The stages below provide an overall idea of how abilities change once symptoms appear, and should only be used as a general guide.
The stages are separated into three different categories:
- Mild or early Alzheimer’s disease,
- Moderate Alzheimer’s disease, and
- Severe or late Alzheimer’s disease.
Be aware that it may be difficult to place a person with Alzheimer’s in a specific stage as stages may overlap. The stages of Alzheimer’s are helpful in finding the words to discuss Alzheimer’s. Caregivers find them particularly useful in support groups, as well as in conversations with doctors and other professionals.
Mild or early stage Alzheimer’s
In the early stages of Alzheimer’s, a person may function independently. He or she may still drive, work, and be part of social activities.
In the early Alzheimer’s stage, people may experience:
- Memory loss for recent events,and repeatedly ask the same question.
- Difficulty with problem-solving, complex tasks and sound judgments.Planning a family event, keeping score in a game, or balancing a chequebook may become overwhelming.
- Changes in personality.People may become subdued or withdrawn — especially in socially challenging situations — or show uncharacteristic irritability or anger. Decreased attention span and reduced motivation to complete tasks also are common.
- Difficulty organizing and expressing thoughts.
- Getting lost or misplacing belongings. Confusion of where things belong is possible (e.g. may put a towel in the fridge)
Early stage Alzheimer’s and home care services
Families with loved ones in early stage Alzheimer’s rarely request home health care services. When families get nervous about leaving their loved one alone, or there is no primary family caregiver, the service of companionship is often requested to ensure safety and company.
Moderate stage Alzheimer’s
Moderate stage Alzheimer’s is typically the longest stage and can last for many years. As the disease progresses, the person with Alzheimer’s will require a greater level of care.
People with moderate Alzheimer’s disease may:
- Individuals lose track of where they are, the day of the week or the season. They often lose the ability to recognize their own belongings and may inadvertently take things that don’t belong to them.
- They may confuse family members or close friends with one another, or mistake strangers for family.
- People may forget details of their personal history, such as their address or phone number, or where they attended school. They repeat favorite stories.
- Assistance may be required with choosing proper clothing for the occasion or the weather and with bathing, grooming, using the bathroom and other self-care.
- Undergo significant changes in personality and behavior. It’s not unusual for people with moderate Alzheimer’s to develop unfounded suspicions. Individuals often grow restless or agitated, especially late in the day. People may have outbursts of aggressive physical behavior.
- Changes in sleep patterns, such as sleeping during the day and becoming restless at night
Moderate stage Alzheimer’s disease and home care services
This is the stage at which it is often not possible for a person with Alzheimer’s to live alone. Home care services can provide a personal support worker (PSW) to help with bathing, dressing and toileting, as well as meal preparation, walks and exercising, and companionship. It is the case with some families that they do not have the time or resources to be with their loved one all of the time, and families accept the risks that come with this. Primary family caregivers living with their loved one will need respite, and possibly a home health care company or family member to look after their loved one to provide peace of mind. Also, a family member worried about a loved one up in the night will suffer disrupted sleep themselves, so a PSW may be hired to be alert and provide companionship to the loved one during wakeful nighttime hours.
Loved ones in moderate stage Alzheimer’s should not be driving. In Toronto, it may be difficult for some people to take the TTC alone, and would have to be accompanied by a caregiver. For a list of senior friendly transportation in Toronto, please see our recent blog post here. People with dementia will not qualify for Wheel Trans if they are physically able, so IRide or Toronto Ride may be best.
Severe or late stage Alzheimer’s disease
It is at this stage that family members often suffer the most, because the loved one with Alzheimer’s loses much of the ability to recognize those around him or her, even a spouse, sibling, parent or child. Care is required 24 hours a day.
A loved one in late stage Alzheimer’s may exhibit:
- Severe memory loss continues to intensify
- Withdrawal from surroundings
- Leaving home and getting lost
- Problems recognizing loved ones
- Increased restlessness and agitation toward late afternoon and evening hours
- Paranoia, suspiciousness
- Repetitive, compulsive behavior (verbal and/or nonverbal)
- Bathroom management becomes difficult; at this stage it often is necessary to switch to incontinence briefs
Late stage or severe Alzheimer’s disease and home care services
For families and caregivers, this is a point where their involvement increases substantially. Due to the loved one being up a lot in the night, it is often necessary to have a PSW present from a home care company. During the night the PSW would stay alert and ensure safety and companionship for the loved one, and to allow family caregivers to sleep. Live-in care or 24-hour care from home health care companies is normal during late stage Alzheimer’s as family caregivers have simply run out of energy to do it alone.
End of life
At the end of the severe (late) stage of Alzheimer’s, people generally:
- Require total assistance with eating, dressing, using the bathroom and all other daily self-care tasks.
- Swallowing may become difficult, choking is a risk causing vulnerability to infections, especially pneumonia
The last stage of Alzheimer’s disease, as with any other illness, is a very individual matter and no two journeys end the same way. People with Alzheimer’s seem to experience little physical pain.
A home health care company in Toronto can help you with the care giving journey of looking after someone with Alzheimer’s disease. We offer private dementia care in-home or additional care in assistive living, retirement homes, hospitals or long term care.