Every person with Alzheimer’s is unique, and each person has their own experience of this disease. That said, most people progress through seven stages, and it can be helpful for loved ones to understand the progression of Alzheimer’s disease. Understanding what is going on, and preparing for what is likely to happen next, can help you respond to your loved one with Alzheimer’s as calmly and compassionately as possible. It can also help you to know when to seek support as a caregiver. Here are the seven stages of Alzheimer’s disease:
Stage 1: No Impairment
In the first stage of Alzheimer’s, the disease is undetectable. The person with Alzheimer’s is not experiencing any problems with memory loss. A doctor or other medical professional who speaks with him or her would not detect any signs of developing dementia.
Stage 2: Very Mild Cognitive Decline
The person with Alzheimer’s may experience memory lapses, but may chalk them up to something other than dementia, such as being stressed or very busy. At this stage, family, friends, coworkers, and others would not notice any cognitive problems, and a medical examination would not suggest any symptoms of dementia.
Stage 3: Mild Cognitive Decline
At this stage, family, friends, and others who spend time with the person are likely to start noticing problems. The person might hesitate when searching for the right word, or the name of a familiar person. He or she may misplace important items, such as car keys, sometimes in an unusual spot.
At Stage 3, a person with Alzheimer’s may have difficulty retaining new information. He or she may struggle to remember names when introduced to someone new, and quickly forget information that was just read. The person may have greater problems with planning and organizing, and may also experience increasing difficulty functioning in work or social settings.
Stage 4: Moderate Cognitive Decline
At this point, a family member may have urged the person to see a doctor about the problems he or she has been having. A medical examination and interview will likely find several symptoms of developing dementia, including forgetfulness of the patient’s own personal history or of recent events. The interview, or input from a family member, may reveal that the patient is increasingly moody or withdrawn, or that he or she struggles with complex, multi-step tasks such as managing finances or planning a meal for company.
Stage 5: Moderately Severe Cognitive Decline
By the time the person reaches Stage 5, memory lapses and problems with thought process are noticeable to others, and he or she may need assistance with routine activities. People at this stage may become confused about details such as the date or where they are, but still remember some important facts about themselves and their families. They may have trouble remembering details such as their address or telephone number.
Stage 6: Severe Cognitive Decline
In Stage 6, they may be able to distinguish between familiar and unfamiliar faces, they may struggle to remember even the name of a spouse or close family member.
In Stage 6, the memory of people with Alzheimer’s continues to get worse. They frequently need a lot of help with daily activities such as getting dressed. Personality changes are common, which can be very stressful for caregivers.
Other common symptoms of patients in severe cognitive decline include wandering and becoming lost; significant changes in sleep patterns; and incontinence of bladder and bowel. Patients may lose awareness of their surroundings and of recent experiences. While they may be able to distinguish between familiar and unfamiliar faces, they may struggle to remember even the name of a spouse or close family member. They may remember their own name, but little about their personal history.
Stage 7: Very Severe Cognitive Decline
This is the last stage of Alzheimer’s, and may last anywhere from a few weeks to several years. In this final stage, people with Alzheimer’s may lose the ability to respond to their environment, including the ability to smile. They may be able to say some words or phrases, but generally cannot carry on a conversation. In terms of physical changes, their muscles become rigid, reflexes grow abnormal, and they may have difficulty swallowing. Patients may become unable to hold their heads up or to sit without support.
Developing Alzheimer’s disease can be very frightening both for patients as they feel their cognitive abilities slipping away, and for the loved ones who are helplessly watching them change. It is natural to want to deny what is going on for as long as possible. Unfortunately, denial is not a helpful strategy. Consult your doctor to learn about treatments that can help to slow the progression of the disease as long as possible.
Another thing you must do as soon as you become aware that a loved one may be developing Alzheimer’s is to consult an experienced elder law attorney. An elder law attorney can help you plan to be able to assist your loved one as needed with their finances, health care decisions, and elder transitions planning.
If you have questions about planning for a loved one with Alzheimer’s, please contact our law office to schedule a consultation.