If your loved one is showing early signs of Alzheimer’s disease, it’s common to feel worried and uncertain about the future. This is a disease that will impact every area of your loved one’s life and many areas of your life too. But understanding what’s to come and what to expect throughout each stage makes it easier to plan and prepare so you can help your loved one to maintain a higher quality of life.

The typical progression of Alzheimer’s disease is often broken down into three stages:

  • Early Stage Alzheimer’s
  • Mid-Stage Alzheimer’s
  • Late Stage Alzheimer’s

Let’s dissect these stages a little further and talk about what might be in your future.

Early Stage Alzheimer’s

What it Looks Like:

In the earliest stage of Alzheimer’s, signs of dementia are virtually undetectable. Your loved one might show no cognitive decline or only minor cognitive decline. This is often when a person’s forgetfulness is most likely to be associated with aging, or they simply think they are having temporary memory lapses.

Perhaps your loved one can’t remember where they put their car keys, or they experience some difficultly focusing or maintaining concentration. Performing ordinary household tasks can feel slightly more challenging as if they simply lack motivation. Perhaps bills will begin to pile up or the house will appear less tidy.

Expect a progressive decline through this initial stage of Alzheimer’s disease usually lasting between 2 and 4 years.

Things to Do During This Stage:

When memory lapses start to become more common, it’s a good idea to check in with your doctor. Early diagnosis of Alzheimer’s disease offers the best opportunity for effective treatments that might slow the rate of decline. Additionally, if these memory lapses are due to something other than dementia, certain diagnostic testing can help determine the root cause so you can get treatment fast.

Before diagnosis is also the ideal time to encourage your loved one to begin advanced care planning. Since this is the time when cognition is still completely or mostly intact, the senior is in a better place to make important decisions about their medical wishes and articulate goals related to aging in place or moving to a facility.

This is also a good time for your loved one to name a power of attorney and healthcare power of attorney, write a will and have important discussions with your family about any future estate planning if that hasn’t already been decided. If plans have long been in place, encourage your loved one to review them to ensure they are up to date and in line with their current wishes and goals.

Your Role as a Family Caregiver:

In this stage of dementia, your loved one will likely remain mostly independent with day-to-day tasks, household management and personal care. In some cases, offering minor support with managing bills or assisting with transportation is valuable, but it’s also important to recognize and respect your loved one’s desire to remain independent. This is also the ideal time to start having conversations about in home care or any future role you might take as a family caregiver should your loved one reach a point where they need more support. The sooner you start having these conversations, the better prepared you and your loved one will be in the future.

Mid-Stage Alzheimer’s

What it Looks Like:

This is widely viewed as the longest stage in the progression of Alzheimer’s disease and can last up to 10 years. It is when your loved one’s dementia symptoms become more pronounced. Tasks like paying bills or following a recipe are more difficult, but your loved one will still remember significant details about their life. You might notice increased frustration or anger.

Finding the right words is often challenging for the senior. They might begin to withdraw from social engagements or lose interest in a favorite hobby and even refuse to bathe or manage other personal care tasks. In day-to-day life, you might also notice your loved one forgetting what day it is or choosing clothing that is seasonally inappropriate. Denial about this forgetfulness is common, and your loved one might resist any offers for care or support.

Things to Do During this Stage:

In this stage, it’s important for you and your loved one to begin putting a plan in place to best meet their immediate and future care needs. This might include going back to those goals they set earlier and relying more on family caregivers or hiring a professional home caregiver. It’s also the time to reduce stress while maintaining the highest level of independence by simplifying daily tasks as much as possible. For instance, your aging loved one might outline a weekly menu of their food choices so you or a caregiver can then handle organizing a grocery list and shopping. Or a family member might organize a pill box, set out clothing for the senior or leave snacks and beverages in plain sight.

Maintaining communication with a medical professional is also important, so your loved one might need support in scheduling doctors appointments and arranging safe transportation to and from these appointments. Advances in Alzheimer’s research have made it easier for doctors to prescribe medications that can delay the onset of late stage dementia, but properly managing the type and dosage of these medications often involves careful observation of the senior’s current symptoms and rate / pace of decline.

Your Role as a Family Caregiver:

As a family caregiver, one of the most important things you can do throughout this stage of dementia is to continuously watch for any immediate safety needs. If your loved one can perform a task without risk, even if it takes longer or isn’t performed in the most ideal way, encourage them to maintain their independence. Prioritizing tasks and actions can help you and your loved one to avoid stress and simplify day-to-day life.

It’s also important to keep the conversation going about how and when you will provide support. Be honest with yourself and your loved one about their expectations and your abilities both physically and emotionally. There’s no shame in saying that a task is more than you can handle alone, and there’s always value in calling on a home care provider to manage more challenging tasks or provide respite time, whether you need help or simply need a break.

Late-Stage Alzheimer’s

What it Looks Like:

This is the final stage in the progression of Alzheimer’s disease often lasting from 1 to 3 years. At this stage, your loved one has likely lost their ability to speak or communicate. They cannot manage toileting needs, eating or bathing alone and may be bedbound. Around the clock supervision and support is often necessary. Seniors in late stage Alzheimer’s are often vulnerable to pneumonia, bed sores and infections because of their lack of mobility and a weakened immune system.

Things to Do During this Stage:

In this last stage of Alzheimer’s disease, your loved one’s care needs will be the most extensive. They often exceed what family members can provide at home without much more intensive support. Your loved one will not be able to communicate pain or express hunger or thirst, so it’s important to watch for signs of these things and recognize more subtle clues including:

  • Labored breathing
  • Tense facial expressions
  • Tight fists
  • Pulling away when someone comes near
  • Sallow skin color

As a concerned caregiver, it may be helpful to put the senior on a schedule for essential tasks like toileting and eating in addition to monitoring for signs of discomfort. Receiving proper instruction and education from a nurse or physical therapist can also help you to feel more confident and reassured. Depending on the senior’s earlier stated goals, this may be the time to move to a facility or seek out hospice care.

Your Role as a Family Caregiver:

During this final stage of Alzheimer’s disease, your primary role as a family caregiver is to preserve dignity and quality of life for your loved one. The senior almost certainly can’t talk or thoughtfully communicate. However, research shows that some core of the person you once knew likely remains. So, there’s value in letting them know you are there through touch or by playing a favorite song, stroking their hair, reading a book or poem out loud or simply sitting with them quietly and going through old photographs.

While you’re working to take care of the person you love, it’s also important to take care of yourself. Recognize what you can and can’t do as well as what you are and aren’t willing to do. If caring for your loved one is too much, accept support or discuss options such as hospice care with a medical professional. If you haven’t already done so, consider joining a support group or searching for a counselor to provide one-on-one therapy. Remember that stress and uncertainty can impact your physical wellbeing, so be sure you’re making time to see your doctor, taking any prescribed medications as directed and making a conscious effort to take breaks, eat healthy meals and exercise.

In Closing

Alzheimer’s is a progressive disease that worsens with time. While your loved one’s symptoms and the time they spend in each stage of the disease might vary from what is described here, there’s value in familiarizing yourself with each stage so you can prepare for what’s ahead and ease fears and uncertainties. This is a challenging road to walk alone, so don’t be afraid to ask for help and seek out support. Salus Homecare of San Gabriel Valley is here for you. Give us a call anytime, and we’ll work with you to figure this out together.