Alzheimer’s has several stages, and it’s important to be able to recognize each one. Keep in mind, however, that the progression of the disease varies widely depending upon the individual. In some cases it moves rather rapidly; in others, it’s a slow process. In addition, the progression often plateaus for a time, and some people don’t experience all of the stages. Here’s a brief description of the symptoms associated with the three basic phases of the condition:
- Early Stage. In addition to experiencing short-term memory loss, the person may be unable to recall some major aspect of his present life, such as a longtime address or telephone number. This stage may also be characterized by impaired language, mood swings, and personality changes. The patient may also have problems balancing his checkbook, finding his way around, identifying the season or day of the week, or remembering where he put things. To top it all off, he may deny this loss of memory or respond to it with irritability, hostility and agitation.
- Intermediate Stage. The elderly person is unable to learn anything new or to recall new information, and may even have trouble remembering past events. He may require assistance in eating, bathing, dressing, or toileting. Obsessive symptoms may appear, such as the continual repetition of simple tasks or chores. There is a tendency to lose all sense of time and space, to wander and become agitated, and to display uncooperative, anxious or violent behavior. At this stage the person is at a significant risk for falls and accidents.
- Severe or Terminal Stage. At this point in the progression of the disease the patient may lose the ability to walk, may be totally incontinent, and cannot perform any daily activity. He is now usually devoid of all memory and may not even be able to swallow. As a result, he is at risk for malnutrition and pneumonia, and must have 24-hour-a-day care. He may eventually become mute and unable to describe any of his symptoms. The end stage of Alzheimer’s disease is coma and death.
It’s important to point out that, short of an autopsy, there is no definitive way to diagnose Alzheimer’s disease. But physicians can make a fairly accurate probable diagnosis by doing a thorough evaluation that includes a physical exam, a mental assessment, and several neurological tests. In recent years, cerebrospinal fluid analysis and MRI have also shown have great diagnostic promise for Alzheimer’s disease. Blood urine analysis, electrocardiogram, CT scans, MRI, and X rays can also help rule out other potential causes of dementia, such as problems with medications, vitamin B12 deficiency, thyroid disease, or altered body chemistry. For more information, we recommend that you contact the
Alzheimer’s Association. In addition to free booklets, they offer a website that contains a helpful series of articles and a section explaining how to spot the warning signs of Alzheimer’s disease as well as other mental illnesses.
If it turns out that your spouse does indeed have Alzheimer’s disease, remember that this is not the end of his life, nor does it terminate your relationship with him. You can find courage and comfort in knowing that many caregivers have experienced great joy and numerous moments of deep significance while ministering to a loved one with AD. But you should also be prepared: this is a task that can take a heavy toll on you and your family. The long hours and energy required can leave you feeling angry, guilty, depressed, and overwhelmed. If your spouse lashes out at you or no longer recognizes you, you may be stricken with grief and sadness. That’s why you need to take time now to map out a plan of action. Here are a few suggested steps to take:
- Get a definite diagnosis. Don’t keep yourself in the darkness of uncertainty. The sooner you know the truth about your spouse’s condition, the better you will be able to manage the situation.
- Write a daily schedule. A structured day of planned activities will help your spouse gain a comforting sense of routine and stability.
- Locate available resources. Take advantage of the services and information offered by county and state health or social service organizations. Contact the Alzheimer’s Association. Let family and friends know specific ways in which they can help.
- Seek financial and legal advice. Discuss your spouse’s needs, such as wills, trusts and durable power of attorney with a professional financial adviser or lawyer.
- Cope with change and be realistic about your loved one’s changing capabilities. Instead of becoming frustrated, concentrate on your spouse’s remaining strengths. Try to recognize what you can and cannot do.
- Ask your pastor to visit. This is a good opportunity to pray and worship together in a small, intimate setting. Your pastor may be able to recruit others to visit as well.
For additional help and information on this topic, we’d encourage you to consult the resources and referrals highlighted below. Or if you have relationship concerns and challenges associated with this situation, please don’t hesitate to give our Counseling department a call.