What kind of changes should I expect in each stage of Alzheimer's disease?

Alzheimer’s develops slowly and gradually worsens over several years. Knowing what to expect and how to plan can provide a sense of control, and most importantly, peace of mind.  There are five stages of Alzheimer’s, but the three general stages are: early, middle, and late. Below is a breakdown of what to expect during each of them.

Early Stage (Mild) Alzheimer’s

People with mild cognitive impairment have mild changes in their memory and thinking ability. During the early stages of Alzheimer’s, a person may function independently. They may still be able to drive, work, and be part of social activities. Symptoms may not be widely apparent at this stage. A person in the early stage of Alzheimer’s may:

• Find it hard to remember things
• Be repetitive
• Get lost in familiar places
• Lose things or put them in odd places
• Have trouble handling money and paying bills
• Forget to take medication
• Take longer than normal to finish daily tasks

Middle Stage Alzheimer’s (Moderate)

During the middle stage of Alzheimer’s, symptoms will become more pronounced.  A person will have difficulty performing some tasks, and generally should not drive, pay bills, or work independently. As this stage advances, the individual may require a higher level of care.

In this stage, a loved one and caregiver need to seek education about the behavior changes to expect and strategies for coping with them. People with the moderate dementia stage of Alzheimer’s disease may exhibit:

• Increased memory loss and confusion
• Difficulty recognizing acquaintances
• Forgetting the names of some friends or family members
• Difficulty learning new things and coping with new situations
• Trouble completing tasks with multiple steps
• Changes in behavior or mood
• Forgetting the names of common items
• Wandering

 Late Stage (Severe Dementia)

The last stage of Alzheimer’s disease is the most difficult. This stage is often referred to as “Severe Dementia” due to mental function continuing to decline, and the disease has a growing impact on movement and physical capabilities.

During this time, around-the-clock care is usually required. This is when prior planning and communication about the wishes of the person affected can be useful, and can greatly ease stress for caregivers. In the late stage, people may:

• Lose the ability to communicate
• Sleep more
• Lose weight
• Have trouble swallowing
• Struggle with incontinence