The Three Stages Of Alzheimer's

By Christine Gorman

Do you know someone with Alzheimer's? Until science comes up with better treatments, the best you can do is recognize its stages and give appropriate support and care. Not every patient exhibits the same symptoms, and the stages tend to overlap. But it helps to know the hallmarks of the disease and to have a plan for dealing with each stage before it arrives.

Stage 1: Mild From two to four years

SYMPTOMS

--Increased forgetfulness that interferes with ability to hold job or complete household tasks

--Forgets names for simple things like bread or butter

--Has trouble recognizing what numbers mean

--Loses initiative and interest in favorite activities or hobbies

--Decreased judgment that leads to, for example, wearing a bathrobe to the park

WHAT CAREGIVERS CAN DO

--Make sure you have the right diagnosis. Many conditions can affect memory

--Avoid correcting confused or faulty memories

--Create a simple "orientation area" at home in which you keep essential items like keys, glasses, clock and calendar

--Encourage the patient to keep in touch with friends, listen to music, exercise

--Monitor driving habits

--Plan for the future; decide when financial responsibilities should be turned over; set treatment options; designate a health-care proxy

--Register with Safe Return, a program for reuniting lost or wandering Alzheimer's patients

Stage 2: Moderate From two to eight years

SYMPTOMS

--Unable to recognize close friends and family

--Wanders about, gets lost

--Increased confusion, anxiety and personality changes

--Forgets how to complete common daily tasks like getting dressed or brushing teeth

--Delusions

--Insomnia

WHAT CAREGIVERS CAN DO

--Label drawers, closets, rooms and appliances as well as photos of family, friends and pets

--Maintain familiar surroundings

--Make sure hallways and bathrooms are well lighted at night. Install support rails and slip-proof surfaces in bath. Label hot- and cold-water faucets

--Take away car keys

--Install door locks from the outside, or rig doors with alarms

--Lay out articles of clothing one at a time

--Brush your teeth at the same time to show how it's done

--Start looking into residential care facilities, if that's what you want

Stage 3: Severe From one to three years

SYMPTOMS

--Unable to remember anything or process new information. Can't recognize family

--Can't use or understand words but still responds to music, touch or eye contact

--Difficulty eating, swallowing

--Unable to dress, bathe or groom self; unable to control bladder and bowel function

--Bedridden

WHAT CAREGIVERS CAN DO

--Communicate often with patients who are institutionalized

--Try to communicate in a different way, through exchange of old photos or through music

--Minimize unnecessary blood tests and other painful procedures

--You may not want to treat medical problems such as pneumonia and hip fractures as aggressively as you would for a healthy person

--By Christine Gorman