What You Should Know About Alzheimer’s Disease

If you’re supporting a loved one who’s living with Alzheimer’s disease, you already know how challenging being a family caregiver can be. However, you might not know what to expect in the upcoming weeks, months, and years, particularly if you plan on keeping your family member at home for as long as you possibly can. Unfortunately, Alzheimer’s is a progressive degenerative disease with no known cure, and that makes being a dementia caregiver especially difficult. 

While caring for someone who has Alzheimer’s can feel isolating, it’s important to know that you’re not alone. An estimated 6 million Americans are currently living with Alzheimer’s, and one in nine seniors aged 65 and older have the disease.

In this guide, you’ll learn about the signs and symptoms of Alzheimer’s disease and what you and your family can expect in the coming months and years. It also provides practical tips on how to manage day-to-day life as an Alzheimer’s caregiver and information on where you can find help from memory care professionals. 

Early Signs and Symptoms of Alzheimer’s Disease

Recognizing the early signs and symptoms of Alzheimer’s disease can be difficult. Given the prevalence of dementia among older adults, it’s easy to assume that all seniors who experience cognitive decline have Alzheimer’s. 

Subtle, progressive cognitive changes, such as mild forgetfulness, word-finding, slowed thinking, and difficulty with short-term recall are all a part of the normal aging process. These changes are caused by age-related reductions in the size of certain areas of the brain, but when these changes happen quickly, or in conjunction with other issues, it could be time to consult with a medical professional. Only a licensed medical doctor can make a diagnosis of Alzheimer’s, so if you have concerns about a family member’s health, start by seeking assistance from their physician. 

The prevalence, duration, frequency and severity of dementia symptoms vary between patients, but here are some of the most common early signs and symptoms of Alzheimer’s disease: 

Memory Lapses

One of the first symptoms experienced by many people with Alzheimer’s is forgetfulness or memory loss that interferes with day-to-day functioning. This can mean forgetting important dates, such as medical appointments, or struggling to remember the names of familiar people. Issues with memory can also present as your loved one asking the same question over and over or becoming completely reliant on memory aids, such as alarms and reminder notes, for everyday tasks. 

Confusion Over Words

People who have Alzheimer’s disease often struggle to find the right words when speaking or writing, a condition known as word-searching or word-finding. You may notice that your loved one suddenly stops talking mid-sentence or isn’t as chatty as they once were. They may also misname common objects or have difficulty remembering what everyday objects are called. 

Marked Changes in Mood or Personality

In the early stages of Alzheimer’s disease, affected individuals are often acutely aware that they are experiencing significant changes in the way their brain works. This can lead to feelings of anxiety, frustration, anger, and depression, and those feelings can manifest as significant personality and mood changes. Your loved one may suddenly seem to be withdrawn, short-tempered, and/or have little interest in things they previously enjoyed, such as social activities, sports, and hobbies. 

Trouble With Abstract Thinking

Individuals who have Alzheimer’s disease often have trouble dealing with complex information and solving problems. This can mean that someone who was previously able to troubleshoot mechanical issues with an automobile is no longer able to do so or that a person who always did the bookkeeping for their small business now has difficulty balancing a checkbook. In the early stages of Alzheimer’s, individuals often conceal their struggles with abstract thinking by coming up with excuses for why they can no longer deal with complex information or solve multistep problems. 

Difficulty Completing Familiar Tasks 

While many of the other early signs and symptoms of Alzheimer’s disease are often dismissed as being a part of normal aging, once an individual begins to have difficulty completing familiar tasks, there’s no denying the need for an accurate medical diagnosis. When your loved one has this symptom, you may notice that they have trouble preparing a simple meal, forget how to play a favorite card game, or are unable to finish a hobby project. 

Disorientation

Another common early sign of Alzheimer’s disease is disorientation. You might have noticed that your loved one is having a hard time remembering how to get to familiar places, such as their church or neighborhood grocery store. They might not remember how they arrived at a particular destination, forget where they parked their car or have a hard time remembering what day it is. 

Misplacing Items

Although it’s not unusual to occasionally misplace your car keys or lose the remote control for your television, when these types of things happen on a frequent basis, it could be a sign of a serious problem. Individuals with early-stage Alzheimer’s may put items in unusual places, such as placing their purse in the freezer or storing vegetables in their bedroom closet. They may also begin to think that someone is stealing from them because they can’t remember where they left their belongings. 

Impaired Judgement

Dementia makes it hard for individuals to make sound, healthy choices, and that can lead to odd behavior, such as dressing inappropriately for the weather, neglecting to brush their teeth and take showers or baths or giving money away to people or charities that they wouldn’t have normally supported. This makes those living with memory loss especially vulnerable to financial fraud, as their judgment of people, situations and risks is often impaired. 

The Stages of Alzheimer’s: What to Expect

Alzheimer’s is what’s known as a progressive degenerative disease. This means that over time, the signs and symptoms of the disease will get worse. However, not everyone with Alzheimer’s will experience all these stages, and the duration of each stage varies widely between patients. 

As a family caregiver, you should also be aware that Alzheimer’s doesn’t progress in a linear fashion. Simply put, you can expect your loved one to have good days and not-so-good days. They may seem to be relatively high-functioning one day and then struggle with basic tasks the next. This unpredictability is one of the reasons why caring for an individual with Alzheimer’s can be so incredibly challenging. 

Normal Behavior

Also known as the preclinical stage, this stage lasts for anywhere from 10 to 15 years before any symptoms appear. During this stage, you won’t notice anything unusual about your loved one, despite the fact that a number of neurological changes are occurring. Currently, there are no known medical interventions that can be used at this stage, but researchers are working to develop treatments to delay the onset of issues for those with preclinical Alzheimer’s disease. 

Very Mild Changes

During this stage, individuals with Alzheimer’s disease may present with periodic memory lapses or forgetfulness that’s virtually impossible to differentiate from normal age-related memory issues. They may start misplacing small items or occasionally forget familiar names, but they can otherwise maintain their usual daily routines. 

Mild Decline

This is the stage of Alzheimer’s when cognitive changes become much more noticeable, both to the affected individual and their family, friends and coworkers. 

Common issues associated with this stage include: 

• Difficulty with short-term memory, such as recalling what happened during a movie they just watched
• Trouble organizing their daily schedule, making plans and remembering important events
• The emergence of Primary Progressive Aphasia, a language deficit characterized by an impaired ability to use the correct words while speaking and/or writing
• Avoidance of social settings, such as parties, due to increased anxiety around word searching and memory loss

This is the stage where many individuals seek assistance from their health care provider. Most people with Alzheimer’s are diagnosed when their disease is at this stage. 

Moderate Decline

This stage of Alzheimer’s disease involves a marked progression in memory loss, as well as difficulty with organizing thoughts, making plans, and reasoning. Once your loved one reaches this stage, you may notice that: 

• They struggle with their short-term memory on a constant basis
• They’re able to recall events in the past with clarity, but they might not know what day it is or where they are
• They have difficulty managing their medications, leading to skipped doses and accidental double-dosing
• They’ve developed irregular sleep patterns, such as taking excessively long naps during the day and failing to sleep during the night
• They don’t dress appropriately for the weather
• They often get lost or have started to wander 
• They may become withdrawn or depressed

Individuals at this stage of Alzheimer’s recognize many of the changes they are experiencing, and that can lead to anger, depression, and anxiety. They may withdraw, lose interest in maintaining contact with family and friends, and become suspicious or fearful of those who they previously trusted. If they previously held a valid driver’s license, by this stage they will no longer be able to safely operate a motor vehicle, and their driver’s license will be suspended by their physician. 

Although medications cannot cure or completely prevent the onset of many symptoms of moderate decline, some people with Alzheimer’s may benefit from prescription drugs to treat issues with low mood and sleep. 

Moderately Severe Decline

At this stage of the disease, your loved one will likely need significant support with day-to-day activities, such as maintaining their personal hygiene, keeping up with their household chores, and managing their finances. They’re likely to be unable to live independently, so at this stage, most people with Alzheimer’s either require placement in a specialized residential memory care program, or they need to live with a full-time caregiver. 

Things you might notice at this stage include: 

• They may have difficulty remembering familiar faces and names
• They might need some help getting dressed, using the toilet and brushing their teeth
• They can no longer manage their finances
• They’re experiencing a wide range of emotions, often without provocation or warning
• They’ve become fearful and/or paranoid
• They may experience urinary and/or fecal incontinence, and they might begin relieving themselves outside of the bathroom

Severe Decline

At this stage of the disease, your loved one will no longer be able to manage basic life-sustaining activities, such as dressing themselves, bathing independently, or even remembering to eat or drink. Behaviors and signs of this stage can include:

• Difficulty speaking 
• Trouble recognizing close family members
• Inability to orientate themselves to time and place
• Pacing, fidgeting, and moving objects around repetitively
• Verbal and/or physical outbursts
• They likely need hand-over-hand assistance to eat and drink

Very Severe Decline

Once individuals reach the final stage of Alzheimer’s, they require around-the-clock hands-on care. They may become completely mute, or if not, their vocabulary is often limited to just a few words that are difficult to understand and used out of context. 

When your loved one enters this stage, you may also notice that:

• They can no longer control their facial movements, which means they can’t smile or laugh
• They can’t walk or turn over in bed
• When in the seated position, they’ll fall over unless the chair has armrests
• Their joints may become rigid, and they might be unable to bend their legs or arms

Because this stage involves a near-complete lack of physical mobility, it’s common for individuals to suffer from pneumonia, bedsores and other mobility-related problems. 

What Is the Life Expectancy of Someone With Alzheimer’s? 

The life expectancy for someone diagnosed with Alzheimer’s disease ranges from as little as three years to over 20 years, with the average being 11 years from the date of diagnosis. 

Alzheimer’s longevity is influenced by a number of factors, such as:

• The age of the individual when diagnosed with the disease
• Their gender, since women tend to live slightly longer than men
• Any other acute and chronic health conditions the patient may have, such as diabetes, cancer, heart disease and arthritis
• Genetic predisposition to health issues
• Whether or not the individual engages in high-risk behaviors, such as wandering, or if they’re prone to falling
• What kinds of supports the individual receives to help delay the progression of Alzheimer’s related health issues, such as dehydration, poor medication management, malnutrition and lack of activity

How to Help a Loved One With Alzheimer’s Disease

If you’re caring for a loved one who has Alzheimer’s disease, there are some things you can do to help support their strengths, assist with their overall health and wellness and delay the onset of further symptoms. 

Keep Their Mind Stimulated

One of the best things you can do for your family member is keeping them mentally active. Continue to involve them in conversations, include them in family dinners and events and chat with them about their hobbies and interests. 

Take the time to find activities they enjoy. This might mean playing a game of cards, watching a television show or simply going for a relaxing walk. Temper your expectations and avoid the urge to correct any misplaced words or memory errors. 

Simplify Their Daily Tasks

Look for ways to reduce the cognitive demands on your loved one. This might mean offering to manage their household finances, setting up a meal delivery service so they don’t need to cook or shop for groceries or hiring a housekeeper to do daily chores. 

Maintain Some Routine

People with Alzheimer’s tend to do best when they follow a predictable routine. If you’re living with your loved one, try to set a daily schedule and stick to it. This means eating meals at the same time every day, going for daily walks and minimizing disruptions to their schedule. 

Use High-Tech Solutions

There are a number of electronic devices and apps that can be used to help family caregivers support their loved ones. Internet-connected cameras that you can view through a secure smartphone app may be a good option if you need to leave your family member alone but you’d still like to be able to monitor them. 

You might also want to consider getting your loved one a senior-friendly cell phone that’s equipped with a GPS location tracking app. These apps let authorized caregivers and first responders quickly locate the cell phone user, and that can be especially helpful when supporting Alzheimer’s patients who are prone to wandering. 

Another popular high-tech solution for those living with Alzheimer’s disease is a medical alert device that’s equipped with automatic fall detection and GPS location tracking. These devices are available as either a pendant or wrist-mounted button, and some of these devices include a caregiver app that you can use to monitor your loved one’s whereabouts, check their activity levels and add information about their medical condition and history. 

Care Options for Seniors With Alzheimer’s Disease

As a family caregiver for someone who has Alzheimer’s, you should know that even the most dedicated families often need to enlist outside memory care help, especially during the latter stages of the disease. Two of the best options for memory care services are in-home care and residential care in a specialized memory care community. 

In-Home Care

In-home memory care, often called home care or home health care, can be used to support your loved one while also giving you and your family a much-needed break from your caregiving duties.

In-home care services are provided on a one-on-one basis. A home care provider who specializes in working with individuals who have Alzheimer’s disease can be hired on an hourly or live-in basis. These professionals can help with activities of daily living, such as bathing, dressing and grooming, that your loved one might not want a family member helping them with. 

Home care providers can also assist with light housekeeping and laundry, meal prep and in some cases, pet care. This type of care may be ideal if you’re looking for someone who can supervise your loved one while you attend to your own health and well-being or on a respite basis. 

Memory Care Communities

Memory care communities are specially designed senior living communities that provide around-the-clock nonmedical care to those with Alzheimer’s disease and other types of dementia. These communities look and feel much like assisted living facilities but have added security features to help keep residents safe, such as delayed-egress exit doors, tastefully enclosed outdoor areas and location monitoring systems.

Memory care communities are staffed by professional caregivers who have completed specialized memory care training. These caregivers are experienced in safely and respectfully managing the behaviors exhibited by individuals with memory loss, and these facilities have more direct care staff available than you’ll find in an assisted living facility. 

In addition to being staffed by specialized caregivers, memory care communities provide residents with a highly structured and predictable environment. Daily individual and small group activities are designed to delay the further onset of Alzheimer’s symptoms while enhancing residents’ strengths and supporting overall health and wellness. Many memory care communities offer respite services, so your family can try out the placement on a short-term basis before deciding whether or not the community is a good fit for your loved one. 

Frequently Asked Questions

Works Cited

“What is Alzheimer’s? Alzheimer’s Disease and Dementia.” Alz.org,  https://www.alz.org/alzheimers-dementia/what-is-alzheimers. Accessed July 12, 2020. 

“Facts and Figures. Alzheimer’s Disease and Dementia.” Alz.org, https://www.alz.org/alzheimers-dementia/facts-figures. Accessed July 12, 2020.

“Memory, Forgetfulness, and Aging: What’s Normal and What’s Not?” National Institute on Aging, U.S. Department of Health and Human Services, https://www.nia.nih.gov/health/memory-forgetfulness-and-aging-whats-normal-and-whats-not. Accessed July 12, 2020.

“Healthy Aging.” UCSF Memory and Aging Center, https://memory.ucsf.edu/symptoms/healthy-aging. Accessed July 12, 2020.

“What Causes Alzheimer’s Disease?” National Institute on Aging, U.S. Department of Health and Human Services, https://www.nia.nih.gov/health/what-causes-alzheimers-disease. Accessed July 12, 2020.

“Stages of Alzheimer’s – Alzheimer’s Disease and Dementia.” Alz.org, https://www.alz.org/alzheimers-dementia/stages. Accessed July 12, 2020.

“The 7 Stages of Alzheimer’s Disease.” Penn Medicine,  https://www.pennmedicine.org/updates/blogs/neuroscience-blog/2019/november/stages-of-alzheimers. Accessed July 12, 2020.

“Primary Progressive Aphasia.” National Aphasia Association, November 6, 2020, https://www.aphasia.org/aphasia-resources/primary-progressive-aphasia/. Accessed July 13, 2020.

“Alzheimer’s stages: How the disease progresses.” Mayo Clinic, April 29, 2021, https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers-stages/art-20048448. Accessed July 13, 2020.