Alzheimer’s Disease & Dementia Care – Stages of

Alzheimer’s DiseaseSeniors Home Care

Alzheimer’s disease is a gradual mental and physical deterioration that typically progresses in three stages.

Learning about the stages of Alzheimer’s helps caregivers understand the disease and ultimately provide better care.

Alzheimer’s disease affects people differently. Symptoms and progression vary, but generally can be categorized into three stages:◦ Mild Alzheimer’s Disease (early stage)◦ Moderate Alzheimer’s Disease (middle stage)◦ Severe Alzheimer’s Disease (late stage)

About Alzheimer’s Disease

Signs and symptoms in the first stage of Alzheimer’s disease are often vague. In this stage, a person may function independently but begin to experience memory lapses. Difficulties may include:◦ Memory loss and confusion – While long-term memory remains intact, an

individual may have trouble recalling recent events or names of familiar people or things. They may repeat themselves, get lost in conversation, and misplace things.

◦ Disorientation and getting lost in familiar surroundings – Sense of direction and time often decrease.

◦ Inability to learn or retain new information – People in the first stage of Alzheimer’s disease may forget how to use tools or equipment, such as appliances, a toothbrush, or eating utensils.

◦ Personality change and mood swings – A person may act more withdrawn, frustrated, irritable, mellow, sensitive, or inconsiderate of others.

◦ Trouble with routines – People with mild Alzheimer’s may lose the ability to handle finances or telephone calls. It may become difficult to use a checkbook or prepare meals.

◦ Decline in grooming, ability to care for oneself, and performing activities of daily living –A previously well-groomed person may be untidy or unbathed.

Mild Alzheimer’s Disease (Early Stage)

During the second stage of Alzheimer’s disease, symptoms become more obvious and the person becomes more dependent on their caregiver. Individuals with moderate Alzheimer’s may need assistance with all activities of daily living. Noticeable symptoms often include:◦ Poor short-term memory – After completing a meal, a person with moderate

Alzheimer’s disease may ask, “When do we eat?”◦ Disorientation to person, place, or time – A person may not know the name or

relation of a close relative or think that the current year is 10 to 30 years earlier.◦ Inability to perform skilled movements – Someone with moderate Alzheimer’s

may not be able to use eating utensils, tie their shoes, or operate the washer or stove.

◦ Language difficulties – It may take more effort to express ideas or needs. Sentences may not make sense and it may be difficult to understand others.

◦ Social withdrawal – Individuals may be socially dependent on their caregiver and feel uncomfortable in new places or with groups of people. Depression is also common.

◦ More spontaneity, fewer inhibitions – The person with dementia may make inappropriate comments, ask questions to strangers, or behave inappropriately in public spaces.

Moderate Alzheimer’s Disease (Middle Stage)

◦ Agitation – People with Alzheimer’s disease are easily overwhelmed by noise, temperature, and discomfort. They may exhibit anger and anxiety when faced with confusing situations or are unable to make needs known. Frustration may lead to verbal or physical outbursts.

◦ Restlessness, fidgeting, pacing, or aimless wandering – Short attention spans are common and people with dementia may wander around the house or pace the hallway.

◦ Sleepiness – A person may sleep up to 10 hours at night and nap during the day. Sitting can result in a nap, even during a meal.

◦ Severe sleep disturbances – Some people sleep 14 to 16 hours a day. Others sleep only two or four hours each night, with or without daytime naps.

◦ Sundowning – Wandering, confusion, and agitation may increase as the sun goes down.

◦ Hallucinations – There may be evidence of hallucinations or delusions.◦ Changes in eating habits – Examples are erratic eating, weight loss, or weight gain.

People with dementia also may develop a preference for sweet foods. ◦ Decrease in grooming and hygiene – Someone with moderate Alzheimer’s may

refuse to take baths or change clothes. People with moderate Alzheimer’s should not be left unsupervised due to

their lack of judgment and risk of wandering.

Moderate Alzheimer’s Disease (Middle Stage)

In the last stage of Alzheimer’s disease, individuals require constant supervision and assistance. Often, people with severe Alzheimer’s disease are unable to walk or sit up without help. They may not be able to speak and likely cannot recognize family members. Other symptoms include:◦ Little to no memory – Short and long-term memory are severely impaired. ◦ Great difficulty communicating with others – Someone with severe dementia may be

unable to speak or understand words. ◦ No recognition of family or friends – In late-stage dementia, a person may think their

spouse, or even their own reflection in the mirror, is a stranger. ◦ Need for assistance –A caregiver is necessary to assist with all activities of daily living

and interactions.◦ Difficulty remembering how to eat – It may be a struggle to coordinate biting, chewing,

and swallowing. Weight loss is common, despite good nutrition and meal supplements. Tube feeding or a puree diet with thickened liquids may be necessary.

◦ Incontinence – Loss of bowel and/or bladder control is common.◦ Difficulty with coordinated movements – A person may walk unsteadily or struggle to

hold objects. ◦ Increased frailty – Muscles may be weaker and people with dementia are often more

susceptible to infections and other physical illnesses.◦ Upset sleep cycle – Sleep may only be possible with the help of medication. On the

contrary, an individual may sleep much more in late-stage dementia.

Severe Alzheimer’s Disease (Late Stage)

Caring for a loved one with Alzheimer’s disease (or other forms of dementia) is demanding, especially as they require more constant assistance and supervision.

Teaming up with a home care agency helps family caregivers get the respite they need to continue leading a healthy life.

About Alzheimer’s Disease

Seniors Home Care (SHC), a privately owned company operated by a Registered Nurse, has been providing professional and compassionate St. Louis-area elder care since 1987. SHC offers complete personal and household services that allow seniors to maintain their dignity and independence, wherever they call home.

About Seniors Home Care