Alzheimer's Disease is a slow, progressive disease that begins with innocuous cognitive impairments, such as mild memory problems, decreased word-finding skills, and inability to complete simple tasks such as balancing a checkbook or remembering where an item is placed. Individuals with Alzheimer's can live as few as three to four years after diagnosis or 10 years or longer, depending on the patient's age, health problems at onset and level of cognitive difficulties at the time of diagnosis. The moderately severe and final stages of the disease are the most difficult for both Alzheimer's sufferers and loved ones. Often, the patient requires placement in a skilled care facility, such as a nursing home or assisted living center.
Progression of Alzheimer's Disease
Patients with Alzheimer's disease begin to experience severe decline in cognitive abilities in the moderately-severe stage of the disease. While patients may be able to recall distant events, they are unable to remember what happened mere minutes ago. While they may recognize familiar faces, they are unable to remember names of those closest to them, including spouses, children, family members and caregivers. Completing simple activities of daily living, such as dressing appropriately and tending to toileting needs, requires assistance from a caregiver (incontinence is common). Pronounced change in personality is noted; patients with Alzheimer's may experience periods of aggression, delusions and hallucinations. For example, patients may accuse family members of being "imposters." Wandering off and getting lost is common. Compulsive behaviors such as hand-wringing may be noted. At this stage, patients require daily care to ensure their safety.
Alzheimers and Public Situations
According to the Alzheimer's Association, caregivers may find themselves in difficult situations as the disease moves into the moderately-severe stage. Patients with Alzheimer's may make inappropriate sexual advances toward others and need to be distracted or led to a private place. At times, patients may remove their clothing in public or forget to pay for items in a store, inadvertently "shoplifting."
Final Stages of Alzheimer's Disease
Patients in the last stages of Alzheimer's require around-the-clock care. They are unresponsive to environmental stimuli and frequently cannot speak or control motor movements. Occasional words and phrases may be uttered, but may be slurred and unrecognizable to listeners. Patients are unable to walk, and require assistance to sit up. At this stage, patients are incontinent and require catheterization. Difficulties swallowing foods and liquids can lead to aspiration pneumonia, and some patients are unable to eat.
When It's Time to Seek Help
While caregivers may be able to provide adequate support to a patient in the early stages of Alzheimer's disease, as the disease progresses to the moderate to severe stages, there may come a time when it is questionable if keeping the patient at home is in his or her best interests---or those of caregivers. Experts at the Mayo Clinic suggest that caregivers consider if their own health and quality of life is compromised as a result of caring for the Alzheimer's patient. Caregivers may experience sleep deprivation, loss of work and inability to tend to their own household matters. Alzheimer's patients may be difficult if not impossible to care for, particularly when it comes to symptoms such as incontinence, aggression, paranoia and wandering. In some cases, the patient's home is no longer a safe place---stairs may be impossible for the patient to navigate and standard bathroom facilities difficult to utilize. In some cases, patients may experience falls, choking episodes and/or weight loss, signaling the need for placement in a skilled care facility.
Support for Friends and Family Members
Caregivers ultimately bump up against the difficult ultimatum of placing a loved one with Alzheimer's in a skilled care facility or risking the patient's health and safety by keeping them in their own home. The Alzheimer's Association offers a 24-hour helpline, (800) 272-3900, that offers counseling services for caregivers in times of crisis as well as referrals to facilities in their area. The Association's website (alz.org) also offers an interactive map in which caregivers can find support groups in their area.
Tags: with Alzheimer, Alzheimer Disease, care facility, skilled care, skilled care facility, Alzheimer Association, Alzheimer Disease Patients