While everyone responds to cognitive decline and dementia in different ways, almost all seniors with mental decline will go through various stages. Like many other cognitive disorders, Alzheimer’s patients will go through different periods of decline as areas of the brain become more affected. This includes a progression of decline with memory, thinking, problem solving, judgment, and in the later stages, personality, range of motion and language.
The seven stages of Alzheimer’s
Having a clear framework in regards to your loved one’s care can make these transitions somewhat easier for you and your loved one. According to the Alzheimer’s Association, there are seven stages of Alzheimer’s. This progression was determined by Dr. Barry Reisberg, clinical director of the New York University School of Medicine’s Silberstein Aging and Dementia Research Center. Keep in mind that the following framework isn’t set in stone: Your loved one may skip certain stages altogether, or it may look slightly different than what is outlined below. Becoming knowledgeable about what to expect could make the transition much easier for your entire family when it comes to caregiving.
Stage 1: No impairment –
This stage is where we all begin. In stage 1, a health care professional will determine that there are no symptoms of cognitive decline by testing memory, language and problem solving.
Stage 2: Very mild cognitive decline –
This stage can vary between typical age-related memory problems that most seniors face (such as forgetting certain dates) or could include some of the beginning signs of Alzheimer’s disease. Some of the side effects that correspond with this stage include:
- forgetting everyday phrases
- forgetting the location of important objects (such as where your father left his keys)
Stage 3: Mild cognitive decline –
Depending on the severity of your loved one’s symptoms, this phase could include the earliest stages of Alzheimer’s disease. Many of these side effects will become noticeable to not just family, but co-workers and friends.
During this stage, your mother may begin to:
- develop anxiety in social or work settings
- have difficulty finding the right word or phrase
- easily forget the names of people after having just been introduced
- start to experience a pattern of losing or misplacing important belongings
Some individuals also have difficulty planning and organizing.
Stage 4: Moderate cognitive decline –
This is also defined as mild or early-stage Alzheimer’s disease and should be overseen by a medical professional. Some of the most obvious symptoms include:
- having no recollection of recent events
- the failure to perform certain math problems such as multiplication or long division
- not being able to take part in important financial tasks like paying bills
- acting out or reacting negatively when faced with situations that test social and mental skills
- losing memories of personal history.
Stage 5: Moderately severe cognitive decline –
At this stage in the framework, your mother’s symptoms may become noticeable to others and she will start needing day-to-day care giving assistance. Side effects in this stage include:
- inability to recall the date
- not knowing where they are or what day it is
- failure to perform very basic math problems
- choosing inadequate clothing for the season (i.e. wearing sandals in the winter)
- not being able to recall basic personal information like a telephone number or address
However, at stage 5, your mother will still be able to remember details about family history and will be able to eat and use the restroom on her own.
Stage 6: Severe cognitive decline –
In stage 6, your father may need professional care giving help to carry out daily activities, such as going to the toilet or dressing himself. He will remember his own name, but might forget the names of immediate family members – though he will recollect their faces. There might also be major shifts in his sleep and eating patterns, as well as changes in his personality and behavior (for example, having delusions or paranoid thoughts). At this stage, he may also have the tendency to become lost or wander off.
Stage 7: Very severe cognitive decline –
This is the most difficult of the stages, as loved ones will completely lose the ability to respond to others or their environment. An individual will no longer be able to carry a conversation, their muscles will become stiff and they might not be able to smile or swallow.
Care giving throughout the stages of Alzheimer’s
Care giving in the early stages
Although most of your loved one’s immediate medical needs can be managed on their own in the early stages, you may need to assist with tasks associated with memory. This can include keeping up with doctor’s appointments and helping manage financial matters, medications, and social and work obligations. At times, they may also need help remembering places, people, words and names. In the early stages, you will want to encourage them to:
- maintain their independence
- relish in activities that they enjoy
- express their emotions
- establish a routine to possibly help delay the disease from worsening
Care giving in the middle stages
According to the Alzheimer’s Association, this can be the longest period that you will face as a caregiver, as the symptoms can go on during the majority of your loved one’s later years. During this time, you will need to learn to develop patience, flexibility and understanding as their day-to-day functions become more difficult to achieve. Your loved one might need assistance dressing, act out in strange ways or grow frustrated and angry with you, which can be stressful. Be sure to take care of yourself and reach out to family, friends and other support services to make this transition smoother.
Care giving in the late stages
According to the Alzheimer’s Society, the later stages will be the most difficult, as your loved one is now very frail and relies on you for most of their daily care. At this stage, encouraging your loved one to eat and sleep will grow increasingly difficult and they may lose the ability to walk steadily. During this time, an occupational therapist may help them stay mobile without falling, and speech therapists and nutritionists might give you greater insight to their speech and eating patterns. Incontinence, severe memory loss and disorientation, immune system problems, repetitive movements and strange or unusual behavior must all be managed during this stage as well.
Helping a loved one during the stages of Alzheimer’s is never easy. With a solid framework, adequate support (emotional and health care), and an understanding of these behavioral changes, you can help your loved one and yourself through each stage of Alzheimer’s.