Alzheimer’s is a disease that affects the brain. Most people think of Alzheimer’s as forgetfulness and while forgetfulness is one of the most common manifestations of Alzheimer’s, it is not the only one. There are many other manifestations of symptoms of Alzheimer’s and some might be more serious.
Moreover forgetfulness plagues even millennials today (because they are so distracted) and pretty much all seniors. You won’t have any trouble finding stressed middle aged execs who complain of forgetfulness either. So no, forgetfulness cannot be the only symptom, marker or measure of the presence of Alzheimer’s or its profession.
A more thorough understanding of Alzheimer’s is absolutely imperative in supporting the patient through its various stages. In fact, in early Alzheimer’s, you might feel a surge of hope and relief that the disease is not so bad after all. Even in later stages, there will be moments where the patient seems, according to many caregivers “more there than otherwise” which is a euphemism for a lesser display of dementia.
First of all, let’s understand what Alzheimer’s is:
In Alzheimer’s the patient’s brain cells begin to degenerate, as do the connections between them. Moreover the disease is progressive, which means that the symptoms get progressively worse with time. As such, Alzheimer’s has 3 stages. Let us understand the symptoms and patterns that are typically characteristic to each stage.
The Potential Precursor – MCI
First things first: Not everyone who has MCI, or mild cognitive impairment, will necessarily develop Alzheimer’s. In MCI the patient might display memory loss or loss of other cognitive abilities (or other mental functions).
A lot of seniors live with MCI and it does not affect their lives negatively to a large extent.
However, if the senior in your care displays signs of MCI, it is important to get a diagnosis and to test/ check that the brain changes linked to Alzheimer’s are not being manifested.
The doctor might order a PET scan or a spinal fluid test to check for the presence of amyloid beta protein that is linked to the degeneration of brain cells in Alzheimer’s.
A person suffering from MCI should ideally be evaluated every 6 months. The idea is to identify any progression towards Alzheimer’s.
Stage 1: mild/ early stage
In this stage, the associated forgetfulness and dementia is often almost unnoticeable and negligible except to family members/ people that the patient lives with.
The patient themselves is quite often also very aware that they are unable to remember things and this is often a source of stress for the Alzheimer’s patient because they worry that their condition is deteriorating. Stress is no good for Alzheimer’s patients and as such it is important to reassure them that they are doing alright and that they are cared for and supported. Do celebrate small victories with them.
Patterns that one might notice in stage 1:
- Inability to arrive at the right word
- Inability – at least momentarily – to come up with the right name
- Challenges in performing familiar tasks at work, at home or in social settings
- Forgetting something that has just happened or something that they just watched/ read
- Losing or misplacing important or valuable items like spectacles, smartphone etc
- Inability to plan even simple things
Stage 2: moderate/ middle stage
This is most often the longest-running stage of Alzheimer’s. It can be challenging, not just logistically but also emotionally for the caregivers and family members and as such, they too must prepare themselves to cope with this stage as it calls for tremendous patience, compassion and vigilance.
This is when you might have to make changes to your home as well, or might need to hire additional help. Knowing what to expect ahead of time will help you to plan and budget for these changes.
Patterns likely to be witnessed are:
- Inability to remember past events, even significant ones
- Inability to remember own past
- Not sure of current year/ location
- Inability to dress self
- Changing sleep patterns like sleeping in the day and restlessness at night
- Challenges in controlling bladder and bowels
- Tendency to wander and get lost in account of forgetting address, location and date
- Compulsive behaviour, most often pacing
- Feeling moody, upset, overwhelmed in mentally challenging situations
Stage 3: advanced/ severe/ late stage
The final stage of Alzheimer’s can be very challenging and heartbreaking for caregivers and other family members and as such, being mentally prepared can enable better coping. In this stage, the degeneration of brain cells is very extreme and therefore almost all mental function becomes lacking or problematic.
Hiring extra help or turning to palliative facilities to offer care for the Alzheimer’s patient may be even more necessary at this point as they need very frequent assistance.
Patterns one will notice are:
- No awareness of surroundings or recent/ ongoing happenings
- Need for assistance with personal care and hygiene
- Difficulty walking, sitting and even with swallowing food
- Inability to form words and therefore difficulty communicating
- Higher incidence of catching infections
Family members must understand that the patient can still benefit from soft familarusuc and gentle touch by their loved ones.
Takeaway: Alzheimer’s can manifest distinctly in different individuals and because of this, symptoms might also come about in a unique fashion. Do not get alarmed if you see a moderate stage symptom in a mild case and so on – but do keep your doctor in the loop of any changes in the patient’s pattern. Additionally, even if all is going well, regular medical evaluation is a must.