From memory lapses to violence, irrational outbursts to dwindling fine motor skills, the decline that accompanies Alzheimer’s disease can be swift or slow. But whatever course the disease follows, it can be difficult for loved ones to remain loving. Watching someone you know so well deteriorate into a complete stranger is beyond compare.
It can be of some comfort, however, to have a general idea of what to expect next for (and from) your spouse, parent, grandparent, or other family member with Alzheimer’s disease. A sufferer’s abilities change and decline throughout the course of the disease, and not everyone will experience the exact same symptoms. While it’s difficult to place an individual with Alzheimer’s into a specific stage as the phases of Alzheimer’s may overlap, the Alzheimer’s Association identifies seven stages of Alzheimer’s:
Stage 1: No impairment. Simply enough, this person doesn’t experience any memory problems and there is no evidence of dementia symptoms.
Stage 2: Very mild decline. Memory lapses may occur, and it could be a very early sign of Alzheimer’s disease. But normal age-related changes could be the cause of forgetting the location of everyday objects or common words.
Stage 3: Mild decline. Early-stage Alzheimer’s can be diagnosed in some individuals who are exhibiting noticeable problems with memory or concentration. During this stage, symptoms may include difficulty recalling a name or coming up with the right word; difficulty performing tasks in social or work settings; losing or misplacing valued objects; trouble planning or organizing; forgetting material that was just read.
Stage 4: Moderate decline. Cognitive decline begins to intensify in this early stage of Alzheimer’s disease and clear-cut symptoms will be exhibited in several areas: forgetfulness of recent events; difficulty paying bills or managing finances; forgetfulness about personal history; becoming moody or withdrawn, particularly in socially or mentally challenging situations.
Stage 5: Moderately severe decline. In moderate or mid-stage Alzheimer’s disease, the gaps in memory and thinking are very noticeable and the sufferer may begin to need assistance with day-to-day activities, like choosing the proper clothing for the weather or a particular occasion. The person may become confused about what day it is, where they are, or be unable to recall details like their address, phone number, or alma maters. At this stage, however, they can still remember significant family and personal details and are unlikely to require assistance with eating or using the bathroom.
Stage 6: Severe decline. Symptoms of Alzheimer’s disease become numerous and compounded in this stage. As memory worsens, upsetting personality and behavioral changes may begin to take place, including delusions, suspiciousness, or compulsive behaviors like wringing the hands or shredding tissues. Help is needed with many basic tasks at this point, from dressing properly to using the bathroom. They may also have trouble controlling their bladder or bowels. The sufferer may be able to distinguish between familiar and unfamiliar faces but they may have trouble remembering the name of a caregiver or even a spouse. There can be a loss of awareness about their surroundings, a tendency to wander or become lost, and major changes in sleep patterns such as daytime sleeping and nighttime restlessness.
Stage 7: Very severe decline. The final stage of Alzheimer’s finds the individuals with an inability to respond to their environment, have a conversation, or control movement. Help is needed with daily personal care, from eating to using the bathroom. Other physical changes take place as well: reflexes become abnormal, muscles grow rigid, swallowing is impaired, and they may not be able to hold their head up or sit without support.