Stages of Alzheimer’s Disease
Alzheimer disease is the most common type of dementia. It is a brain disease. It is often described in terms of three “stages” that may occur as the disease advances. The stages are useful in giving caregivers an idea of what to expect with the course of disease, as well as how to plan for their loved one’s care. It is important to know that there is a lot of overlap in the stages and no two people progress through the stages at the same rate or with the same symptoms.
EARLY STAGE
The first symptoms of Alzheimer’s disease are not always easy to see and it may not be clear that something is wrong. If symptoms are noticed, they are often blamed on old age, stress, or some other cause. A memory problem is often the first symptom. In the early stage, a person with Alzheimer’s disease can often care for themselves.
Other common symptoms:
• Memory loss, trouble learning new things
• Having a hard time with daily tasks, loss of interest in activities
• Depression, changes in mood, fatigue
• Changes in how the person acts or increased moodiness
• Language changes, not knowing the names of common objects, problems finding the right words
• Poor judgment, often don’t see the problems and resist help, blaming others
• Sense of time may change, not knowing time of day, month or year
• Becomes lost in familiar places, confused about where they are
• Problems with knowing what was said to them
HOW TO HELP
1. Gain their trust and agreement
2. Make daily routines simple
3. Break down tasks into smaller steps
4. Make the home safe
5. Adjust what you expect to match what the person is able to do
6. Provide support and assist in solving problems
7. Learn about the disease
8. Get help from your health care provider
MIDDLE STAGE
As the disease worsens, the symptoms described in the early stage may increase. Memory loss is worse, and reminders are often not enough. Social skills decline and confusion about time and place is more common. Safety is a major concern as the person may not be able to make good decisions. Direct supervision and help with daily activities and cares are needed.
Other common symptoms:
• Increased depression, problems sleeping, problems trusting others
• Weight loss, trouble swallowing
• Increased behavior changes, may be more anxious or worried
• May strike out with words or force
• May act or speak in ways that do not make sense, such as out of place comments or actions
• Wandering or pacing
• May lose control of bladder and/or bowel function
• May be less steady when walking
• Decline in bathing or grooming skills
• Changes in the ability to see, smell, or hear what is going on around them
HOW TO HELP
1. Give one-step directions
2. Limit choices
3. Do the same things the same way over and over
4. Encourage strengths
5. Remind and repeat gently
6. Limit noise and activity.
7. Speak softly, simple and clear
8. Do not argue. Accept that the person may not talk to you at times
9. Make memory aids. For example, pictures of the toilet on the bathroom door
10. Check safety needs. Constant checking is often needed
11. Seek professional advice, outside help and support
LATE STAGE
During the last stage, memory loss is severe. Little or no short term memory remains. But there may be times when a memory surfaces or the person responds to something from the past. Sometimes the person at this stage will no longer know who family members are.
Other common symptoms:
• Problems with walking, standing or rising from a chair
• Falling can become a major risk
• Loss of bladder and bowel control is more common
• Needs assist with all cares
• Unable to use words
• May not be able to swallow
• May see or hear things that are not there
• They may do things like picking at clothing, putting items in mouth, or grabbing for everything
HOW TO HELP
1. Reassure and comfort
2. Approach person slowly
3. Show and tell before doing a task
4. Be aware of the person’s feelings more than the words
5. Seek professional advice regarding best care setting. May need placement or 24 hour care and supervision
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 10/25/2011
Copyright © 10/25/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5262
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