Where Passion Meets Reality!
Good Afternoon. Welcome to Demystifying Alzheimer’s. I’m your hostess Mary Yamin-Garone.
Today’s topic is “The Stages of Alzheimer’s: What to Expect.”
You and your mother have decided to go out to eat at her favorite restaurant to celebrate her 70th birthday. When you walk in, she says, “This is a nice place. Look at the pretty pictures on the wall. Your father would have loved this.” You’re a little taken back. “Mom, we’ve been here hundreds of times before. Don’t you remember?” “No we haven’t,” she replies. “This is the first time I’ve been here.” You let the conversation move on to other things. Now it’s time to order. Your mother says, “I think I’ll have the baked fish.” You respond, “Me, too. We’ll have our favorite dinner together. You and Dad used to like that dinner.” Your mother says, “What do you mean? My favorite dinner is meatloaf.” You say, “Mom, when we were here for your 68th birthday you said you and Dad used to come here all the time and that you liked baked fish.” Your mother starts to answer and argue. The meal wasn’t as pleasant as when you were celebrating her 68th birthday.
The brain is different from other organs of the body in that every nerve cell does something unique, something no other nerve cell can do. Every part has a function and all of them must work together for your brain to work properly.
As Alzheimer’s progresses, it consumes brain functions. One puzzling thing about this disease, especially in its stages, is how it effects each person differently. The individual you’re caring for might not experience every symptom or changes in behavior. The disease’s timetable also can vary. A particular stage may last years longer for one person than for another and symptoms can be experienced at earlier or later stages. Because Alzheimer’s is a progressive disease, however, it always starts with mild symptoms and gradually worsens as it continues.
The earliest noticeable signs of Alzheimer’s are subtle. They’re often mistaken for normal aging or senility. That’s particularly true because many people with AD appear to be healthy and functioning normally at home, work and in social settings.
The destruction of neurons first takes hold of the parts of your brain that control memory, especially the hippocampus. That’s why memory loss is often the first sign of Alzheimer’s. As nerve cells in the hippocampus break down, the memory of recent events starts to fail. The rest of the brain, however, continues to work normally so the individual still moves, feels, thinks, sees, hears and integrates information. Because judgment, reasoning and social skills are still normal, they can develop compensatory coping strategies to deal with their memory issues. Because of those compensations, it’s likely that no one will be aware of the disease in the beginning. Since the person still appears normal, a physician isn’t consulted.
From memory lapses to violence, irrational outbursts to dwindling motor skills, the decline that accompanies Alzheimer’s can be swift or slow. No matter what course the disease takes, it can be difficult for loved ones to remain loving.
It can be of some comfort, however, to have a general idea of what to expect for (and from) your spouse, parent, grandparent, other family member or friend who has AD.
Here are some of the changes you can expect to see in the mild/early stages.
Memory: Memory lapses are typically the first sign, often years ahead of later symptoms. At this stage, it’s common to forget things more often or have trouble remembering details. Of special difficulty will be recalling recent events and people met later in life, as well as learning and retaining new information. That’s why asking repetitive questions is a hallmark of the disease. So is writing notes to oneself about things like where the car is parked. It’s common, too, to repeat comments and stories within minutes without realizing it. Ironically, long-term memory, such as childhood recollections, may remain fairly detailed.
Communication and social skills: Someone with Alzheimer’s may have trouble finding the right word. Often people in this early stage are aware that something is amiss, although they may not be sure what’s wrong. As a result, they may shy away from situations where they feel put on the spot or vulnerable to embarrassing mistakes, such as in social outings, time with friends, even telephone conversations.
Everyday life: At this stage, they’re easily confused and distracted. They may find it hard to keep track of the time and miss appointments or favorite TV shows. Abstract thinking and making sound judgments become more challenging. They may lose the initiative to partake in activities that were once pleasurable, such as cooking or gardening, or routine, like writing a check or making a grocery list. They may misplace things or put them in strange places, then forget where they put them.
Personality: Someone at this stage may seem to be acting unlike their old self. They may become irritable or angry when disease symptoms are disruptive or embarrassing. Mood swings are commonplace and typically stem from frustration.
You’ll notice “good” days, where the person you’re concerned about seems unchanged, and “bad” days when they’re having trouble coping, especially in new, unusual or otherwise stressful situations. At this stage, it’s also common to get lost, leave a stove burner on or lock themselves out of the car.
Instead of worrying about losses, the focus during the early to mild stage should be on the abilities, skills and talents that remain and can be used and nourished.
That’s all for today. Thanks for listening. I hope this information was helpful.
Join me at 1 pm Monday when I’ll discuss tips to assist caregivers in the early to mild stage.