Stage 6 Alzheimer’s Disease-Caregiver Response

April 2, 2008 by  
Filed under ALZHEIMER'S

I started talking about the stages of Alzheimer’s disease on Last Thursday. In that post, I covered stages one and two, on Monday, I talked about stages three and four.  On Tuesday, I covered stage five. That means we are up to stage 6.  Before I get into the details, I want to say again, in case you are just tuning in, that there is a plethora of information on the stages of Alzheimer’s disease.  Most organizations, websites and blogs that talk about Alzheimer’s have sections on the stages of the disease.  It is my intent not just to give you information on the stages; but to help you to prepare by suggesting ways that you, as a caregiver, should respond to the particular stage your loved one is currently facing.

Stage 6

If you haven’t gotten really down in the dumps as yet, you probably will at this stage in the battle against Alzheimer’s disease.  I don’t mean to be negative or insensitive.  It is just very difficult to watch your loved one slip away, while his or her body is still in tact.  I mean, if grandpa has his leg amputated, it’s a horrible thing, but he is still grandpa, just without a leg.  By this stage of Alzheimer’s disease though, in addition to very significant memory loss, personality changes may also occur.  If grandpa was stubborn and set in his ways before, you may have to become very creative to get him to cooperate at this stage.  Kathy from notes, “We have a chalkboard that I write the day and date on for my dad, and when I need to change the schedule, I just change the date. Yesterday, I put out last Tuesday’s paper and wrote last Tuesday’s date on the board. Viola! Haircut on Monday – Victory!”

Your loved one may experience delusions, hallucinations, become very suspicious and engage in repetitive behaviors such as picking at lint on a sweater or tearing paper.  His sleep pattern may be way out of whack.  He’ll want to sleep during the day and wander throughout the night.  He’ll need assistance getting dressed and undressed and probably won’t be able to handle the individual tasks of going into the bathroom, using it, cleaning himself, disposing of the paper, flushing the toilet and washing his hands.  He’ll start to become incontinent and may even forget the name of his spouse, children or primary caregiver. He may eat more slowly and communicate less or speak gibberish at times.

Caregiver Response

You are now looking at ‘round the clock care.  Your loved one will certainly hurt himself or wander away if he is left unattended.  It is not wise to attempt to do this alone.  If you have not solicited help you really need to rally the friends and family, an outside agency, even some strangers! Do what you need to do, but get some help.  It will take more time to dress and care for grandpa, you might even have to feed him at times and if he is still going to the bathroom on his own, you will certainly have to provide reminders and some help with the process as well.  Someone other than grandpa will be completely responsible for his cleanliness, grooming, getting up, daily activities, eating and going to bed. At this stage, grandpa will not be able to do any of these tasks on his own.

You’ll begin to grieve even more. You have been all along, but it will be more pronounced as the days progress and you become the “adult” while your loved one becomes the child.  Get in a support group.  It will help to be able to talk about what you are experiencing with people who understand.  It is often around this time that families start thinking seriously (and painfully) of placing their loved ones in long-term care facilities.  It’s a very personal and difficult decision that should be weighed carefully.  If you allow yourself to feel, you’ll have bouts of seemingly unexplained sadness.  It’s natural.  You are losing someone you love and it’s becoming more and more obvious.

May I offer you a virtual “Penny for your thoughts?” Please share here or feel free to drop me private note

Tomorrow, Stage 7

Stage 5 Alzheimer’s Disease-Caregiver Response

April 1, 2008 by  
Filed under ALZHEIMER'S

Today is the third day that I’ve discussed the stages of Alzheimer’s disease.  People are very different and they all start from different “norms.”  For example, I have an excellent memory for phone numbers.  Someone else may have never been good at remembering numbers, so our norm from the beginning would be different.  That said, there are still benchmarks and tell tale signs that would signal the various stages of Alzheimer’s disease.

As stated previously, my goal is to give you the characteristics of each stage AND to let you know how you as a caregiver can respond to the things going on in that particular stage.

Stage 5

You will go from providing some assistance in daily activities to more sustained and consistent assistance.  For example, in stage 4 you may have started helping with finances and meal preparation. 

In this stage, stage 5, you will find that your loved one needs help with most daily activities.  For example, grandma may still know how to put her clothes on, but she may forget to take her pajamas off before she gets dressed.  She may put her bra on over her sweater or put her nightgown on OVER her clothes. It’s probably not safe for her to cook because she may put something inappropriate into the microwave or turn on the stove and forget it’s on.  There is also potential for a severe burn as she may not recall that the pot handle is hot.  She may not remember that she just poured boiling water into a cup and therefore attempt to drink it before it is at the correct temperature.  She spends much more time in the past than she does in the present, although she probably remembers close family and friends (most of the time). With regards to time and space, she may forget where she is, the date, time and or season.

Caregiver Response

At this stage, you will become much more involved in day to day care.  Your loved one will need help getting dressed properly and preparing meals.  If your loved one lives alone, you’ll have to consider moving her in with someone who can provide round the clock supervision because wandering and safety will become more and more of a concern.  If you haven’t already, you should consider adult day care programs and senior center activities.  These day programs will keep your loved one’s body and mind active, while providing appropriate supervision.  My mom attended adult day care for a few years. Transportation was provided and it was safe for her and provided an opportunity for me to run errands, work, care for my young son, take care of household duties and get ready for her return in the evening.

You should start to think seriously about the future.  As caregiving requires more time, will you bring in outside help? Consider an Alzheimer’s Care facility? Rally friends and family?

NOTE:  If you haven’t already gotten durable Power of Attorney (POA), it may be too late.  If your loved one can still be logical and make some decisions, you need to handle this matter RIGHT NOW.  Stage 6 will be too late for sure. There are other options, but they are more time consuming, more costly and much more involved than just getting the Power of Attorney.

Stages of Alzheimer’s Disease – Caregiver Response

March 27, 2008 by  
Filed under ALZHEIMER'S

This post discusses Alzheimer’s Disease Stages One and Two 

I promised that I’d talk about stages, and in the meantime, I got a GREAT idea that I believe will be quite beneficial.  You and I both know that there are numerous places that you can get information about the STAGES of Alzheimer’s disease. As a caregiver, I really wanted to understand what was coming next, so those sites and resources definitely filled that need.  As time went on, though, I discovered that as much as I needed to understand the stage and what was coming next, I needed to know what that meant for me as a caregiver.  I wanted answers to questions such as, how would my role change as the stages progressed?  As my mom’s need for care increased, were there organizations I could look to for help with daily activities?  At what point should we consider adult day care and would there be a time that she would  no longer be “eligible” for adult day care?  What is assisted living and is it realistic for us to consider an Alzheimer’s care facility? Does everyone with Alzheimer’s eventually become incontinent?

So, what I propose to do is not just share the stages with you, but also help you to be prepared and armed to battle Alzheimer’s disease from stage one to stage seven.  The format will be as follows, I’ll describe the stage, provide links for more information and then give you pertinent information regarding your role as a caregiver. 

Today, let’s take a look at stages one and two.

Stage 1 is really a misnomer in the sense that it refers to a normal individual who has no memory issues.  I am not sure who fits into this category, certainly not those of us who are parents of toddlers and/or teens.  On a serious note, though, this is not a stage of disease, rather it is the stage BEFORE the disease.

Stage 2–Person has very mild decline that appears as a slight, but increasing lapse of memory; such as frequently misplacing keys and glasses.  The extremely close and observant friend or family member may notice.  At this stage, its easily shrugged off as stress, “senior moments,” or just plain old age.

Caregiver Response–At this stage there is usually not a “caregiver” per se, unless there is some other medical condition that requires it.  In most cases others are not aware that there is a problem.  The affected individual may feel something is wrong and either be adept at hiding it or just not able to pinpoint the problem.

Although there are seven stages, they are often broken into four larger categories such as mild or early stage, moderate or mid-stage, moderately severe or mid-stage and severe or late stage Alzheimer’s disease.

In the coming week, I’ll describe the remaining stages and provide a Caregiver Response for each stage, so that you will know what’s coming, how to prepare and how to respond so that you can provide the best care for your loved one.

In the meantime…Penny for your thoughts? Please feel free to comment specifically on this post, ask a general question or contact me privately at

Coming up tomorrow–Caregivers Corner

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NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.