Stages

In general terms, Alzheimer’s can be broken down into three stages: Early Stage, Mid Stage and Late Stage.

Early Stage Alzheimer’s

The most common early symptom is trouble recalling something you just learned. In this early stage, you may also notice it’s a little harder to remember other things, make decisions, and find your way around new places. Other people may not notice your symptoms at first.

Friends, family or co-workers begin to notice difficulties. During a detailed medical interview, doctors may be able to detect problems in memory or concentration. Early stage difficulties include:

• Noticeable problems coming up with the right word or name
• Trouble remembering names when introduced to new people
• Having noticeably greater difficulty performing tasks in social or work settings Forgetting material that one has just read
• Losing or misplacing a valuable object
• Increasing trouble with planning or organizing

lf you haven’t already seen a doctor about symptoms like these, do it now. If it is Alzheimer’s, your doctor can prescribe medication to improve your memory and thinking. A careful medical interview should be able to detect clear-cut symptoms in several areas:

• Forgetfulness of recent events
• Impaired ability to perform challenging mental arithmetic — for example, counting backward from 100 by 7s
• Greater difficulty performing complex tasks, such as planning dinner for guests, paying bills or managing finances
• Forgetfulness about one’s own personal history
• Becoming moody or withdrawn, especially in socially or mentally challenging situations

Early Stage Alzheimer’s can last for years. You may be able to live on your own throughout, but you’ll need a good support system. Lean on your family and friends or get advice from your doctor or local Alzheimer’s groups on how to get help with shopping, meals, and getting out and about. This is also a good time for you to decide how you want to be cared for as the disease progresses.

Mid Stage Alzheimer’s

This is the longest stage of Alzheimer’s. It can last many years — it’s different from person to person. As your Alzheimer’s evolves, your memory will get worse. You’ll have more trouble with language and thinking clearly. You may:

• Not always know family and friends
• Lose track of the day of the week or where you are
• Forget details in your life, like your address, phone number, or where you went to high school or college
• Have trouble putting clothes on in the right order or picking the right clothes, and later bathing and using the toilet
• Jumble words
• Have poor judgment about your health, finances, or safety

Your personality may also change during this stage. You may:

• See or hear things that aren’t there
• Suspect people of lying, cheating, or stealing from you
• Be depressed or anxious
• Become angry or violent

When your Alzheimer’s is moderate, you’ll probably need to live with family or in a residential care setting, or have a trained caregiver in your home. You may need help to get dressed, take your medicines safely, and manage your finances. It may be unsafe for you to use the kitchen and be alone. Your doctor may change your current medication and suggest drug or non-drug ways to deal with personality changes.

Late Stage Alzheimer’s

In late-stage Alzheimer’s, you may no longer be aware of where you are or remember your life history. Your physical abilities are also affected, and you may not be able to carry out simple tasks. You may:

• Be unable to speak more than a half dozen words
• Need help walking and later be unable to sit up, smile, or hold up your head
• Have trouble controlling your bowels or bladder
• Wander and get lost
• Know familiar faces but have trouble remembering their names
• Have more personality changes
• Have habits like wringing your hands or shredding tissues

When Alzheimer’s is most severe, your brain seems unable to tell your body what to do. You may sit on the toilet, forgetting what to do there, or hold food in your mouth, not remembering how to swallow. As your body shuts down, you may spend most or all of your time in bed.

When your Alzheimer’s is severe, you will need a great deal of help with daily activities and personal care. In order to get the care you need, you may need to live in an Alzheimer’s care setting. Hospice care can keep you comfortable in the final months of the disease.

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