Alzheimer’s is a disease that progressively affects one’s memory, mind, and behavior. While some forgetfulness and behavioral changes are to be expected during aging, Alzheimer’s is not a normal part of the aging process. It is a disease that gradually degenerates brain cells, causing confusion, memory loss, and dementia.
Symptoms typically begin after the age of 65, although in rare cases of early-onset Alzheimer’s symptoms can appear earlier. The disease is currently not curable, but there are medications that can alleviate symptoms temporarily.
Understanding the Difference Between Alzheimer's and Dementia
When a loved one is diagnosed with Alzheimer’s or dementia, many people struggle to understand their condition. But it’s natural to want to know what our friends or family members are going through.
People tend to think that Alzheimer’s and dementia are interchangeable. The truth is they are not the same thing. Dementia is not a specific disease. It is actually a group of symptoms that affect mental and social abilities. It often is caused by conditions or changes in the brain.
Alzheimer’s is a disease and the most common form of dementia. It is a condition in which nerve cells in the brain die making it hard for the brain to transmit signals properly.
Stages of Progression
The seven stages of the Global Deterioration Scale are used to assess Alzheimer’s symptoms in patients. However, each person is different and may show different signs at different times.
Select a stage to learn about symptoms, what to expect, and helpful tips.
Home and Environment
A calm, quiet living space may reduce agitation and delusions, and make your loved one feel more secure. Especially in the mid and late stages, try to limit activities that could cause your loved one confusion, like traveling or having unfamiliar houseguests. Even seemingly harmless stimuli, like bright lights or the sound of a television, can be stressful and disorienting for someone with Alzheimer’s.
You’ll also want to make sure your home is safe. That means locking away cleaning chemicals, removing knobs from your stove so that it can’t be turned on and installing extra locks near the tops or bottoms of doors so that your loved one can’t wander away. These are just a few of many safety measures you can take to Alz-proof your home.
Exercise and Activity
Staying active is important for those with Alzheimer’s, no matter what stage they’re in. Studies show that staying active can improve mood, increase self-esteem, and even slow mental decline throughout the early stages of Alzheimer’s. It can also help avoid falls and make it easier for your loved one to carry out daily tasks like getting dressed.
Depending on your loved one’s abilities, they may be able to take a daily stroll with you or work in the garden. During the later stages when mobility is limited, a physical therapist or doctor can show you some gentle, short range motions that can ease stiffening muscles and joints.
Learn the Lingo: Understanding Terms, Acronyms and Phrases
Recognizing the symptoms, stages and signs.
The seven stages of the Global Deterioration Scale are used to assess Alzheimer’s symptoms in patients. Identifying which stage your loved one may be in can help you navigate the best care path for them.
Stage 1 - Shows no symptoms
During the pre-clinical stage of Alzheimer’s, there are no apparent signs of the disease. You may only know about your loved one’s risk for Alzheimer’s from family history, and they are still fully independent and functional.
TIPS: While symptoms may not be present, it’s still important to be screened for Alzheimer’s if the disease runs in your family. The sooner the disease is caught, the sooner it can be treated and potentially slowed with medical treatment.
Stage 2 - Slight Memory Loss
The forgetfulness that occurs during the second stage of Alzheimer’s can be easily overlooked. Your loved one is still functioning well at home and work, and may simply appear to have the normal memory loss that comes with age — forgetting where they put something or having trouble recalling names or words.
TIPS: The main difference between normal memory loss and Alzheimer’s is the rate at which the memory loss worsens. Keep an eye out for any decrease in memory. It’s important to be screened by a physician early and often for Alzheimer’s, even if you’re unsure whether your loved one is exhibiting symptoms. The sooner the disease is diagnosed, the sooner you can start planning for the future. Sometimes, depression and other mental health issues have similar symptoms to the early stages of Alzheimer’s — yet another reason it’s important to get a professional diagnosis
Stage 3 - Mild Cognitive Impairment
While your loved one will still be able to live independently and even work during this stage of Alzheimer’s, this is often the stage when family and friends suspect that something may be wrong. Your loved one will still recognize his or her surroundings and family, but has a harder time recalling names, words or directions. Their behavior might change, making them more irritable or more likely to act out inappropriately in social settings. This stage tends to last for about seven years.
TIPS: While symptoms are increasingly noticeable to family and friends, it’s common for those with Alzheimer’s to be in denial during this stage. They may be resistant to visiting a doctor for screening, but it’s important to have your loved one tested as soon as possible. It’s never too early to plan ahead for Alzheimer’s. Even if symptoms are not yet severe, now is the time to begin thinking about safety, living arrangements, finances, legal paperwork, and other future concerns. Talking to a friend, family member, or neighbor who has cared for someone with Alzheimer’s can help you prepare for what’s next. You can also join a support group.
Stage 4 - Mild Dementia
Stage four of Alzheimer’s marks a big shift in memory and behavior. Your loved one will have difficulty doing more complex daily tasks and may avoid complicated activities such as paying bills or going new places. It’s also during this stage that their personality will begin to change, as they become more withdrawn and their emotional responses dampen.
Safety concerns also become more serious during this stage. Everyday tasks like walking down stairs or cooking are no longer safe. Wandering out of the home and getting lost are also serious issues, which means your loved one will need more careful monitoring.
TIPS: Start planning for long-term care. If you are currently acting as a live-in caretaker, consider whether this is the best long-term option, or whether a memory-care living facility will be the most comfortable option for you and your loved one. Look into your loved one’s financial situation. They may have bills they have forgotten or payments they’ve avoided because of their memory loss.
Stage 5 - Severe Decline
At this stage, your loved one will need help with daily life, whether through assisted living or moving in with a family member. They will still be able to use the restroom and eat without assistance, but may need help choosing the right clothes for the weather and completing other tasks. They will likely be confused about the date, season, or year, but generally remember major facts about themselves, their children, and spouse, including names and faces. However, they have difficulty remembering other crucial details of their current life, such as their phone number, address, or the names of their grandchildren.
TIPS: Don’t forget to care for yourself. Going through Alzheimer’s is extremely difficult not only for your loved one, but also for yourself as a caretaker, friend, or family member. If you haven’t already, it may be helpful to find a support group or seek professional help to guide you through the transition.
Stage 6 - Severe Alzheimer's
This stage is especially difficult for caretakers and requires a lot of support. At this point, your loved one usually remembers their own name, but may only have some hazy memories of their past. They often forget the names and faces of those around them — even spouses or loved ones who provide daily care. This may cause them to accuse their caretakers of being impostors. Other delusions may occur, such as seeing or talk to imaginary figures, which may lead to extreme anxiety and even violent behavior.
TIPS: Keep a regular schedule. Having a routine can help reduce anxiety, nervousness, and delusions for your loved one. Change the subject. If your loved one gets stuck in a repetitive motion or conversation, or if they’re beginning to have a delusion, gently try to distract them by switching topics. Keep things simple and calm. The best way to communicate is by staying calm and avoiding lengthy explanations or complicated ideas that may confuse them.
Stage 7 - Loss of Function
The final stage of Alzheimer’s means a complete loss of motor and verbal skills. Most often, those with Alzheimer’s are no longer able to speak at this stage, except for the occasional random phrase. The brain is no longer able to tell the body what to do, causing incontinence and the loss of basic motor skills such as the ability to walk or eat.
TIPS: Keep in mind that late-stage care is extensive and may be more than you can provide at home, even with help. Consider finding a residence for your loved one so that they can get the help they need. Monitor weight, as well as food and liquid intake. Because it’s difficult for them to eat and drink independently, malnutrition and dehydration are common at this stage. Keep an eye out for symptoms of pneumonia. It’s a common illness during the late stages of Alzheimer’s.