According to the Centers for Disease Control, Alzheimer’s disease is the most common form of dementia. It’s a progressive illness that worsens over time. It impacts emotional, physical, and mental functions, typically in older people aged 65 and over. In certain cases, it may appear before that (i.e., early onset).
Researchers aren’t sure what causes it. It’s thought that the illness stops brain cells from working correctly. There isn’t a cure. This diagnosis is understandably worrisome. People will eventually need continuous care. Often, this is provided by family and friends.
Stages of Alzheimer’s There are seven stages of Alzheimer’s disease:
- No impairment. No indicators of the disease are detectable.
- Very mild impairment. Slight memory problems that may not be noticeable to others.
- Mild impairment. Others may notice symptoms. The affected person may lose things, have difficulty planning or remembering new information. This is the stage that symptoms will become apparent on medical memory assessments.
- Moderate decline. Person may forget past information, and struggle with short term memory and basic math. They may need help managing finances.
- Moderately severe decline. People may forget details about themselves, struggle to dress themselves, and experience some confusion.
- Severe decline. Confusion worsens, and personality changes. People may struggle to recognize faces, or control bladder/bowels. Need help to bathe. They may wander and get lost. 24/7 care is required.
- Very severe decline. People need help with every part of life. Loss of communication abilities and (potentially) ability to swallow. In this stage, the individual dies.
The Early Stages
In the beginning, people with Alzheimer’s are aware of the impact of the condition. Memory and thinking skills remain intact. People can make plans and understand most things. Use this time to discuss who will handle financial responsibilities once they can’t. Also, it’s important to discuss what healthcare decisions they preferred. This gives the affected person choice over what happens to them. Plan for housing arrangements in advance, to lessen stress later.
People may wish to live independently during the early stages. Still, they may need help managing tasks like tracking appointments, remembering to take medication, etc. Work with them to brainstorm a strategy. This might include setting phone reminders, using a pill box, etc. Additionally, encouraging a healthy lifestyle (exercise, social connection, mental engagement, etc.) may help slow disease progression.
The Middle Stages
Following a daily schedule may reduce unnecessary stress and confusion. Maintain household routines, such as waking/sleeping, mealtime and bath time. Ensure that those with Alzheimer’s remain involved in daily activities (safely).
Caregivers should keep conversation simple (focus on one topic at a time). Repetition is often necessary, so patience is key. Don’t point out memory difficulties. If they ask a repetitive question don’t say, “I just told you! Don’t you remember?”. Simply repeat the answer.
Use engaging body language, like smiling, making eye contact, touching, etc. Communication limitations may be frustrating for everyone. This is normal. It’s important to regulate these feelings; don’t lash out.
People with Alzheimer’s may display distressing emotional behavior. Below are some examples and how to help.
- Wandering and getting lost. Install child safety mechanisms to keep doors and windows secure during times the person typically wanders. Notify neighbors, so they can be on the lookout. Provide a medical ID bracelet, or use a service like the Alzheimer’s Association 24/7 Wandering Support program.
- Aggression/anger. Don’t try to discuss or correct aggressive behavior. People with Alzheimer’s cannot control it. Allow them space to express the behavior if everyone is safe. Consider which situations trigger it, so they can be avoided. Provide a calming distraction, if possible.
- Sleep problems. Some people with Alzheimer’s experience “sundowning”, restlessness and increased agitation at night. They may fear the dark, as limited light creates shadows, which they may misinterpret. Increasing exercise during the day, providing a comfortable sleep environment, and using a nightlight may help. If they pace at night, provide a safe space to do so.
Late Stages
During this time, loved one’s needs may be too great to handle alone. A nursing home may be a good care solution. Alternatively, palliative or hospice care can be given. Likely, a support worker will come to the home. This way, people can spend the last part of their life in a familiar environment. Though our loved one cannot speak to us, we can still talk to them. We can play music, read a book, or offer physical touch.
Don’t Forget Self Care Caring for someone with Alzheimer’s disease can take an emotional and physical toll. It is important that we look after ourselves during the process. We should try to maintain our physical health and routines. Stress management, such as speaking with a therapist, meditation and getting proper rest is crucial.
References
https://www.alz.org/alzheimers-dementia/what-is-alzheimers
https://www.alz.org/help-support/caregiving/safety/medicalert-with-24-7-wandering-support