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Caring for a Loved One with Alzheimer’s in Each Stage

Alzheimer’s disease affects more than 5 million Americans. The disease leads to changes in memory and behavior that can affect someone’s ability to care for himself or herself.

Family caregivers often step in to help a loved one with Alzheimer’s, taking the loved one to doctor’s appointments, preparing meals and providing emotional support and companionship as the condition progresses. There are different stages of Alzheimer’s disease and each has its own challenges—even for caregivers.

Coping with a loved one’s behavioral and personality changes during each stage is a great responsibility, but it also can be stressful. As we commemorate National Alzheimer’s Disease Awareness Month, it’s important to remember there are countless resources that provide support to caregivers and those battling this disease. There also are different ways caregivers can better cope with the day-to-day challenges associated with Alzheimer’s and manage their loved one’s care.

Here are some helpful tips:

Stages of Alzheimer’s Disease

Alzheimer’s disease normally encompasses five stages: preclinical Alzheimer’s disease, mild cognitive impairment, mild dementia, moderate dementia and severe dementia due to Alzheimer’s. As the disease progresses, symptoms such a memory loss, behavioral changes, the ability to carry on conversation and changes in bodily functions will become more visible.

How Alzheimer’s advances in each person can vary greatly, but it’s important for family members and caregivers to understand what happens during each stage and prepare for it accordingly. Certain stages can last several years and your loved one’s caregiving needs will change during each period.

Early-Stage Caregiving

Alzheimer’s disease progresses slowly in the early stages and symptoms may not be visible to caregivers or the person with the condition. This stage, often known as preclinical Alzheimer’s, can go on for many years until changes in behavior and memory become more apparent.

However, as the disease advances through this stage, you may begin to notice mild changes in your loved one, such as forgetting things that should be easily remembered. You also may notice differences in the person’s decision-making abilities. These changes might not be severe enough to affect your loved one’s ability to work or be independent, but it’s still important to be as supportive as possible during this time. You also should do your best to reinforce positive memories and maintain a routine for your loved one, which can help to keep him or her stimulated and active.

Middle-Stage Caregiving

Most people with Alzheimer’s are diagnosed during this stage. The middle stages of the disease often can be the most challenging because this period typically lasts the longest and symptoms become more pronounced during this time.

During this stage, people with Alzheimer’s experience significant changes in their mental ability and personality. They begin to have more challenges with their memory and thinking, may become more isolated and withdrawn or may even begin to wander. Verbal expression becomes more challenging and they may be more irritable and prone to unexplained outbursts of anger.

As a family member or caregiver, you may notice your loved one having more trouble doing routine tasks that he or she previously could do without help. The person also may respond to these changes in unlikely ways, such as refusing to bathe, avoiding conversation or completely ignoring those around them. This loss of independence can be very frustrating for many people, so it’s critical to be as patient as possible.

You should try to maintain a routine for your loved one during this stage and continuously reinforce positive memories and relationships. Keeping your loved one engaged also will be important. If there is a favorite activity that the person enjoyed, such as gardening, listening to music or playing cards, you should try to maintain participation in the activity as long as it is safe for the person to do so.

You also should seek advice and outside help during this time. A doctor can explain the disease in more detail and suggest resources such as support groups or therapies that can help you manage your loved one’s care. You also should lean on friends and other family members. Though some may not know how to respond when they learn your loved one has Alzheimer’s disease, most likely will offer to help with some of the caregiving responsibilities or at least be there to listen whenever you feel distressed about the situation.

Late-Stage Caregiving

There will be substantial changes in your relationship with a loved one as Alzheimer’s disease progresses.

At times during this late stage, caregiving may feel overwhelming. In addition to declining memory and thinking abilities, physical impairments also become more common during this time. Your loved one may not be able to communicate as much or as well and he or she likely will need daily help with care and regular tasks such as getting dressed, eating or using the bathroom.

Grief is common during the late stages of Alzheimer’s, especially as you notice these changes in your loved one and in your relationship. This is understandable. However, this also is the time when your loved one will need your support more than ever—and when you’ll need support from others, as well. As your caregiving responsibilities increase, it’s important to take care of yourself as best you can. Doing so will ensure that you give your loved one the best care possible. Though it may be difficult, you should try to savor the time you still have with your loved one and gather friends and family so the person has more support as the disease advances.

Alzheimer’s is an incredibly difficult disease for both the person diagnosed with it and family members who must care for the individual. Caring for a loved one can change during each stage of Alzheimer’s. As the disease progresses, caregiving responsibilities increase and the relationship between you and your loved one changes. It can be extremely challenging to maintain a positive outlook amid these ongoing changes, but it’s so important to give your loved as much support as you can and seek help from others when you need it most.

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