Your loved one has received an Alzheimer’s diagnosis. Their personality has started to change. Maybe they become angry a lot. Perhaps they repeat themselves or do repetitive things. Maybe they get agitated as it gets close to dinner time. Any of these may indicate that your loved one is entering the second or middle stages of Alzheimer’s. The Alzheimer’s Association calls this Moderate Alzheimer’s.
Moderate Alzheimer’s can last from 2 to 10 years.
Moderate Alzheimer’s is the stage where you see the greatest change in your loved one. This is also the stage where daily responsibilities grow for the caregiver.
Family discussions about breaks for the caregiver is one way you can prepare during the early years of Moderate Alzheimer’s. Early preparation for the very busy later years of Moderate Alzheimer's sets your family up for success.
Moderate Alzheimer’s is classified as Stage 5 or 6 cognitive decline on the 7 stage Global Deterioration Scale (also known as GDS or the Reisberg Scale). NOTE: It is possible for your loved one to be at one stage of cognitive decline and a different stage of functional ability. (Functional Assessment Staging Test (FAST Stage 4).
It is important that you and your physician are aware of the symptoms experienced by your loved one.
Moderate Alzheimer’s Symptoms
New signs of inability to
- Remember recent events
- Remember personal history, including address
- Remember the names of spouse or child(ren)
- Count down from 10
- Experiences paranoia, confusion, depression or anxiety
- Has trouble following or joining a conversation
- Repeats actions
- Repeats words
- Behaves with suspicion, agitation, aggression or anger. Easily upset.
- Reports hallucinations. Hallucinations are when something is perceived to be present when it is not.
- Shows evidence of delusions. Delusions are when things are believed to be true that are not
- Many people first experience incontinence (a loss of bladder or bowel control) at this stage. Incontinence can be caused by many factors, including an inability to recognize the need to use the restroom, forgetting where the bathroom is located, medications, stress, certain physical conditions, clothing that is difficult to remove and constipation. If incontinence is a new problem, consult with the doctor to rule out potential causes such as a urinary tract infection or medications.
Many people with Alzheimer’s experience changes in their sleep patterns. Scientists do not completely understand why this happens. As with changes in memory and behavior, sleep changes somehow result from the impact of Alzheimer’s on the brain.
- Sleep disturbances are more frequent and tend to be more severe in Alzheimer’s than in normal aging.
- Many people with Alzheimer’s find that a good night’s sleep takes effort. They wake up more often and stay awake longer during the night. Those who are awake in the middle of the night may wander, become restless in bed, yell or call out. This can disrupt the sleep and negatively impact the health of their caregivers.
Many people living with Alzheimer’s find themselves very drowsy during the day and unable to sleep at night. They become restless, confused or agitated in the late afternoon or early evening. This is called sundowning.
- As the disease progresses, loss of appetite and weight loss may become concerns. Distractions, too many choices, and changes in perception, taste and smell mean eating requires more effort.
- Loss of appetite can be caused by:
- Not recognizing the foods that are on the plate.
- Poor fitting dentures. Eating may be painful, but your loved one may not be able to tell the caregiver this.
- New medications or a dosage change may affect appetite.
- Needing more exercise.
- Food may not smell or taste as good as it once did.
- Staying hydrated is also important. Encourage fluids with water or other liquids throughout the day. Foods with high water content, such as fruit, soups, milkshakes and smoothies also help.
Moderate Alzheimer’s Treatment
Caring for a Loved One at Home
- Help them get to the bathroom in time
- Help them bathe
- Help them choose the right clothing & get dressed
- Help them brush their teeth
- Provide help preparing healthy meals
- Help the person living with Alzheimer’s prepare their plate or eat during meals.
Treatments for disrupted sleep
- For sleep changes due primarily to Alzheimer’s disease, there are non-drug and drug approaches to treatment. The National Institutes of Health (NIH) strongly encourage use of non-drug measures rather than medication. Studies have found that sleep medications generally do not improve overall sleep quality for older adults. Use of sleep medications is associated with a greater chance of falls and other risks that may outweigh the benefits of treatment.
Giving Caregivers a break
Medical professional recognize the importance for every caregiver to have breaks from caregiving. Services that care for loved ones during these breaks are referred to as “respite services” or simply “respite”. Respite services offer care for a loved one while giving a caregiver a break.
Examples of Respite Services include:
- Adult Day Program – Supervised program where loved one interact with peers for half or full days. Caregivers are free to go to work, rest, exercise or do something enjoyable.
- In-home senior care – In-home services for people living with Alzheimer’s. Care providers range from those who provide specialized care for people with chronic diseases to companion services for people who benefit from assistance with daily activities. Caregivers are free to go to work, rest, exercise or do something enjoyable.
Impact on Caregiver and Family
Years of caregiving plus the grief of watching a loved one get worse may impact a caregiver’s mental and physical health. Some caregivers disregard their own health. During Moderate Alzheimer’s, it is important for caregivers and family members to notice how stress is affecting the caregiver. Stress is easiest to see in a caregiver’s mood and outlook. Once stress or depression is identified, it can be addressed.
During Moderate Alzheimer’s, little by little, caregivers and family members learn the importance of turning to others for help. Local support groups, adult day programs and other respite efforts share resources nearby loved one. Online support groups and chats are available day and night.
Survive Moderate Alzheimer’s
Survive your loved one’s Moderate Alzheimer’s by using the early years to get ready. AlzTimeline: Patterns in Time is the first resource that invites you to prepare for your family’s Alzheimer’s journey using a real family’s experience. This timeline tracks the impact of Alzheimer’s on one woman and her family. It reveals the choices she and her family made for her care. Most importantly, it challenges you to weigh the care choices you and your family will need to make. Order your copy today.