When it comes to most cases of dementia, Alzheimer's disease is usually the cause. Because of this, the focus of this article is going to be on Alzheimer's specifically. Unfortunately, there is no known cure for this disease but there are ways to care for someone suffering from it.
Diagnosis Stages Mild Moderate Severe Journey
When a person receives a diagnosis of dementia, is not due to one specific symptom, but it is rather used to describe two or more cognitive declines at one time. To explain, dementia is diagnosed when the cognitive issue is no longer just a memory problem. When it becomes a memory problem and either impaired communication or impaired judgement, then a diagnosis of dementia is often given.
When multiple cognitive functions are beginning to decline at one time, your client's dementia due to Alzheimer's can then become slightly more unpredictable. Since there is no specific order of decline, your client can forget things randomly without notice. As no two people are alike, neither is their decline in cognitive function disorders. It's best to learn the stages to better understand how the decline breaks down throughout the process.
Alzheimer's is a slower progressing disease and is usually labeled under three different stages.
The mild stage of Alzheimer's is harder to moderate or keep track of. Earlier signs tend to mimic typical forgetfulness which means mild stages can be misdiagnosed more easily earlier on as Alzheimer's and dementia begin. Earlier signs can be, but are not limited to, slow progressing forgetfulness, issues with word-finding, and impaired thinking. As this stage progresses it becomes more clear that there is a larger reason for the forgetfulness.
Slow progressing forgetfulness in the mild stage affects mostly the short term memory. Your client may forget something you just told them, they may repeat stories or phrases they told you, or forget where they placed something they just had earlier that day. It is good to remain patient in this stage.
As the progressing forgetfulness continues, it can become frustrating for the client as well as the caregiver. It is always good to keep in mind that most clients in this stage are "aware" of their forgetfulness. Because of this, they do not need to be reminded as it can cause their stress to excel which can progressively lead to depression.
Be mindful that it is not their fault that they can't remember these things. Just be there to assist them when they lose something and make sure you are prepared to have patience as they tell you the same story or phrase multiple times.
In the moderate stages of Alzheimer's, your client may be less aware or completely unaware of their forgetfulness altogether. This is when regular daily life may be more complicated for the client and caregiver alike.
As the client begins to go through this stage, the forgetfulness will reach peaks. For some things that they forget, they may eventually remember later on while other things they may never remember again. Forgetting more familiar faces becomes more common as well as forgetting to eat. They may think they have already ate or, even the opposite, thinking they have not eaten when they already have.
Redirecting can be difficult in this stage as some things the client may remember for an hour or so while other things the client may forget within a couple of minutes. As this stage continues, these can become more and more of an issue for the clients health. It is good to keep a schedule for clients in moderate stages of Alzheimer's and dementia such as when they eat, nap, watch television, exercise, take their medicines, etc.
It helps to not only create a steady routine for the client to become more comfortable with, but it also helps to ensure that the client is receiving everything they need throughout the day to remain as healthy and cared for as possible. This is especially true since most clients in this stage do not know when to ask for things or even how to ask for simple things they need. It also ensures the client is not under eating or over eating.
Long term memory will progressively decline as the moderate stage continues. So asking your client to tell you stories about their life may cause stress. It is good to steer away from looking through older photos or asking them about their history because even though they may not notice their forgetfulness as often in this stage, not being able to answer a question may cause them stress since they do not understand why they can not answer it.
Their forgetfulness will be excelled enough that you should expect to hear the same phrases quite often. The excel may also be so extensive that the client may feel "lost" or "unsure" about what they should be doing regularly. Be sure to inform them that they are doing what they need to be. This is also where having a schedule often comes in handy so you can more easily explain and show them exactly when and what needs to be done. Even if they do not fully understand, it may offer some comfort knowing that certain tasks are taken care of.
This stage can also cause your clients to want to sleep more or to be less active. When this happens, wait a little bit and try again to encourage regular daily activities. Movement and regular daily interactions can assist with preventing stress or depression in your client's lives.
As they progress through the moderate stage and get closer to the more severe stage, your client can begin demonstrating issues with eating. Not just swallowing, as that is a common issue, but also with doing something as simple as picking up the fork to get started. They may not know what silverware to use or how to get the food from the plate to the silverware.
They may even be confused about what they are supposed to do with the food once they have it. Verbal and physical cues to keep them independently eating as long as possible is recommended. However, at some point you may need to assist more hands on with feeding if the verbal cues do not seem to be working or is causing them more frustration as they progress.
In the severe stage or late stage, most accurately known as severe dementia due to Alzheimer's disease, assistance is usually required to complete any daily task. Communication can even become a problem as not being able to find the right words turns into the inability to find any words at all. The decline up to this stage effects the cognitive process such as thinking and memory.
This stage however not only effects those things but regular daily movements, bodily functions, as well as speaking. They will at some point need to be chair bound or even bed bound to prevent falling as their brain no longer has the ability to send the signals necessary to keep everything working properly. Click here for more on taking care of patients on bedrest or more information on being a fall risk.
Late stages can also effect more complicated things such as bowls. Hygiene can become an issue and infections can become more and more common. So it is good to remain patient and keep your client as clean as possible. Check them regularly for the need to be changed. Doing this can assist in preventing those infections from reoccurring as often.
Keep in mind that this disease is very widespread and can affect different people differently throughout the decline but some symptoms to expect in this stage are:
As the late stage continues to create this chaos in your client and slowly take away their minds, more and more hands to help will be required resulting in the possibility of 24 hour care from medical professionals as well as caregivers. Click here for more tips on late stage Alzheimer's disease.
Alzheimer's and dementia can last years. The progression is usually so slow that it can take up to 20 years although the most common time of progression after a diagnosis is 8-10 years.
It's good to remain patient with your clients as this can be a very stressful and tiring disease to endure. As the caregiver, the best thing you can do in early to moderate stages is to remain positive, remain patient, and be the stability for your client that they are helplessly losing.
People say losing a loved one is like losing a part of yourself. This disease causes you to slowly lose all of yourself with no way for you to keep it from happening or stop it. It's good to always keep that in mind as sometimes people become depressed or even angry with life when this disease begins to progress. Be sure to give yourself plenty of caregiver care.
Being that positivity and stability for your client can help decrease the risks of depression and anger as well as give them a sense of relief. Knowing that someone is there who is willing to help them when they need it the most can make all the difference in the world.
Thank you Gerry Allen for contributing this article.
For more information on Alzheimer's and dementia, view these posts:
Dementia Caregiver Info, Help, and Tips
Stages and Types of Dementia: In Depth Overview
Do Medications Help Dementia Symptoms?
Changing the ER / Hospital to Better Assist Dementia
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