Stage 1: No impairment
Stage 2: Very mild decline
Stage 3: Mild decline
Stage 4: Moderate decline
Stage 5: Moderately severe decline
Stage 6: Severe decline
Stage 7: Very severe decline
Moderate cognitive decline
(Mild or early-stage Alzheimer’s disease)
At this point, a careful medical interview should be able to detect clear-cut symptoms in several areas:
- Forgetfulness of recent events
- Impaired ability to perform challenging mental arithmetic — for example, counting backward from 100 by 7s
- Greater difficulty performing complex tasks, such as planning dinner for guests, paying bills or managing finances
- Forgetfulness about one’s own personal history
- Becoming moody or withdrawn, especially in socially or mentally challenging situations
but perhaps moving into the beginnings of Stage 5:
Stage 5: Moderately severe cognitive decline
(Moderate or mid-stage Alzheimer’s disease)
Gaps in memory and thinking are noticeable, and individuals begin to need help with day-to-day activities. At this stage, those with Alzheimer’s may:
- Be unable to recall their own address or telephone number or the high school or college from which they graduated
- Become confused about where they are or what day it is
- Have trouble with less challenging mental arithmetic; such as counting backward from 40 by subtracting 4s or from 20 by 2s
- Need help choosing proper clothing for the season or the occasion
- Still remember significant details about themselves and their family
- Still require no assistance with eating or using the toilet
Most of the time, it’s not a big deal. She goes to the Dunedin Day Center three times a week, which she just loves. Edna, her home health aide, comes on Thursdays for her shower. We go to Felix’s Hair We Are every 6-7 weeks for our haircuts, grocery shopping every other week, to the drugstore monthly. She’s always cheerful and pleasant and easy-going.
But every once in awhile, something comes up that reinforces for me that even though the decline is very gradual, it is still there.
We went to a local restaurant for Thanksgiving dinner and had to park one small parking lot over due to the crowd. When we left, the walk from inside the restaurant, around the line of people still waiting outside, and maybe 40 yards on to our car had Mother so winded that she had to lean heavy on my arm the last few feet, and she huffed and wheezed half the way home. It has nothing to do with her lung function, and everything to do with the fact that she not only watches TV every waking moment she’s not at the senior center, but that she lies down on the couch to do it. She is so very sedentary that any amount of walking seriously tires her.
After going out to dinner for her birthday, we stopped at the drugstore to pick up one of her medications that was waiting. Since the pharmacy is in the rear of the store, she has to walk more than she would like and more than she is used to. After picking up her meds and returning to the front of the store, we had to wait a moment for Steve to check out at the front register. Since Mom was tired, she wanted to sit down, but there was no chair or bench. So, she sat down on a stack of cases of plastic water bottles in a display at the front of the store, with no idea that this was not good plan or a safety issue. I told her she couldn’t sit there, and she couldn’t understand why not, and I had to insist that she stand while she was insisting that she was tired and needed to sit. And, since Mom is very hard of hearing, this conversation was carried out at a volume to allow everyone in the store to listen in.
When we got home, I talked to her about it again, and explained that the water bottles could have fallen, then she would have fallen, then they would have fallen on top of her, and she needed to agree that in the future she would only sit on things that were chairs or benches. She agreed, but she seemed amused by it and I don’t think she really understood my concern or why I was making such a big deal about it.
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