Alzheimer’s

Alzheimer’s disease is the most common form of a neurocognitive disorder (NCD).  A neurocognitive disorder occurs when there is global impairment of cognitive functioning that is progressive and interferes with social and occupational abilities.  Generally, a NCD is classified as either mild or major and the distinction is primarily the severity of the symptoms that are present.  The prevalence of Alzheimer’s disease doubles for every five year age group beyond age 65.  It is important for you to recognize characteristics of Alzheimer’s disease, because it could affect you or your loved ones at some point in your life.

Neurocognitive disorders can be classified as either primary or secondary.  Alzheimer’s disease is a primary NCD, meaning that it is the major sign of some organic brain disease and it is not related to any other illness.  On the other hand, a secondary NCD is caused or related to another disease or condition, such as HIV.  In a NCD such as Alzheimer’s, impairment is evident in abstract thinking, judgment, and impulse control.  The common rules that we all normally follow in social situations are no longer taken into consideration, plus communication may become impaired.  Behaviors may become uninhibited and inappropriate, and neglect will be noticed in the individual’s personal appearance and hygiene as compared to their norm. 

There are seven stages to Alzheimer’s disease as listed below.  It is important for you to become familiar with the characteristics of each in order to intervene early to help slow its progression.  The seven stages are:

o   Stage 1:  No Apparent Symptoms

o   In the first stage, you will not be able to notice any apparent decline in memory.

o   Stage 2:  Forgetfulness

o   In this stage, the individual involved will begin to lose things or forget the names of other people.  Short-term memory loss is common.  The individual will realize and become aware of their forgetfulness and they may become ashamed, anxious, or depressed, which may continue to worsen their symptoms.  In this stage it is a good idea to begin to organize a structured routine and create lists for daily tasks.  Others generally do not observe decline in this stage, only the individual.

o   Stage 3:  Mild Cognitive Decline

o   Interference with work performance occurs in this stage and it is also noticeable by other co-workers.  In addition, the individual may get lost when driving.  Concentration may be interrupted and a decline is evident in the ability to plan or organize.  There is increased difficulty recalling names or words, which is now noticeable by family and close associates.

o   Stage 4:  Mild-to-Moderate Cognitive Decline

o   At this point, the individual involved may forget major events in personal history, maybe something such as a birthday of his or her child.  There will be a continued decline in the ability to perform tasks, such as managing personal finances or being unable to understand current news events.  Confabulation may occur in order for the individual to cover up their memory loss.  Confabulation is the creation of imaginary events to fill in memory gaps, like blaming someone else for putting the keys in the drawer.  Depression and social withdrawal are often noticed in this stage.

o   Stage 5:  Moderate Cognitive Decline

o   Here, individuals lose the ability to perform some activities of daily living (ADL’s) independently.  They may need ongoing assistance with their hygiene, getting dressed, and grooming.  Forgetting addresses, phone numbers, and names of close relatives will most likely occur.  They will maintain the knowledge about themselves, but they may become disoriented regarding place and time. 

o   Stage 6:  Moderate- to-Severe Cognitive Disorder

o   In this stage of progression the individual may be unable to recall recent major life events or may not even be able to recall the name of his or her spouse.  Disorientation continues and they may not be able to recall the day, season, or year.  The individual will be unable to manage ADL’s without assistance.  Incontinence of bowel and bladder is common in this stage and sleeping becomes problematic.  The individual may begin to wander, become obsessive, easily agitated, and possibly even aggressive toward others.  There is generally an increasing loss of language skills and most individuals will be placed in institutions for 24/7 care.

o   Stage 7:  Severe Cognitive Decline

o   In this end stage of Alzheimer’s the individual is unable to recognize his or her own family members.   Commonly this person will be bedfast and non-verbal, which may result in compromised skin and contractures due to decreased mobility.

The exact cause of Alzheimer's disease is unknown.  There are various medication treatments that can be put into place to help slow its progression, it is not fully reversible.  It is very hard for family members to see their loved ones go through Alzheimer's disease.  Ongoing support is needed in these difficult situations and that is where Total Home Health comes into the picture.

Total Home Health has a program that is right for you or your family member that is affected by Alzheimer's disease.  Our compassionate, patient, and professional staff are ready to provide ongoing assistance to your loved ones in such a life-changing and vulnerable time.