the experience: stages of alzheimer's
People with Alzheimer’s and their families are more involved in care decisions than ever before. Today, there is a new view that there can be a quality life after diagnosis, especially for those diagnosed in the early stage. Many people with Alzheimer’s want to know how they can slow the progression of the disease and make the most of their time with loved ones.
The day-to-day progression of symptoms for someone with Alzheimer’s disease is far from predictable. Someone who forgets how to use the microwave one day might have no symptoms the next. Every time a brain function is lost, the mind tries to compensate. When Alzheimer's attacks one synapse, the brain tries to use another, but eventually, the disease takes away all possible detours.
Rather than focusing on what is lost, many caregivers have learned to focus on the abiding qualities of the person with Alzheimer’s—the here and now.
How Alzheimer’s progresses in each stage
Early StageUnderstand and carry on conversation.
Plan common tasks like dinner.
Navigate through familiar surroundings without help.
Recognize familiar people and places.
Hold information in head long enough to reason and rationalize.
Explain away strange behaviors.
Read and write.
At the time of diagnosis, your doctor should talk with you about staging—a determination of if the disease is in the early, middle or late stage.
Staging has several benefits including offering doctors and families a baseline—helping doctors choose which drugs might offer the best treatment option and giving families a sense of what to expect as the disease progresses over months or years.
In this stage, the brain seems to function more slowly. There may be changes in eating habits and difficulties with handling money. For caregivers and families, there may be issues of guilt, frustration and anger—even exhaustion. Support groups may be helpful for those with Alzheimer’s and their caregivers.
Middle StageRemember things that happened long ago.
Recognize people from early in life.
Recognize own face.
Understand short phrases.
Read and understand singular words.
Make simple interpretations of sensory experience.
Mimic simple actions.
Walk and move without difficulty.
Make simple yes/no, either/or decisions.
It’s rarely clear when someone passes from the early stage into the middle stage of Alzheimer’s. There are usually behavioral changes, loss of sense of time and place, and noticeable changes in sleep patterns in the middle stages of Alzheimer’s. They may have a lower tolerance to stress.
A caregiver’s responsibilities will change in this stage as well. There may be issues with wandering and lack of normal sleep patterns to deal with. There will be challenges for caregivers—and there is also an opportunity for positive change and growth through the struggles.
Today, family and friends are learning to accept the realities of the disease and recognize that often there isn’t anything really “to do,” but to be present.
Interpret and use basic body language.
Enjoy sounds, tastes, smells, sights and touch.
In this stage, the person’s abilities decline significantly and nursing home care may be necessary. People in the late stage of Alzheimer’s are not able to make decisions on their own. Often, the person with Alzheimer's is in a nursing home. There may be a focus on palliative care in the late stage of Alzheimer’s.