Alzheimer's disease a Mild Case (Mini-Series Part 2)
- Alzheimer's disease a Mild Case (Mini-Series Part 2) Enriched Life Home Care Services 19:03
Today, we are continuing with our Seven Stages of Alzheimer’s series. Last episode, we discussed what Alzheimer’s is and some of the common signs and symptoms, as well gave a brief overview of the seven stages. We went a little more in-depth with the first two stages and today we are going to be moving on to stage three.
But first, we’ll discuss how stages one through three are seen as the early or mild stage of Alzheimer’s and what mild Alzheimer’s can look like. After that, we’ll jump straight into talking about stage three Alzheimer’s – mild cognitive decline. Now let’s move on to the rest of the show.
There are a few different models of the progression of Alzheimer’s disease. The seven-stage model we are looking at in this series, the five-stage mode, which combines a few stages of the seven-stage model, and the three-stage model, which is what you may be most familiar with. The three-stage model shows the progression as being mild or early-stage, and then it goes on to the mid-stage, ending with late-stage dementia or Alzheimer’s.
When talking about the first three stages in the seven-stage model, what we are discussing today, it is easiest to relate them to the preclinical stage in the three-stage model. The preclinical stage is Alzheimer’s before it has been diagnosed, which is why it isn’t listed as a stage in the three-stage model. In the model we’re discussing today, a diagnosis usually happens during the third stage – mild cognitive decline, which triggers the transition to stage four – moderate cognitive decline. Now, this isn’t the case for every single person with Alzheimer’s. Not everyone is diagnosed this early. But, according to the National Institute on Aging, a new study has found that half of the people living with Alzheimer’s may have mild Alzheimer’s rather than moderate or severe cases. Researchers studied a sample of one thousand people and found that among people with Alzheimer’s disease, 50.4 percent had mild disease, 30.3 percent had moderate disease, and 19.3 percent had severe disease.
According to the Senior Link, the preclinical stage of Alzheimer’s makes up the first three stages of the seven-stage model of Alzheimer’s. During these stages, a person is not considered to have Alzheimer’s until they have an official diagnosis. During these early stages, many of the signs and symptoms of Alzheimer’s can easily be confused with signs of normal aging.
As we discussed last episode, there are no signs of the disease being displayed in stage one. There are changes happening in the brain, but nothing physically telling of the disease. A WebMD article explains that Alzheimer’s disease usually starts silently, with brain changes that begin years before anyone notices a problem. When your loved one is in this early phase, they won’t have any symptoms that you can spot. Only a PET scan, an imaging test that shows how the brain is working, can reveal whether they have Alzheimer’s.
The second stage, where some symptoms may start to appear, masks itself as normal aging, especially since most cases of Alzheimer’s happen in older adults. As we age, forgetfulness begins to become a part of our daily lives. Forgetfulness also happens to be one of the most noticeable symptoms of Alzheimer’s. Most of the time, a friend or family member may notice signs or symptoms during this stage before a person with Alzheimer’s does. WebMD also says that you still might not notice anything amiss in your loved one’s behavior, but they may start developing small signs or symptoms, things that even a doctor is unable to catch. This could include forgetting words or misplacing objects. At this stage, subtle symptoms of Alzheimer’s don’t interfere with their ability to work or live independently. It’s also important to keep in mind that these symptoms might not be Alzheimer’s at all, but simply normal changes from aging.
Stage three is usually where you can start noticing the signs and symptoms in a loved one with dementia. A neuroscience blog for Penn Medicine states that common difficulties in this stage go beyond forgetting names and misplacing objects. Your loved one may have trouble remembering recently read material, such as books or magazines, or they may find remembering plans or organizational tasks becoming increasingly difficult. They may also have more difficulty retrieving a name or word and experience challenges in social settings or at work.
This stage may bring about more Anxiety for your loved one, and some people may even deny that anything is wrong. If you or your loved one have noticed any of these signs or symptoms, you should schedule an appointment with their doctor. These feelings of anxiety are normal, but not talking to a physician will only allow symptoms to get worse. The best way to keep symptoms at bay is to talk to your loved one’s physician about treatment options, including medications, and care planning. Early detection is key for this disease, the earlier it is diagnosed, the longer you loved one will be able to maintain their independence and enjoy a fulfilling life.
Now that we’ve gone over the basics of the first three stages of Alzheimer’s, let’s take a closer look at the changes that happen between stages two and three.
Alzheimer’s News Today tells us that patients with Alzheimer’s disease experience a slow progressive decline in memory and cognitive ability, among other symptoms, due to the spread of damage in the brain. Between stages two and three, changes in a person’s abilities or behavior may only be minor. As a result, the symptoms may not be noticed as a sign of Alzheimer’s, and may not be noticeable to others, except those who are close to the patient, like family members and close friends, which we have already talked about today.
Alzheimer’s News Today also says that people with early-stage Alzheimer’s are mostly independent and can usually perform the same actions they could prior to the onset of the disease, such as driving, working, and engaging in social activities. At stage three and moving into stage four, however, they may need assistance with some of the more complicated tasks. The most common feature of mild Alzheimer’s is lapses in memory and concentration, making it more difficult to recall recent events and to learn new things.
Alzheimer’s affects everyone differently. WebMD says that the stages don’t always fall into neat boxes, and the symptoms might vary, but they can be a guide and help you plan for your loved one’s care. The symptoms your loved one may experience will differ from those that other people living with Alzheimer’s experience and some symptoms may not appear until the later stages of Alzheimer’s, or not at all. Once a symptom is evident, however, it tends to worsen with time. Although in some cases, some symptoms may disappear in later stages, such as irritability.
During stage three, the symptoms that your loved one were showing in stage two become more prominent and are more easily distinguishable between the signs of normal aging. WebMD states that there is no cure for Alzheimer’s disease, so it can help to know what to expect so you can plan to meet your loved one’s needs in each stage.
According to Senior Link, since there is no medical consensus for Alzheimer’s stages, as there is with something like Cancer, it is important for caregivers to be aware of the individual symptoms and situation that their patient or loved one is experiencing. While healthcare providers may refer to a patient’s condition as “late” or “early” stage, any specific stage is less important than the context and understanding of what this means for care going forward.
Senior Link also says that learning about the stage of Alzheimer’s disease that a loved one is experiencing helps provide perspective and context. This knowledge makes it easier to have conversations with doctors about the patient’s condition and how to approach future treatment options. Understanding the later stages of the disease also helps when planning for Lifestyle changes, new equipment, and other items that may be needed. One of the other major benefits in understanding the overall progression of Alzheimer’s disease is preparing for future living arrangements, such as a memory care community or professional home care, that could become a preferred option during later stages of the disease. Because the cost of dementia care is high, families should begin planning as soon as possible following a diagnosis.
The Alzheimer Society says that the early stage of Alzheimer’s disease, also referred to as “mild Alzheimer’s disease”, marks a beginning that will bring with it significant changes for your loved one and the people that care about them. They will likely retain many of their abilities and require minimal assistance during this third stage. They may have insight into their changing abilities and therefore, can inform others of their experience of living with the disease and help to plan and direct their future care.
They may also be feeling overwhelmed and apprehensive about the future. It is normal for both you and your loved one to have many mixed emotions including feelings of Grief and sadness. Many people are concerned about how the changes will affect them, how they will plan for the future, and how they will get the help and information that they need.
If you or your loved one are worried about how to handle some of the common symptoms of Alzheimer’s, the Alzheimer Society has a handy chart that you may find useful. We have a link to the document in our show notes if you would like to look at it yourself, but we’re going to be going over it here, as well.
If your loved one is experiencing some forgetfulness, try using labels, notes, calendars, alarms and timers, and pill dispensers to make their day easier. You can also create a memory station by the phone to post emergency numbers and people that they contact frequently.
Is your loved one having difficulty learning new things and following conversations? Try breaking tasks into smaller steps. Make sure you, and your loved one, acknowledge their limits. Knowing where to stop can be hard but setting boundaries ahead of time can save you time and frustration later. When visiting with groups, try to keep the size of the group as small as possible. The larger the group, the more confusing it can be for someone with Alzheimer’s to follow the conversation. Have a conversation with your loved one to understand what they need in order to participate in conversations. They may need to take more frequent breaks or rests or need to write things down to follow a conversation. Having this conversation with your loved one can make sure they have all the tools they need to participate in and enjoy a conversation and keep up with their social life.
Your loved one may have difficulty concentrating or have a limited attention span. Try picking activities that are manageable by them and do only one thing at a time. Listening to audio books or music or watching movies can also help them practice concentrating. Make sure they have the option to take breaks and be careful to avoid overstimulation. Following a daily routine can also help your loved one concentrate on tasks better.
Many people with Alzheimer’s develop problems with orientation, getting lost, and following directions. If this happens to your loved one, you can schedule rides with family and friends or call for a cab. When the time comes, make sure to have a conversation with your loved one about their ability to drive. During the early stages of Alzheimer’s, many people are still able to drive, but everyone is different. If it is unsafe for them or others on the road, your loved one should not be driving.
Communication difficulties are something many with Alzheimer’s face. Make sure that your loved one has enough time to talk or think through their answer. Inform friends and family that your loved one may be slower to respond, but to make sure to not try to fill in the silence between their responses. Go with your loved one to their appointments or make sure someone else is able to go with them if you are unable to make it. Your loved one may need someone there to help communicate for them and add much needed Clarity that they may not be able to do themselves.
If your loved one is currently working, they will want to have a plan for when they have difficulty handling problems at work. It’s important that they are realistic about their abilities and that they don’t try to push themselves too hard. When necessary, they should also talk to their manager about reducing their hours or finding new tasks and opportunities. The part that they will need your help with the most is planning for a time when they will not be able to work. You can help them determine at what point they will step away and make a financial plan for that time, as well.
You loved one may experience mild coordination problems at times. You will want to make sure that they have safe and secure handrails and grab bars available. You should also make sure that their living space is free from items that may cause tripping hazards, like rugs. Brighter lighting can also help them to see better and make it easier, and safer, for them to get around.
If your loved one has an impaired ability to perform challenging cognitive tasks, again, discuss their abilities and limitations with them. Help them with tasks but try not to do the tasks for them. If they do a task, but it isn’t done quite how you think it should be done, don’t correct them, unless it could be dangerous or unsafe for them or someone else. If they don’t want to do tasks or get frustrated easily, focus on tasks you know they can manage and enjoy. Completing a task successfully can increase their self-esteem and help improve their mood.
We’ve already talked about mood shifts, Depression, passiveness, and withdrawing from social situations and hobbies in previous episodes so we are not going to be going over these strategies, but you can see what the Alzheimer’s Society suggests by finding their link in our show notes.
Now that you’ve heard some strategies that you may find useful during stage three and beyond, we’re going to hear from people that have been diagnosed with Alzheimer’s and what they want you, as a caregiver, family member, or friend, to know.
One person, in regards to having a conversation and getting details of a memory wrong, says please don’t correct me. I know better – the information just isn’t available to me at that moment. Another says remember, my feelings are intact and get hurt easily. A third says try to ignore off-hand remarks that I wouldn’t have made in the past. If you focus on it, it won’t prevent it from happening again. It just makes me feel worse.
You may find that your loved one says the wrong word when referring to an item. For example, they may call a watch a hand clock. Another person with Alzheimer’s says I usually know when the wrong word comes out and I’m as surprised as you are.
I need people to speak a little slower on the telephone, one says. While another says speak to me clearly, one thought at a time; don’t ask a question when you can provide a statement.
Some people become confused at times. One person that experiences times of confusion says I may say something that is real to me but may not be factual. I am not lying, even if the information is not correct. Don’t argue; it won’t solve anything.
In group settings, someone with Alzheimer’s recommends that you please keep an eye on me because I can get lost easily! But please don’t shadow my every move. Use gentle respect to guide me. Another person says that if you can anticipate that I am getting into difficulty, please don’t draw attention to it, but try to carefully help me through it so nobody else will be aware of the problem.
When talking with your loved one with Alzheimer’s, there are many times where you can both accidentally offend or hurt the other’s feelings. One person living with Alzheimer’s says sometimes you give me the message that you think I am faking these problems. What you don’t see is my terrible confusion and my hurt knowing how you feel. Another person says I don’t mean to frustrate you. I know you get impatient and tired of telling me things, three times in a row. Please be patient.
People with Alzheimer’s also say they want you to ask them what they think or want. Don’t assume that you know and ask them in a straightforward language when you have their attention.
The most important quote we found is believe I still love you, even if I am having trouble showing it. You loved one is going through a lot of changes and struggles, and the change in dynamics of your relationship with them may be confusing, but they still love you, even if it becomes harder for them to tell or show you.
The Alzheimer’s Society says that despite your best efforts, caring for someone with dementia becomes harder as the disease moves on, and the person you are caring for becomes more dependent on you. This is a time when many family members need more support for themselves. Our goal is to be a place of support for you during this difficult time. We hope that this episode has helped you learn more about the third stage of Alzheimer’s and how you can support your loved one with Alzheimer’s through this stage of mild cognitive decline and into the next four stages.
If you would like to learn more about Alzheimer’s and how you can prepare now to support yourself or a loved one later, check out our website for resources. You can also visit your local senior center or the Alzheimer’s Association to see what help is available in your area. You can also check out our Alzheimer’s and Dementia playlist on YouTube for a complete list of all the episodes we have done on this topic.
We want to say thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate these long-term care issues. Please visit us at allhomecarematters.com there is a private secure fillable form there where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone who could benefit from this episode, please share it with them.
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Sources:
https://www.nia.nih.gov/news/half-alzheimers-disease-cases-may-be-mild
https://www.seniorlink.com/blog/the-7-stages-of-alzheimers
https://www.webmd.com/alzheimers/guide/alzheimers-disease-stages
https://www.pennmedicine.org/updates/blogs/neuroscience-blog/2019/november/stages-of-alzheimers
https://alzheimer.ca/sites/default/files/documents/progression_early-stage-3.pdf
