Stage 7 Alzheimer’s Disease – Caregiver Response

April 3, 2008 by  
Filed under ALZHEIMER'S

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I have been sort of avoiding writing this post.  As I have described each stage of Alzheimer’s disease, I can remember my mother and how she declined through the stages.  I can remember the anxiety and fear that each stage brought (for me).  I can remember feeling sick in my gut as I realized that she was coming to the end.  I recall wondering, how will it actually happen?  How long does this stage last?  How will she actually die and more importantly, how will I possibly live without my favorite girl in the whole wide world.  Well, that answer is for another post at another time, but for now, I have to talk with you about stage seven, the final stage of Alzheimer’s disease.  I have to tell you what will happen while your loved one still lives.  To say that stage seven is difficult is like saying that gas prices are a little high, it’s a gross understatement.

Stage 7

Your loved one won’t do much wandering in this stage because, in the early part of this stage, she won’t be able to walk without assistance.  As time goes on, she won’t be able to walk at all.  Then she’ll lose the ability to sit without support.  She may not be able to hold her head up.  As these changes occur, you’ll notice that there is very little interaction with the outside world.  She will have gone from inappropriate responses to the world around her to no responses at all.  The muscles may get rigid and the reflexes are not working properly.  As this occurs, grandma may not smile anymore.  Her facial expression is blank for the most part.   Swallowing becomes very difficult, there may be lots of drooling and if there is speech, it’s unintelligible.  By this time, your loved one is experiencing urinary and fecal incontinence and is totally dependent on someone else for care.

Caregiver Response

Totally dependent.  Let those words sink in.  At this stage of the battle against Alzheimer’s disease, your loved one needs complete, round the clock care for everything.  If it happens to or for your loved one, it’s because you or someone else is doing it.  Let me be clear here.  You or your designee will be responsible for feeding, bathing, dressing, diaper changes and grooming.  Your loved one has officially gone from your parent, grandparent, aunt, uncle to your baby and it’s painful.  So, take time to grieve the loss that is occurring. 

If your loved one is still at home, you might be considering a long term care facility.  On the other hand, you might be digging in thinking, “I’ve made it this long, and I’m seeing it through to the end.”  Don’t dig in your heels, “just because.”  Remember, you are in a position of trust and honor.  So, do what is BEST for all involved.  Maybe that’s keeping grandma at home, maybe it isn’t.  Just be willing to consider your options.  There is value in transferring the day to day work of caregiving to someone else, so that you can spend your time just being there with your loved one.  It may seem as if he or she has not a clue what is going on, but who knows for sure?

Think about the hard question. If grandma has a heart attack or needs surgery for a blood clot or something of the sort, what are you going to do?  Is there an advance directive in place?  What about a Do Not Resuscitate (DNR) order?  If not, you will more than likely have to determine how much care and intervention you want to do in case of a medical emergency.  I would not DARE tell you what to do; I will say that it’s better to consider your options before you have to make such a decision.

Finally, TOUCH your loved one. She may not be able to understand your words. He may not know who you are, but many people are comforted by a gentle and loving touch. Brush her hair, or give her a back rub.  Stroke his forehead or hold his hand.  Remember the good times and enjoy the time you have now.

Tomorrow:  Caregiver’s Corner!

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6 Responses to “Stage 7 Alzheimer’s Disease – Caregiver Response”
  1. Hiya, I am really glad I have found this information. Today bloggers publish just about gossips and internet and this is really annoying. A good web site with interesting content, that is what I need. Thanks for keeping this web-site, I’ll be visiting it. Do you do newsletters? Can’t find it.

  2. Tony says:

    Thank you everyone for your posts, it is helping put things in to perspective. My family is going through the final stages of Alzheimer’s with my Grandmother, and unfortunately we’re getting close to the end. My Grandmother’s battle began more than seven years ago and to see that once sharp and able women lying in that bed it breaks my heart every time.
    At this time we have began to deal with the feeding tube dilemma; and from what I’m finding is quite the sensitive (and common) topic when it comes to this stage. Fortunately my grandmother left a very detailed directive of what her final wishes were in regards to these types of situation. In the directive she left she opted for no artificial means of life support. So in other words she let everybody know what she wanted even outside of the directive of what she wanted as her final wishes. I’m not saying that this is easy by no means, but my Grandmother is one of those “old-school” types that basically thought out her each and every move, and obviously right to the end.
    But after all that I have a few concerns that I would like to see if anyone could possibly shed light on for me; they are as followed:
    • Over the years I have felt that in a way I have said my goodbyes, in addition she doesn’t even know who I am, I seem to upset her when I go to see her. I’m not upset about the matter, but understand that this is just part of the illness.
    • Second, the family stress; how do we deal with this? My biggest fear is that my Grandfather’s health is not the best either, and for some reason the older he gets the more sensitive he gets. I cannot begin to understand what he’s going through; to my dismay I can only glaringly watch from the outside.
    • Is it possible to have no sense of regret, because I know that she had the best care that she could have possibly received? Is it morally wrong to think like this? My Grandmother was one of the most intimidating persons in the world, but I couldn’t have asked for anything better; she is my “Memo” and will always be. She will be missed, but the suffering is just too much.

  3. christy says:

    thank you so much for your post. my father is in the last stage and in the hospital through the weekend when he will return to the nursing home. your post is inspirational. thank you.

  4. Nancy, thanks so much for sharing. Isn’t it amazing how we go from holding on and not wanting to lose our loved ones to realizing that death might be a blessing? Do you have other siblings or family members who are sharing in the care? Nancy, stop by and sound off anytime. This site is for people just like you. You and your sister will be in my thoughts and prayers. Loretta

  5. Nancy says:

    My sister who is 66 yrs. old is in her last stages of alzheimers. It was decided without my knowledge that the nursing home she was in no longer wanted her – she had taken quite ill – so the nursing home didn’t get enough money to care for her. She is in a swing bed at the hospital & getting the care she needs. She’s suffered strokes, seizures & heart attack in March. Has a feeding tube in her stomach, nothing by mouth ever as she aspirates even the feedings she gets now.
    I talk , read & TOUCH is the most important.
    Death would be a blessing, but, God must not need her up there yet.
    thanks for the sound off.

  6. Once again another post that hits home.

    Touch is very important in this stage you are so right. We also found that although my fiance’s grandmother was non-communicative, she still had a sense of what was going on around her. Being a strong believer in her religion her entire life, it was something we quickly realized she still had,right up until the day she passed.

    We found that reading passages to her from her Bible often elicited a response of some kind. Not necessarily verbal, but a hand squeeze, a smile – just something. I often was the one reading these passages and while I had people telling me it did nothing – I disagree completely. If I had trouble with a word and stumbled on it, when I finally pronounced it right was often when these types of responses would occur.

    Whether she did understand or not, we’ll never know, but as Linda says, don’t underestimate the power of touch, or the sound of a friendly voice.

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