, phone number, or where he/she went to school. Your loved one could get confused about what kind of clothes to wear for the day or season.

You can help by laying out the clothing in the morning. It can help him/her dress by himself/herself and keep a sense of independence. If your loved one repeats the same question, answer with an even, reassuring voice. Your loved one might be asking the question less to get an answer and more just to know you're there.

Even if your loved one can't remember facts and details, he/she might still be able to tell a story. Invite your loved one to use his/her imagination at those times.

Stage 6: Severe Decline. As Alzheimer's progresses, your loved one might recognize faces but forget names. He/she might also mistake a person for someone else, for instance, thinking the spouse is his/her parent. Delusions might a set in, such as thinking he needs to go to work even though he no longer has a job. You might need to help him/her go to the bathroom. It might be hard to talk, but you can still connect with him/her through the senses. Many people with Alzheimer's love hearing music, being read to, or looking over old photos.

Stage 7: Very Severe Decline. Many basic abilities in a person with Alzheimer's, such as eating, walking, and sitting up, fade during this period. You can stay involved by feeding your loved one with soft, easy-to-swallow food, helping him/her use a spoon, and making sure he/she drinks. This is important, as many people at this stage can no longer tell when they are thirsty.

Please remember that as your loved one evolves into the later stages, some words may be hurtful. When this happens, do not get upset at your loved one, as they do not realize what they are saying.