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Understanding the disease
• Is the leading cause of dementia - a group of symptoms that can include loss of memory, judgment, reasoning, and ability to communicate and function.
• Is a chronic, degenerative, irreversible organic brain disorder.
• Affects parts of the brain that are responsible for memory, language, judgement, reasoning and ability to communicate.
• Beginning with what may be almost imperceptible changes such as forgetfulness and confusion, it leads to severe intellectual and physical impairment, ultimately leading to death.
• At present, there is no known cause or cure. However, there is now medication to treat some of the symptoms.
• There is currently no single test to diagnose Alzheimer's disease. The diagnosis is made through systematic assessment that confirms symptoms and eliminates other possible causes.
• In general, the course of the disease progresses through a series of predictable stages, with so-called typical symptoms, taking from 8-12 years from point of diagnosis.
• Dividing the course of Alzheimer's disease into stages is purely hypothetical and for convenience – to discuss and identify progression. Progression from one stage to another is not “neat and tidy”. It is continuum with much overlap. Not all persons will experience all the above symptoms.
• Although worsening with time is inevitable, the rate at which clients progress varies with the individual and two clients at same stage have somewhat different symptoms. In addition clients at any stage exhibit symptoms unpredictably, with daily fluctuations and stable “plateaus”.
PROGRESSIVE DECLINE IN ALZHEIMER'S
DISEASE (STAGING) 
| STAGE | CHARACTERISTICS |
INTERVENTIONS |
| 1 | “Forgetful”
early stage - insidious / gradual - recent memory loss - time / space disorientation - mood swings - slower / withdrawal / denial - impaired judgement - subtle language dysfunction - continues to worsen |
-
seek interested & helpful GP - obtain thorough medical assessment - family conferencing - seek counselling / education - obtain legal / financial advice - secure power of attorney - adjust lifestyle (retirement, driving) - initiate individual / group supports |
| 2 | Confusion”
early middle stage - obvious memory deficits - need for supervision in specialized activities - language / communication problems - anxiety / restlessness - problem behaviour becomes more severe - usually most difficult period for client |
-
time for decisions / future planning - seek help in home - learn coping strategies - investigate day programs - examine placement possibilities - focus on safety / anxiety - compensate for deficits & maximize assets (client & family) |
| 3 | “Severe
Dementia” stage - obviously disabled cognitively - full-time supervision needed - marked personality / behaviour problems - disorientation to person - communication very difficult - psychosis - physical disorders appear - can still reminisce |
-
minimize stresses - seek more help from all sources (usually most difficult period for family) - focus on health - continue with support / education systems - step-up respite care - be prepared for placement |
| 4 | “Terminal”
late stage - almost total loss of intelligence / physical functioning - few words spoken / understood - emaciation / susceptible to infection - death |
-
usually requires placement - continue with all systems of support - death / autopsy arrangements - limit visits to institution as needed - rest / regroup |