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By Gerontological Nurse Practitioner Susan Scanland, MSN, CRNP, GNP-BC, CDP
Baby Boomer adult children and spouses of persons with confusion often ask me ?What are the Stages of Alzheimers? ?What stage is my aging family member in??wonder Baby Boomers.? Diagnosis of dementia and memory loss in seniors should be done promptly; as soon as forgetfulness begins to affect daily function.? Atrophy (brain shrinkage) occurs as the diagnosis is delayed! Unfortunately, the average family waits two years to visit their primary care provider for help. By then, the family often realizes they have fallen into the role of stressed caregiver!
No two individuals have an identical course of symptom progression.?? The total length of each person?s Early, Middle and Late Stage Alzheimers? course may range from two years in one person to two decades in another individual.
In each of the three stages, assessments evaluate the ABC?s of Alzheimer?s disease: A: ADL-activities of daily living (level of ability to care for oneself), B: behavioral changes, actions related to the disease?s impact on the brain and C: cognitive changes, which include memory, ability to communicate and understand. So, exactly,? What Are the Stages of Alzheimers??
Early Memory Loss (Mild Alzheimer?s Stage)
- A for ADL (Activities of Daily Living): There is difficulty preparing for social events, taking care of one?s household and doing routine tasks like shopping and keeping appointments.? The home may appear unkempt and disorganized in the early memory loss phase of Alzheimer?s.? Meals may be skipped or nutritionally imbalance.
- B for Behavior: The person may appear depressed or short-tempered as early memory loss begins. The individual often exhibits apathy; lacking the motivation to plan or take action.? Forgetfulness may cause anxiety and difficulty relaxing.? Subtle or obvious personality changes often occur.
- C for Cognition: Memory changes may result in forgetting recent conversations and appointments, confusion with directions or becoming lost on a familiar path or route. Judgment may be affected when driving or with financial matters during the early memory loss (mild) stage of Alzheimer?s.
Moderate Alzheimers Dementia (Middle Stage)
- A for ADL: Basic activities of daily living need assistance.? The person?s wardrobe?may not blend well and they often appear disheveled.? Progression through this moderate Alzheimers dementia stage may require a gradual increase of another?s assistance for eating, dressing, bathing and toileting. The person forgets the sequence of steps for self-care .
- B for Behavior: There is a gradual loss in goal-directed behavior.? The person may forget what his actions were earlier and repeat them again.? Anxiety may cause wandering, pacing or ?shadowing? behaviors (following someone else?s activity).? The sleep/wake cycle often is disturbed with waking at night and increased napping during the day.? Fears of someone stealing from them may increase and result in ?hoarding? behaviors.? Paranoid feelings that someone is against them are common. They may become angry, defensive or accusatory.? Visual hallucinations (seeing someone who is not present) may occur during the middle (moderate) stage.
- C for Cognition: There may be difficulty in recognizing extended family and friends.? Socialization and entering new environments must be planned carefully, as not to overwhelm the person.? Safety issues become paramount; as judgment is further impaired in regards to risk for accidental injury; both inside and outside the home.? Adverse drug events (overdosing or skipping doses) are common if the person is self-administering medication (not recommended)!
Last Stage of Alzheimers (Late/Severe/Advanced Stage)
- A for ADL: Dependence increases the amount of time and efforts to help the person with bathing, dressing, toileting, transferring positions and eating.? Urinary and fecal incontinence (accidents) progress in this last stage of Alzheimers.
- B for Behavior: Most persons in this stage are affected by one or more of the behavioral and psychological symptoms of dementia (BPSD).? These include calling out things repeatedly or verbal outbursts of anger and fear.? Hallucinations are usually visual (seeing people from early parts of their lives or images of their childhood days).? Delusions are false beliefs, including deceased family members being alive in their room, or believing they are still busy with their occupation.
- C for Cognition: There are varying degrees of disorientation among different people:? most not knowing what year it is, where they live, and who their loved ones are. Recognition of family members and identification of personal items often fades.? There is a loss of recall, so recent visitors are forgotten over short periods of time.? Vocabulary decreases and language becomes limited, along with repetition of common phrases (i.e.? ?This is not my house?.I want to go home??).
If you, as one of the Baby Boomers, or a worried spouse, are concerned that your loved one may have any stage of Alzheimer?s disease, don?t delay in contacting your primary care provider to discuss the above symptoms.? Remove the angst from this challenging situation by accessing the ?Family Guide to Memory Evaluation? information product.? This will help to get the Early, Middle and Late Stage Alzheimers properly diagnosed and treated. Research reveals that FDA-approved Alzheimer?s medications slow down behavioral and functional deterioration. This is true across all three stages, even in the moderate Alzheimers dementia stage and later, in the advanced stage. So it?s never too late to get help!
Visit www.dementiaconnection.com ?to sign up for a free e-newsletter with information on Alzheimer?s and other dementias.
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