When making care decisions for a family member who is showing signs of memory loss, dementia or Alzheimer’s, it’s vital to understand the stages that they may go through. By having a better understanding of the changes in behavior and abilities, you can choose the most effective course of action for your loved one’s treatment and care with the help of doctors and caregivers. Alzheimer’s and dementia place a heavy burden on family and friends. The Alzheimer’s Association states that, in 2017, 16.1 million family members and friends provided 18.4 billion hours of unpaid care to people with Alzheimer’s and other dementias, at a value of over $232 billion. Plus, the slow progression through the stages by the patient leads to long-term care duties for the unpaid Alzheimer’s and dementia caregivers. The Alzheimer’s Association says that 86 percent have provided care for at least the past year, and half have been providing care for four or more years. Depending on the severity of the memory loss of the senior, families often seek help from home care services, ranging from a little respite care to 24-hour home care assistance. The following stages are based on the Reisberg Scale, developed by Dr. Barry Reisberg of New York University. Ultimately, the stage of dementia will be determined by a doctor through the use of tests and examinations. To help make the phases more relatable, we’ll outline some real-world scenarios to go with the more clinical definitions. Stage 1: Normal/No ImpairmentThere are no outward signs of memory loss or dementia, and your loved one’s behavior and mood have not changed. “Laura is still keeping a full calendar, from volunteering at the local hospital to meeting her friends for lunch a few times a week. She’s sharp as a tack, too. She’s started working on digital photography courses and picked it right up.” Stage 2: Very Mild/Normal Aged ForgetfulnessThe second stage of dementia is mostly one that the person subjectively notices happening to themselves. Typical examples would be someone thinking they don’t remember names as well as they used to, or temporarily forgetting where their keys are more often. If someone seems to be in stage 2, some studies have shown that they may progress more rapidly through the following stages. “Paul feels that he’s more forgetful when it comes to places and names, but that it’s not affecting him at work. He’s getting older, so it’s probably just typical stuff for someone his age.” Stage 3: Mild Cognitive ImpairmentIn this stage, changes begin to be noticeable by friends and family. The person can probably get through their daily routine, but a range of symptoms can be observed. There can be higher levels of forgetfulness and memory loss, including more repetitive questions from the person. More complex activities that involve planning and organizations can become challenging, which can be particularly worrisome when it comes to staying on top of medications. There can also be a loss of concentration, higher levels of anxiety, and overall confusion. Stage 3 is where initial Alzheimer’s testing typically occurs, so be sure to encourage family members to be tested. “Jackie is starting to worry me because she’s still trying to do everything she’s used to doing, but she has trouble with her memory. I can also tell that she gets frustrated when she notices it happening.” Stage 4: Moderate DementiaFor people in this stage, tasks like cooking, shopping and cleaning are very hard to accomplish without assistance. Issues with memory loss and forgetfulness intensify and should be very apparent to casual acquaintances. Proper speech and “finding the right words” can be a challenge as well. There can also be noticeable psychological changes, most often seen in withdrawal from social situations. Usually, this is a state of denial where the subject knows their mental facilities are in decline but don’t want to admit it, even to themselves. Rather than engage in a conversation and forget a name, or try to order from a menu and misspeak, they will avoid the situation. This stage is also named mild Alzheimer’s disease, and diagnoses in this stage are often very accurate. “I’m glad Les has his family close by because he’s been in decline the last few months. It has to be hard on them to assist in more and more activities, especially as he seems to be more and more withdrawn.” Stage 5: Moderately Severe DementiaWhen a person enters this stage of dementia, they typically need frequent assistance to make it through their daily activities. There is often an inability to recall necessary, deeply ingrained information, such as phone numbers, home address, or schools attended. Someone in stage 5 would have great difficulty living an independent life. They may need living assistance in a variety of areas, from picking the proper clothes for the weather to eating regular, healthy meals to handling basic tasks like paying a bill. “When I saw Mari the other day, she was wearing short sleeves even though it was 40 degrees outside. I’ve also noticed her not being able to recall her home address, which makes me glad she has someone coming to provide in-home care every day.” Stage 6: Severe DementiaIn stage 6, having full-time care is a must for most patients. They often need help to dress, bathe or use the bathroom. Things that seem as simple as flushing the toilet will be forgotten, leading to cleanliness and sanitary issues within the house. The memory loss can also manifest itself in the person wandering or getting lost and forgetting the names of family members. A breakdown of speaking ability can often occur later in this stage, making it harder for family members and home caregivers to meet the needs of the person. Emotional and behavioral changes can be quite troubling in this stage as well, as those who have severe dementia can be increasingly paranoid and hostile. “John’s family seemed very distraught when discussing his current condition with me. They’re so worried about his behavior that they’re cutting back on visits from friends to see him. Plus, he’s at a stage where things that would be very embarrassing are routinely happening, and they want to protect people’s good memories of him.” Stage 7: Very Severe DementiaStage 7 is the final stage of dementia and patients require full-time care. Moving, eating, talking can be nearly impossible for some people, so even trained professional caregivers can find themselves taxed by the needs of the patient. Symptoms of this stage often include a loss of the ability to speak and communicate, a loss of awareness for people and surroundings, and the failure of motor control, which can lead to an inability to control facial expressions. “It’s troubling to visit Doris these days as there isn’t much of her personality or even physical state left that you would recognize. Thankfully, she has very patient and caring people looking after her who are trying to make her final days as good as they can be.” ConclusionIf you can identify symptoms from any of the stages outlined above in your loved ones, please reach out to their primary caregiver to begin the process of testing. Early detection can be instrumental in managing the progression of the disease and also give you time to plan the approach to caregiving that is right for your family, whether it’s assisted living, friends and family, or in-home care by HHAs and CNAs. About Visiting Angels Newton/Canton Visiting Angels Newton/Canton MA is an award-winning local home care agency providing high caliber in-home care services to elderly and people with disabilities. Countless families have benefited from our dementia home care, Alzheimer’s care, companion care, respite support, transitional aid, and senior home care services in Needham, Dedham, Brookline, Chestnut Hill, Wellesley, Newton, Canton, Westwood, Watertown, Natick, Stoughton, Roslindale, Norwood, and nearby towns. While non-medical in nature, the care provided by Visiting Angels Newton/Canton can make a significant impact on your loved one’s happiness and quality of life.
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As we grow older, our minds and bodies tend to age at different rates. Some of us slow down physically years before we lose any of our mental quickness. Others stay active well into old age but start to lose their memory earlier. The distinction between physical and cognitive aging can be an issue for friends and family of older adults. Because of this, recognizing and assessing physical and cognitive abilities is crucial in professional home health care. How we distinguish between physical and mental aging has a significant effect on the way we treat our older loved ones. If we confuse symptoms of physical decline as signs of cognitive aging (or vice versa), we can inflict much unintentional damage. On the one hand, we might underestimate our loved ones’ abilities, treating them as less-than-capable adults. On the other, we might miss symptoms of a serious problem, like early-stage Alzheimer’s. An understanding of this distinction is equally vital for senior home care providers. Caregivers who don’t fully understand the difference between physical and mental decline are liable to provide their clients with substandard care. Meanwhile, caregivers who recognize the difference between aging bodies and aging minds can personalize care according to their clients’ needs. Knowledgeable caregivers can also serve as a resource for families, providing advice and guidance about age-related concerns and challenges. This way, families are less likely to confuse signs of physical and cognitive decline, making it easier to care for their loved one. |
AuthorVisiting Angels Newton/Canton is an award-winning in-home care agency that provides high quality home care to seniors and disabled adults in Greater Boston, MA. Archives
July 2022
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