Continuing to use the stages as defined by the Alzheimer’s Association, Stage 6 is severe cognitive decline or also defined as moderately severe/mid-stage Alzheimer’s disease. As memory difficulties continue to worsen, significant personality changes may emerge and affected individuals need extensive help with customary daily activities. At this stage, individuals may:

• Lose most awareness of recent experiences and events as well as of their surroundings

• Recollect their personal history imperfectly, although they generally recall their own name

• Occasionally forget the name of their spouse or primary caregiver but generally can distinguish familiar from unfamiliar faces

• Need help getting dressed properly; without supervision, may make such errors as putting pajamas over daytime clothes or shoes on wrong feet

• Experience disruption of their normal sleep/waking cycle

• Need help with handling details of toileting (flushing toilet, wiping and disposing of tissue properly)

• Have increasing episodes of urinary or fecal incontinence

• Experience significant personality changes and behavioral symptoms, including suspiciousness and delusions (for example, believing that their caregiver is an impostor); hallucinations (seeing or hearing things that are not really there); or compulsive, repetitive behaviors such as hand-wringing or tissue shredding

• Tend to wander and become lost

One of the common problems is that the Alzheimer’s patient sleeps during the day and is awake at night. What a challenge for the caregiver. Can you imagine having your sleep interrupted every night? I do remember dad getting up at night and wandering around the house and needing help getting back to bed. I was always afraid that he would not know who I was and hit me. (He was a boxer in his youth). I could feel myself tensing up.

The big fear is your loved one wandering and becoming lost. In dad’s case, doors were always locked and someone was always watching him. However, many times when we’d take him out and upon returning, he would say he wanted to go home. No amount of convincing him that we were indeed at his home, was believable to him, but a short drive around the block and back home was generally enough to convince him. Of course, he could never tell us what “home” meant. His childhood home? His previous home? If only it was possible to read his mind to determine what he was trying to communicate.

How is dementia different from Alzheimer’s disease? According to ezinearticles.com author Molly Shomer, she says that the term dementia seems to be preferred over Alzheimer’s disease possibly because of the less frightening connotation and that many are using the word interchangeably, but that is not correct. Dementia and Alzheimer’s are different.

Shomer says dementia is a symptom, just as pain is a symptom for something causing the pain. According to the National Institute of Neurological Disorders and Stroke, memory loss by itself does not mean you have dementia. People with dementia have serious problems with two or more brain functions, such as memory and language. Many different diseases can cause dementia, including Alzheimer’s disease and stroke. Drugs are available to treat some of these diseases. For a list of other dementias from the Fischer Center for Alzheimer’s Foundation, click here.

So the actual cause of dementia could be one of a myriad of things where cognitive abilities have been impaired. With dementia, it could simply be a temporary thing if the cause is treated. On the other hand, Alzheimer’s is an actual disease and the disease causes dementia. Many different diseases can cause dementia, including Alzheimer’s disease and stroke. Drugs are available to treat some of these diseases.

What we know about Alzheimer’s disease today, according to the Alzheimer’s Association, is that:

1. Alzheimer’s is a progressive and fatal brain disease.
2. Alzheimer’s is the most common form of dementia.
3. Alzheimer’s has no current cure.

In our next post next week, we will specifically look at how Alzheimer’s disease is defined. In the meantime, challenge your brain to something new as was discussed here.