November Is National Alzheimer’s Disease Awareness Month

November Is National Alzheimer’s Disease Awareness Month

Stages of Alzheimer’s: What to Expect

One vexing thing about Alzheimer’s, especially in the beginning, is how its effects differ from person to person. The individual you’re caring for might not experience every symptom or behavioral change, and the disease’s timetable can vary. A particular Alzheimer’s 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 time moves on.

Mild (Early-Stage) Alzheimer’s Disease

During this first Alzheimer’s stage, someone with the disease is likely to continue his or her usual activities, with Alzheimer’s-related changes being written off as “getting older,” “stress,” being “tired,” or just “simple mistakes.”

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 about even familiar topics. 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, as is writing notes to oneself about things like where the car is parked. It’s also common to repeat comments and stories within minutes without realizing it. At the same time, 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 Alzheimer’s stage are aware that something is amiss, though they may not be sure what’s wrong. They tend to shy from situations where they feel put on the spot or vulnerable to embarrassing mistakes, such as social outings, time with friends, or 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 programs. Abstract thinking and making sound judgments become more difficult. They may lose the initiative to participate in activities that were once desirable (hobbies, a job) or routine (cooking, writing checks). They may misplace objects regularly or store them in unusual places, then forget where they put them.

Personality: Someone at this stage may seem to be acting unlike his or her old self. They may become irritable or angry when disease symptoms are disruptive or embarrassing. Mood swings are common and usually stem from frustration.

Other: You’ll notice “good” days where the person you’re concerned about seems unchanged and “bad” days when he or she is having trouble coping — especially in situations that are new, unusual, or otherwise stressful. At this stage, it’s common to get lost, leave a stove burner on, lock one’s self out of the car or house, or experience other such incidents.

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Moderate (Middle-Stage) Alzheimer’s Disease

Symptoms characteristic of early-stage Alzheimer’s disease now become more evident as they worsen, become more frequent, and are harder to “cover up.”

Memory: Repetitive statements and questions are very common and they occur within minutes of each other.

Communication and Social Skills: As ongoing memory lapses combine with greater difficulty in tracking conversations and contributing meaningfully to them, some people become more timid socially and more apprehensive about speaking up. Others become less inhibited and demonstrate less tact in social situations. In this Alzheimer’s stage, it becomes common to confuse people, especially if they resemble one another (like a mother and daughter). Cognitive impairment and declining hand coordination affect written communication; someone who once wrote letters and sent birthday cards no longer is interested. Many middle-stage Alzheimer’s sufferers stop reading. Even previously favorite TV programs may be too hard to follow.

Everyday Life: Expect more difficulty with abstract thinking and with making good judgments. He or she may have trouble following written directions, such as cooking from a recipe or filling out a form. (Verbal instructions are more challenging, and problems with them are usually evident earlier). Even routine, familiar activities that involve a sequence of steps, such as brushing one’s teeth or getting dressed, may be difficult to complete. Someone who’s still driving is at increased risk because of disorientation, decreased coordination, problems judging spatial relationships, and slower response times. Failing judgment makes him or her vulnerable to poor decisions regarding safety, health, or finances. Personality: Mood changes and personality alterations become more obvious, especially late in the day or when he or she is tired. They may become distrustful of loved ones, including you, or they may make unfounded accusations. Anxiety is common and is sometimes expressed by rummaging through drawers, aggressive behavior, yelling, or wandering through or away from the house. Hallucinations or delusions occur. Depression is a risk, often characterized by changes in appetite and sleep habits (he or she may be a lot hungrier or less hungry than usual, for example…or sleep much more or less than usual. Other: During middle-stage Alzheimer’s, it’s common to get disoriented in familiar environments as well as unfamiliar ones. Unplanned or new activities can be especially troubling. The sense of smell may be less sensitive, and incontinence becomes more common.

Severe (Late-Stage) Alzheimer’s Disease

By this final Alzheimer’s stage, it’s common to be bedridden and completely dependent on others, as the person can no longer reason or manage the most basic self-care.

Memory: As memory problems worsen, they begin to affect recollections from even the distant past. He or she may no longer recognize even close family members, including a spouse or children. He or she may not even recognize his or her own self when looking at photos or in the mirror and may consistently forget to take medicine and do everyday tasks like tooth brushing.

Communication and Social Skills: As language skills decline, many people at this stage speak nonsensically. They may make strange sounds, hum, or moan. Or they might cease to speak altogether. It’s likely by now that the person you’re caring for is quite socially withdrawn and has abandoned many previously enjoyed and familiar activities.

Everyday Life: Even relatively simple, necessary activities, such as eating and taking care of personal hygiene, require assistance. Both gross motor skills, (walking and sitting up) and fine motor skills (buttoning a shirt, holding a spoon) are affected. Falls and injuries are a risk as coordination and depth perception decline. Repetitive movements and actions are common. Someone at this stage spends a lot of time sleeping.

Personality: Because the changes have become so marked, he or she may seem nothing like his or her old self. Sometimes jolly people turn crotchety, while formerly stern people may become docile and benign. By the last stages of Alzheimer’s, many people express no emotions at all.

Other: Monitoring health, nutrition, and safety as well as general caretaking is now a round-the-clock task. He or she may lose significant weight (because eating is difficult) and acquire infections or fall ill easily (because of general weakness). People weakened by this final Alzheimer’s stage more often die from another health problem (pneumonia, secondary infection, cancer) than they do from Alzheimer’s itself.  

Telltale Signs it Might Be Time for Assisted Living

The decision to help an aging adult move out of a current home is a complex one both emotionally and practically. Above all, you want the person to be safe and well. There are many factors that can play into you’re feeling more confident about whether circumstances suggest your loved one should no longer be living alone.

Although every situation is different, reviewing the following signs listed below will give you valuable information in helping make a decision.

  • Big-Picture Signs

Keep the big red flags in mind. Certain situations make it more obvious that it’s wise to start thinking about alternate living arrangements.

Look for:

Recent accidents or close calls. Did your loved one take a fall, have a medical scare, or get in a fender bender (or worse)? Who responded and how long did it take? Accidents do happen, but as people get older, the odds rise of them happening again.

A slow recovery. How did the person you’re caring for weather the most recent illness (for example, a flu or bad cold)? Was he or she able and willing to seek medical care when needed, or did last winter’s cold develop into untreated bronchitis?

A chronic health condition that’s worsening. Progressive problems such as COPD, dementia, and congestive heart failure can decline gradually or abruptly, but either way, their presence means your loved one will increasingly need help.

Increasing difficulty managing the activities of daily living (ADLs) and instrumental activities of daily living (IADLs).  ADLs and IADLs are the skills needed to live independently dressing, shopping, cooking, doing laundry, managing medications, etc. Doctors, social workers, and other geriatric experts evaluate them as part of a functional assessment, which is one way to get an expert’s view of the situation. Difficulties with ADLs and IADLs can sometimes be remedied by bringing in more in-home help.

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  • Up-Close Signs

Give your loved one a big hug. Clues aren’t always visible from a distance…especially when you don’t see the person every day, you might learn more through touch.

Look for:

Noticeable weight loss. Does the person feel thinner? Does clothing look and feel looser? Many conditions, from depression to cancer, can cause weight loss. A person who is having trouble getting out to shop or remembering how to cook (or to eat) can lose weight. Also be sure to check the refrigerator and observe meal-prep skills.

Seemingly more frail. Do you sense anything “different” about the person’s strength and stature when you hug? Can your loved one rise easily from a chair? Does she or he seem unsteady or unable to balance? Compare these observations to the last time you were together.

Noticeable weight gain. Common causes include an injury slowing the person down, diabetes, and dementia (when someone doesn’t remember eating, he or she may indulge in meals and snacks all day long). Someone with money troubles may choose fewer fresh foods and more packaged goods or dried pasta and bread.

Strange body odor. Unfortunately, a close hug can also reveal changes in personal hygiene habits. Causes range from memory trouble to depression to other physical ailments.

Changes in appearance. Does the person’s hair and makeup look normal? Are their clothes clean? Someone known for crisply ironed shirts who’s now in a stained sweatshirt may lack the dexterity for buttons or may have lost the strength for managing an ironing board and iron. A formerly clean-shaven man with an unkempt beard may be forgetting to shave (or forgetting how to shave).

  • Social Signs

Think realistically about the person’s social connections. Social circles tend to shrink with age, which can have health and safety implications.

Look for:

Signs of active friendships. Does your loved one still get together for lunches or outings with friends or visits with neighbors, or participate in religious activities or other group events? Does he or she talk about others or keep a calendar of appointments? Lack of companionship is associated with depression and heart problems in older adults. If friends have died or move away, moving to a place where other people are around could be lifesaving.

Signs that your loved one has cut back on activities and interests. Is a hobby area abandoned? Has a club membership been given up? A library card gone unused? There are many reasons people cut back, but dropping out of everything and showing very little interest in previously frequent involvements, is a red flag for depression.

Days spent without leaving the house. This sometimes happens because the person can no longer drive or is afraid to take public transportation alone and lacks a companion to come along. While many older adults fear being “locked away” in a retirement home, many such facilities offer regular outings that may keep them more mobile and active, not less.

Someone who checks in on a regular basis. If not you or another family member, who does this? Is your loved one willing to consider a home-safety alarm system, a personal alarm system, or a daily calling service?

A plan for a worst-case scenario. If there’s a fire, flood, or some other major natural disaster, is someone on standby to assist? Does your loved one understand the plan?

  • Money Signs

Rifle through the mail. Your loved one’s mail can offer an often-overlooked clue to how he or she is managing money a common early warning sign of a cognitive trouble.

Look for:

Snowdrifts of mail in various places. Finding lots of mail scattered around raises concerns about how bills, insurance, and other matters are being managed. (Piles of mail are also a potential safety concern due to a tripping hazard).

Unopened personal mail. Everybody skips junk mail, but few of us can ignore a good old-fashioned, hand-addressed letter.

Unopened bills. This can indicate that your loved one is having difficulty managing finances one of the most common first signs of dementia.

Letters from banks, creditors, or insurers. Routine business letters aren’t worrisome. But it’s alarming if they’re referring to overdue payments, overdrawn balances, recent accidents, or other concerning events.

Thank-you messages from charities. Older adults are often vulnerable to scammers. Even those who have always been fiscally prudent are vulnerable if they’re having trouble with thinking skills (a common sign of Alzheimer’s disease). Some charities hit up givers over and over, and your loved one may not remember having donated the first time.

Lots of crisp, unread magazines. The person may unknowingly have repeat-renewal subscriptions that he or she doesn’t need.

  • Driving Signs

Take a drive with your loved one behind the wheel, if he or she is still driving. Often, the ability to drive is practically a requirement for living independently in our culture (or the arrangement of alternate transportation options).

Look for:

Nicks or dents on the car. Notice the car body as you get in or out. Damage marks can be signs of careless driving.

Whether the person promptly fastens his or her seat belt. Even people with mild dementia usually follow the basics of driving. It’s obviously worrisome if he or she is forgetting this step.

Tension, preoccupation, or being easily distracted. The person may turn off the radio, for example, or be unwilling to engage in conversation while driving. He or she may avoid certain routes, highway driving, or driving at night and in rain a safe kind of self-policing, but also signals of changing ability.

Warning lights. Check out the dashboard as you ride along. Does the car have sufficient oil, gas, antifreeze, windshield-wiper fluid?

  • Kitchen Signs

Go through the kitchen, from the refrigerator, to cupboards, to the oven. Because people spend so much time in this room, you can learn a lot.

Look for:

Stale or expired foods. We all buy more than we need. Look for signs that food is not only old but that is unnoticed. For example, mold, sour milk that’s still used, or expiration dates that are well past due.

Multiples of the same item. Ten bottles of ketchup? More cereal than can be eaten in a year. Multiples often reveal that the shopper can’t remember from one store trip to the next what’s in stock at home.

A freezer full of TV dinners. Your loved one may buy them for convenience sake, but frozen dinners tend not to make for a healthy diet. If there’s not much fresh food in the house (because it’s too hard for the person to procure or cook), your loved one might be ready to have help with meal prep or delivery services.

Broken appliances. Check them all: stove, refrigerator, microwave, coffee maker, toaster any device you know your loved one uses (or used to use) routinely.

Signs of fire. Are stove knobs charred? Pot bottoms badly singed? Do any potholders have burned edges? Also look for a discharged fire extinguisher, smoke detectors that have been disassembled, or boxes of baking soda near the stove. Accidents happen. Ask for the story behind what you see. Accidental fires are a common home danger for older adults.

Increase use of take-out for simpler cooking. A change in physical or mental abilities might explain a downshift to simpler recipes or food choices.

  • Around-the-House Signs

Look around the living areas. Sometime the most obvious sign is hard to see because we become so used to it.

Look for:

Lots of clutter. An inability to throw anything away may be a sign of a neurological or physical issue. Obviously, it’s more worrisome for a person who has been consistently neat vs. a chronic slob. Papers or pet toys strewn about the floor represent a definite tripping hazard.

Signs of lax housekeeping. Spills that haven’t been cleaned up are a common sign of dementia, meaning the person most likely is lacking the follow-through to be tidy. Keep an eye out for cobwebs, bathroom mold, thick dust, or other signs of slackness. Physical limitations can mean your loved one needs housekeeping help or a living situation where this is taken care of for him or her.

Bathroom grime and clutter. A common scenario: Your loved one makes an effort to tidy up living areas, but overlooks the bathroom. Or the guest bath is clean, but not the one the person uses all the time such as a master bathroom.

  • Pet Care and Plant Care Signs

Be sure to check out how other living things in the home are faring. An ability to take care of pets and plants goes along with self-care.

Look for:

Plants that are dying, dead, or have just disappeared. Most of us have seen plants go brown sometimes. Keep an eye out for chronic neglect especially in a former plant-lovers home.

Animals that don’t seem well attended to. Common problems include: dogs with long nails, cat litter boxes that haven’t been changed lately, or dead fish in the fish tank. Poor grooming, overfeeding, and underfeeding are other red flags.

  • Home Maintenance Signs

Walk around the yard. Yard maintenance…or lack of it…can yield clues that your loved one isn’t faring as well at home along anymore.

Look for:

Signs of neglect. Look for discolored siding or ceilings that might indicate a leak, gutters choked with leaves, broken windows or fences, dirty windows.

Newspapers in the bushes. Are papers being delivered but ignored? Sometimes people pick up those they see on a driveway or front steps, but not those that may land in the yard.

Mail piled up in the mailbox. Go out and check. Surplus mail is an indication that your loved one isn’t retrieving it regularly.

  • Get Help Looking for Signs

Get the input of others who know your loved one in order to collect a fuller picture of reality. Gently probing about what others think isn’t nosy, you’re simply being loving, concerned, and proactive.

Look for:

Input from those in your loved one’s circle of acquaintances. Talk to old friends and close relatives to get their sense of how the person is faring. Listen for stories that hint that the person doesn’t get out much. Comments such as, “She doesn’t come over anymore.” Or “She quit book club,” are potential red flags. Also pay attention to comments that indicate ongoing concerns, like “Has he had that heart test yet?” or “We were worried the day the ambulance came.”

Medical insight. With appropriate permission, your loved one’s primary doctor may share your concerns about his or her patient’s safety at home or they may be able to alleviate those concerns or suggest where to get a home assessment.

A second opinion. A social worker or professional geriatric care manager visits older adults’ homes and does informal evaluation. While your loved one may initially resist the notion of a “total stranger” checking on them, try pitching it as a professional (and neutral) second opinion, or…ask the doctor to “prescribe “ it. Some people wind up sharing doubts or vulnerabilities with a sympathetic, experienced stranger that they normally would by very reluctant to admit to their own adult children or family.

  • Caregivers’ Signs

Finally, realize that some of the information you collect is intangible it has to do with feelings and emotions, and the stress levels of everyone involved.

Look for:

How you’re doing. While the decision for your loved one to remain in his/her home is not primarily about you the son, daughter, grandchild, caregiver your own exhaustion can be a good gauge of a decline in older adults’ ability to care for themselves. Keeping someone at home can require lots of hands-on support or care coordination, and this is time-consuming. If your loved one’s need for care is just plain wearing you out, or…if a spouse or children are feeling the collective strain of your caregiving activities, these are major signs that it’s time to start looking at other options.

Your loved one’s emotional state. Safety is crucial, of course, but so is emotional well-being. If someone living alone is riddled with anxieties or increasingly lonely, then that may tip the scales toward a move not solely based on health and safety reasons. If your loved one has a full life, a close neighborhood and community connections, and seems to be thriving, it’s worth exploring as many in-home care options as possible before raising stress levels by pressing a move from a beloved home.

If on the other hand, your loved one is showing signs that living alone is a strain, it may be time for a talk. Broach the subject of where to live in a neutral way and you may find that your loved one harbors the same fears for current and future safety and security that you do. Find out what your loved one fears most about moving and about staying before launching into your own worries and what you think ought to be done.

Seniors Find Better Health & Happiness with Assisted Living

While many aging parents are wary of leaving their family home to move into assisted living, the truth is that a senior living community could be better than living at home when it comes to quality of life, social life, and overall wellness.

Adult children who notice that mom and dad are needing more care may question how to handle their parents’ changing health needs. Inevitably, the day comes to assess whether our parents need more than they have in their family home environment.

Benefits of Senior Living

Many seniors are resistant to assisted living, often stating that they don’t want to be put in a “home!” However, a little education about the wonderful senior living communities and options available today, in addition to touring communities like The Classic, can help families and their senior loved ones choose the best option for their unique situations.

In fact, research shows that aging parents and seniors prefer assisted living over other types of care, as these communities have expanded their market by providing fun convenience, retirement, and socialization services.

Better Health & Happiness Are a Way of Life in Assisted Living

Senior living is a great step for seniors who need more socialization and help with daily needs than the family can provide at home.

There are many types of senior living care. As an example, The Classic offers assisted living and independent living as well as memory care all on one campus. Each of these options can offer entertainment, fitness, and living arrangements for the stage parents may need.

Listed below are a few compelling reasons why Assisted Living at The Classic can contribute to better health and quality of life for a senior loved one.

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  • Chef-Prepared, Nutritious Meals

Assisted Living offers nutritious, chef-prepared cuisine that can be catered for specific medical conditions and needs. Residents are served three meals a day and can be tailored to their changing health needs.

  • Help With Daily Living

When a senior loved one lives at home, family caregivers are also generally responsible for helping with activities of daily living (ADLs) such as bathing, dressing, and eating. In other cases, the family or the senior themselves must bear the cost of a home care aide. Both of these options can cause strain on the family. In contrast, one of the most basic benefits of assisted living is helping older adults with these ADLs so that they can continue to function as independently as possible.

  • Intellectual Stimulation

Offered at The Classic are many opportunities for learning, such as book clubs, cooking presentations, gardening, and more.

  • No Stress of Housekeeping and Transportation

Keeping up with appointments, daily chores, and housekeeping are often stressful for not only seniors, but also family members. The vast majority of these burdens are relieved for Assisted Living residents at The Classic as weekly housekeeping and transportation services through Abby Vans is offered.

  • Physical Activity and Fitness

The Classic offers regularly scheduled exercise sessions led by trained instructors as well as access to gym equipment in the Fitness Studio.

  • Safe Living Environment

Often, home modifications and in-home care are required for a safe living environment in the family home, which can be very costly. Assisted living is designed for accessibility and mobility, while offering expert care and medical attention if needed.

  • Social Activity

Living at home can be isolating. Seniors often find it difficult to maintain their social relationships when they are retired. Assisted living offers socialization through planned activities and outings, such as cultural events and field trips. Daily living in the common areas also offers fun and socialization for seniors.

Transitioning to Assisted Living

Don’t all the emotional and logistical challenges of finding senior living overwhelm you. Making the decision to move to an Assisted Living community is becoming much easier as families are increasingly learning more about the benefits and services offered at communities like The Classic.