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.

Depending on the source, some say there are seven (7) stages of Alzheimer’s disease while others say there are three (3). The Alzheimer’s Association says that there are seven (7) stages of Alzheimer’s disease. I will cover each stage of Alzheimer’s in separate posts.

Stage 1, according to the Alzheimer’s Association, is No Impairment (normal function). No evidence is apparent to a health care professional during a medical interview. In my post on What is Alzheimer’s Disease? I mentioned three ways that doctors determine how a diagnosis is made –

1. Lab tests
2. Neuropsychological testing (extensive assessment of thinking and memory skills)
3. Brain scans

Apparently, Stage 1 only involves an interview since there is no evidence or reason for more extensive testing at this point. So why a Stage 1? If Stage 1 is normal functioning with no impairment, then it seems to me in order to determine a Stage 1, it is can only be determined AFTER a person has been diagnosed with Alzheimer’s disease. There is no abnormality in Stage 1. So after a person has been diagnosed, then we can go back and say this person with Alzheimer’s was in Stage 1.

On the other hand, it might be possible to detect a Stage 1 if you lived with someone or you know someone very well … a loved one whom you can detect mild memory loss or mild cognitive impairment or other signs and symptoms such as personality changes, all of which may indicate a future Alzheimer’s diagnosis. Or, if you personally feel that something is not right with your memory,  then you may possibly be in Stage 1 of Alzheimer’s disease, but Stage 1 means that you are still functioning normally. At this point, though, from a medical standpoint, an Alzheimer’s diagnosis is not possible. Other problems such as anxiety disorders, bipolar disorders, sleep problems, depression, or medications could also point to Alzheimer’s disease, but that would be conjecture at this time.

If you detect dementia, though, and if you are a future caregiver, you need to remember to most importantly take care of yourself. But it also gives you time to get things in order and prepare for the future. Through our continuous journey, I hope we can learn what to expect (even though each case is unique) and follow the Scout motto: “Be Prepared.”

Alzheimer's Association's E-News

The Alzheimer’s Association has a wonderful Web site packed with a wealth of information. I came across the video below because I signed up to get their weekly E-News and you can click here to sign up as well. It is a one-page update on advances in Alzheimer’s disease care, research, events and a brain-builder puzzle. Although the information is invaluable, it can be overwhelming to those not familiar with navigating Web sites. Additionally, symptoms may be similar, but no two people will experience Alzheimer’s disease in exactly the same way.

The video below reminds us that no one is immune to Alzheimer’s disease and Alzheimer’s is a family disease. The statistics are staggering — every 70 seconds in the United States, someone is diagnosed with Alzheimer’s.  Wow! Imagine being diagnosed with Alzheimer’s disease. The Alzheimer’s diagnosis may not surprise you because you may have suspected cognitive decline, but nevertheless, it is a shock to you and your family to receive the news. This can lead to many problems including depression in older adults, anxiety disorder, personality changes, bipolar disorder, and mental health problems, to name a few. Along the journey, although there is no known cure, I will certainly be looking for tips for getting better.

In future posts, I will be writing about stages of Alzheimer’s disease and the problems each stage brings. In this way, we can prepare for coping with the disease.

Check out this video from the Alzheimer’s Association.

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.