What to Expect if Your Loved One Has Alzheimer’s Disease

Alzheimer’s is a progressive neurological disorder that will eventually become fatal.

Researchers have developed seven stages of Alzheimer’s disease. This report will discuss the seven stages of Alzheimer’s disease and how it will affect your loved one.

When you become aware of how Alzheimer’s affects your loved one, you will be better prepared on how to take care of your loved one as the disease progresses.

Knowledge is power when it comes to this debilitating disease.

Stage One Alzheimer’s Disease

In this stage, there is no visual impairment. Your loved one will not have any problems with memory or cognitive abilities. Alzheimer’s may be starting in the brain, but it is not producing any symptoms as of yet.

In stage one of Alzheimer’s there is no need to worry about your loved one being able to live on their own. The rate at which Alzheimer’s disease progresses varies from person to person. Some people may live twenty years after diagnosis while others may only survive ten years. The first stage of Alzheimer’s is not even apparent to the physician.

Stage Two Alzheimer’s Disease

In stage two, your loved one may start noticing some memory or cognitive problems. But he or she may just think that it is a normal part of the aging process. The memory lapses will be very minimal in stage two and not even noticeable to family or friends. The person with stage two Alzheimer’s is still able to live alone safely and function quite well. The length of time it takes to progress from stage one to stage two will vary from person to person.

Stage Three Alzheimer’s Disease

This is the stage in which memory problems become more apparent to friends and family members. Your loved will start to have frequent memory lapses and trouble with certain cognitive skills. Some of the symptoms may include:

• Trouble finding the right word or remembering names.

• A decreased ability to remember the name of new people they are introduced to.

• They may have trouble retaining information that they read.

• Your loved one will start to have difficulty with organization and planning.

• If your loved one still works, co-workers may start to notice performance issues.

• In this stage, your loved one should still be able to live alone, but they may need checked up one.

You need to realize that the disease is progressing and it is time to start thinking about what you will do when they are unable to live on their own.

 Now is the time to have a long talk with your loved one about future plans. It is critical that you talk with your loved one about appointing someone as their durable power of attorney. This will give the person they choose the power to make medial decisions for them when they are no longer able to speak for themselves.

 Your loved one needs to have a living will made at this point also. The living will is a legal document that outlines the patient’s wishes in the case of terminal illness. The living will addresses issues such as tube feeding, life support, advanced care, etc.

Your loved needs to be getting all legal documents, bank accounts, stocks and bonds, savings account and all other important papers in order at this time. No one wants to think about dying or becoming an invalid, but now is the time to deal with it before the disease gets any worse.

The greatest gift a person that is diagnosed with Alzheimer’s can give members of the family is to get all legal documents together, get living wills made and power of attorneys appointed before the disease progresses.

 It is important that your loved one with Alzheimer’s talks with you about what his or her wishes are for end of life care. Knowing what your loved one wants makes it easier for you to make important decisions when the time comes.

 I cannot stress this enough. Communicate with your loved one about the disease and what they want the end of their life to be like.

Stage Four Alzheimer’s Disease

Alzheimer’s disease symptoms are really starting to get noticeable in this stage. Your loved one may have trouble remembering recent events or occasions. He or she will have trouble doing simple mathematic problems.

 In this stage, your loved may not be able to balance a checkbook or remember to pay bills. Memories of personal history may escape them at this point.

 One of the biggest challenges at this stage is your loved one is aware of the cognitive deficits and the memory problems. He or she will become withdrawn and depressed. They will shy away from social situations to avoid embarrassing themselves. It is important that you give them encouragement at this stage of the disease.

 It now may be the time that you have your loved one move in with you. If your loved one is adamant about staying in their home, you may need to make arrangements for someone to sit with your loved one during the day. An adult day care may be an option at this point also. But with the increased episodes of forgetfulness, it is getting more dangerous for your loved one to stay at home alone.

Stage Five Alzheimer’s Disease

This is the beginning of advanced stage of Alzheimer’s disease. The symptoms of Alzheimer’s are very noticeable and will interfere with your loved one’s ability to care for himself or herself. The symptoms that you will notice in this stage are:

• They may not know the date, season or even where they are.

• They will be unable to recall simple information such as their address, telephone number or the high school or college that they graduated from.

• Simple mathematics such as counting by twos may be impossible in this stage.

• They may become confused when it comes to choosing the appropriate clothing for the weather.

   

At this stage, your loved one will probably still know their own name and the names of their immediate family.

 Your loved should still be able to go to the bathroom and dress independently. But at this point, you have to insist that they move in with you. Your loved one is definitely not safe to stay alone.

Hopefully, you have been getting your home ready for your loved one. You need to make sure the home is safe and that your loved one will have their own room that is free from dangerous hazards such as clutter, scatter rugs, and other things they could trip over.

Getting your loved one moved in and settled is just the beginning of a long, heartbreaking journey. Your life will now change, and you will watch as your loved one slowly slips away from you mentally and physically.

But on the upside, these are years that can be the happiest for both of you. The time you spend together will be precious, and you will have many great memories.

Stage 6 Alzheimer’s Disease

At this stage of Alzheimer’s things begin to get really tough for you, the caregiver. Your loved one has deteriorated significantly and you now need to keep a very close eye on them.

Some of the changes you will notice in stage six are:

• Inability to recall past events correctly. Their personal history will be jumbled up in their mind. They should still be able to recognize their own name.

• Your loved one may not be able to remember the names of family members or caregivers. They should still be able to recognize familiar faces.

• They will not be aware of any recent events. They may not even be aware of their surroundings, not even recognizing their own living environment.

• At this stage, your loved one will need help to get dressed properly. Without the proper supervision, they will have no idea what piece of clothing goes where.

• Toileting is becoming a problem at this stage. Your loved one will need help with going to the bathroom, wiping, flushing and hand washing. Sometimes during this stage, the person with Alzheimer’s loses the ability to know when to go to the bathroom. They will become incontinent and must wear Depends or other types of incontinent underwear.

• A person in stage six will have disruptions of their normal sleeping and waking cycle.

• They may sleep during the day and be up all night. They may stay awake for days , then sleep for days. Sleeping for just a couple of hours at a time is not uncommon.

• Significant personality changes can happen at this stage. Your loved may become delusional. They may start to experience hallucinations and may become very paranoid. Your loved one may think that you are an imposer. It is not uncommon for agitation to increase to the point of violent behavior. Compulsive and repetitive behaviors are common also. For example, your loved one may say the same thing over and over or wring their hands constantly.

• This is the stage in which wandering is quite common. A lot of people with stage six Alzheimer’s will wander away from home and become lost or injured.

   

Taking care of a stage 6 Alzheimer’s patient 24/7 is the most difficult job you will ever do. Just when you think nothing else could happen after a particularly difficult day, it will.

No one should have to endure this alone. Seek help and if it gets to be too much for you, consider nursing home placement.

Stage 7 Alzheimer’s Disease

This is the final stage of the disease. At this stage, your loved one will lose the ability to talk, walk and swallow. Muscles will become rigid. Your loved one may no longer be able to smile.

This final stage of Alzheimer’s will be hard to watch. Your loved one will be bed bound and need total care. You may not be able to feed your loved one and that is when you must decide how long you want your loved one to go on at this stage.

 Some people choose to place feeding tubes and some people do not. Hopefully, you have discussed this with your loved one earlier when he or she was able to verbalize their wishes about end of life care.

 If you did not have this discussion, and you are left to make the decision, you need to discuss your options with the doctor or even your home health nurse if you have one.

Ask questions like:

• Will prolonging life improve the quality of life?

• Is my loved one in pain?

• Will they feel hunger if I choose not to have a feeding tube placed?

• Do they have other health problems such as heart disease, diabetes or high blood

  pressure that can make it difficult for their life to be extended?

• What are the risks in keeping them alive through artificial means?

One question that you should ask your doctor that many people do not think about is:

If it was your loved one in this condition, what would you do?

Health care professionals have seen it all. They know the outcomes and they can see the situation objectively.

 You must remember also that although you don’t want to let your loved one go because you will miss them, sometimes you have to love them enough to let them go. Living your last days in misery and pain is not living, it is suffering.

 It is better not to have to make these decisions by yourself. Gather the family and have a meeting with the doctor. Get all of the facts about your loved one's condition and their options. Then make the decision as a family. This will help to reduce guilt and the fear of making the wrong decision.

If you decide to care for your loved one at home, it will be a challenge. But it will not be without its rewards. Just knowing that you were able to give your loved one happiness at the end of their life is worth it all.

There is no greater gift that you can give someone than the gift of love and family.

I wish you all the best of luck.

Caregivers are special people.

Lucinda Reynolds, RN