Caregivers carry an obligation to educate themselves in order to help others understand and cope with this dread disease. More than 26 million people worldwide, and as many as 5.3 million in the United States alone are living with Alzheimer’s. That worldwide number is expected to quadruple by 2050. According to the Alzheimer’s Association, it is the seventh-leading cause of death in the United States.
Age-Related Cognitive Decline Stage
Person Exhibits Normal Function with No Impairment. Unimpaired individuals experience no memory problems and none are evident to a health care professional during a medical interview.
Very Mild Cognitive Decline (may be normal age-related changes or earliest signs of Alzheimer's disease). Individuals may have memory lapses, and can forget familiar words or names or the location of everyday items such as keys or eyeglasses. These may not evident during a medical examination or apparent to friends, family or co-workers.
Mild to Early Stages of Alzheimer's
Mild Cognitive Decline (Early stage). Deficiencies become noticeable. Problems with memory or concentration may be measurable in clinical testing. Word- or name-finding problems are exposed. Decreased ability to remember names when introduced to new people. Noticeable performance issues in social or work settings. Little is retained when reading. May start to lose or misplace valuable items. Visible decline in the ability to plan or organize.
Moderate Cognitive Decline (Mild stage). Decreased knowledge of recent events. Impaired ability to perform challenging mental arithmetic – for example, to count backward from 75 by 7s. Decreased capacity to perform complex tasks, such as planning dinner, paying bills or managing finances. Reduced memory of personal history. The affected individual seems increasingly subdued or withdrawn.
Moderate to Mid-Stage Alzheimer's
Moderately Severe Cognitive Decline. Inability to recall important details such as current address, telephone number or the name of the college or high school from which they graduated. Become confused about where they are or about the date, day of the week or season. Exhibits trouble with less challenging mental arithmetic like counting backward from 40 by 4s or from 20 by 2s. Requires assistance choosing proper clothing for the season or the occasion.
At this stage, Alzheimer’s patients usually retain substantial knowledge about themselves and do know their own name and the names of their spouse or children. They also do not yet require assistance with eating or maintaining hygiene. At this point, the patient may require constant in-home care or a memory care facility.
Severe Cognitive Decline (moderately severe or mid-stage). Loss of most awareness of recent experiences and events as well as of their surroundings, including events that may have occurred earlier in the day. They can still recall their personal history albeit imperfectly, although they generally recall their own name. Occasionally they will forget the name of their spouse or primary caregiver but generally can distinguish familiar from unfamiliar faces.
They need help getting dressed properly. Without supervision, they may put pajamas over daytime clothes or shoes on the wrong feet. Normal sleep/waking cycle is disrupted. They need help with handling details of toileting (flushing toilet, wiping and disposing of tissue properly). Have increasing episodes of incontinence. Experience significant personality changes and behavioral symptoms, including anxiety and delusions; hallucinations; paranoia (commonly called sundowning); or compulsive, repetitive behaviors such as hand-wringing or tissue shredding. They may tend to wander and become lost.
Late Stage Alzheimer's
Very Severe Cognitive Decline (severe or late-stage). Frequently individuals lose their capacity for recognizable speech, although words or phrases may occasionally be uttered. Individuals need help with eating and toileting and there is general incontinence. Loss of the ability to walk without assistance, then the ability to sit without support, followed by the ability to smile, and the ability to hold their head up. Reflexes become abnormal and muscles grow rigid. Swallowing is impaired.
Alzheimer’s is always fatal, however, knowledge is power and knowing what to expect when serving as a caregiver can help make the challenge of living with this disease a little easier.
JoAnn Sardo - After spending 25 years in the publishing industry, I took a detour to open my own photo processing center. I decided after two years that ...
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