What You Should Know About Alzheimer’s Disease

If you have a loved one who was recently diagnosed with Alzheimer’s disease, you probably feel overwhelmed and worried about the future. You might not know what to expect in the upcoming weeks, months, and years, especially if you plan on being a caregiver for your loved one. Unfortunately, Alzheimer’s is a progressive degenerative disease with no known cure, and that makes being a caregiver especially difficult.

We created this guide to help you better understand Alzheimer’s disease and what you can expect as your loved one’s disease progresses. We also provide 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.

Recognizing the early signs and symptoms of Alzheimer’s disease can be difficult. 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.

But when these changes happen quickly or in conjunction with other issues, it’s time to consult with a medical professional. 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 or appointments, struggling to remember the names of familiar people, or asking the same question over and over again.
• Confusion Over Words: People who have Alzheimer’s disease often struggle to find the right words when speaking or writing. 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.
• 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.
• Trouble With Abstract Thinking: People who have Alzheimer’s disease often have trouble dealing with complex information and solving problems. This can mean that someone previously able to troubleshoot mechanical issues with an automobile can no longer do so or that a person who always did the bookkeeping for their small business now has difficulty balancing a checkbook.
• Difficulty Completing Familiar Tasks: Many people with Alzheimer’s find it difficult to remember all of the steps of a multi-step task. 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: 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.
• Frequently Misplacing Items: Individuals with early-stage Alzheimer’s may frequently lose crucial belongings or 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 Judgment: Dementia makes it hard for individuals to make sound, healthy choices, which 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.

The greatest risk factor for developing Alzheimer’s disease is age– after age 65, the risk of developing the disease doubles every 5 years, according to the Alzheimer’s Association. Other risk factors to be aware of include:

• Genetics: Researchers have identified genes that are associated with Alzheimer’s disease, but at this point, it is unknown to what degree they impact one’s risk of developing Alzheimer’s.
• Family History: If other people in your family have had Alzheimer’s disease, you’re more likely to also develop it. The risk increases if multiple family members have had Alzheimer’s.
• Traumatic Brain Injury (TBI): While minor head injuries have not been shown to lead to Alzheimer’s or dementia, moderate or severe TBI has been shown to increase the risk of Alzheimer’s and dementia.
• Race and Ethnicity: The Alzheimer’s Association reports that Hispanic and black Americans are more likely than white Americans to develop Alzheimer’s disease.

Alzheimer’s must be diagnosed by a physician, which is why it’s so important to make an appointment if you’re seeing early signs and symptoms of the condition. When you go to the appointment, be prepared to tell the doctor about the symptoms you’ve noticed, how long the symptoms have been going on, and the frequency of the symptoms.

There is no single definitive test for Alzheimer’s. Instead, physicians use diagnostic techniques including:

• Neurological Exam: Doctors will test your reflexes, eye movement, coordination, muscle strength, and speech for signs of a brain disorder.
• Cognitive Tests: These tests evaluate one’s ability to think and solve simple problems. Doctors will ask the patient questions such as the date or where they are, or to do simple calculations.
• Brain Imaging Tests: Brain scans done using magnetic resonance imaging (MRI) or computed tomography (CT) are often used as part of the Alzheimer’s diagnosis process to rule out other conditions, like brain tumors or fluid buildup, that can cause similar symptoms to Alzheimer’s.

Some practitioners may also conduct blood tests or brain fluid tests, though the conclusiveness of these tests in diagnosing Alzheimer’s is not yet well established.

Alzheimer’s is what’s known as a progressive degenerative disease. This means that the disease’s signs and symptoms will worsen over time. 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. This unpredictability is one of the reasons why caring for an individual with Alzheimer’s can be so incredibly challenging.

Still, understanding the stages can help you know what to expect in the future.

At the beginning of this stage, individuals may experience 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.

After some time, though, 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 point where many individuals seek assistance from their health care provider. Most people with Alzheimer’s are diagnosed when their disease is at this stage.

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

As this stage progresses, your loved one will likely need significant support with day-to-day activities, such as maintaining personal hygiene, keeping up with household chores, and managing finances.

At this stage, your loved one will no longer be able to manage basic activities of daily living (ADLs), such as dressing themselves, bathing independently, or eating and drinking. Behaviors and symptoms 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

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

Once individuals reach this stage, they require around-the-clock care like you would receive in a memory care community. 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.

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 and assist with their overall health and wellness. Some tips include:

• Keep Their Mind Stimulated: Continue to involve them in conversations, include them in family dinners and events, and chat with them about their hobbies and interests. Activities like playing cards or completing skill-appropriate puzzles can also be mentally stimulating.
• Simplify Their Daily Tasks: Look for ways to reduce the cognitive demands on your loved one, such as managing their 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 a Routine: If you’re living with your loved one, try to set a daily schedule and stick to it by doing things like eating meals at the same time every day and going for daily walks. People with Alzheimer’s tend to do best when they follow a predictable routine.
• Use Technology: A number of electronic devices and apps can help family caregivers support their loved ones, including medical alert smartwatches with an accompanying caregiver app.

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

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. They can provide services including:

• Help with the activities of daily living (ADLs) like bathing, dressing, and grooming, that your loved one might not want a family member helping them with.
• Light housekeeping and laundry
• Meal preparation
• Companionship
• Health services (for skilled care, make sure you hire a home health care nurse)

Caregivers at memory care communities complete specialized training in safely and respectfully managing Alzheimer’s and dementia behaviors, and these facilities have more direct care staff available than you’ll find in an assisted living facility.

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.

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“Facts and Figures. Alzheimer’s Disease and Dementia.” Alz.org, https://www.alz.org/alzheimers-dementia/facts-figures. Accessed June 18, 2024.

“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 June 18, 2024.

“Stages of Alzheimer’s – Alzheimer’s Disease and Dementia.” Alz.org, https://www.alz.org/alzheimers-dementia/stages. Accessed June 18, 2024.

“The 7 Stages of Alzheimer’s Disease.” Penn Medicine, https://www.pennmedicine.org/updates/blogs/neuroscience-blog/2019/november/stages-of-alzheimers. Accessed June 18, 2024.

“Primary Progressive Aphasia.” National Aphasia Association, November 6, 2020, https://www.aphasia.org/aphasia-resources/primary-progressive-aphasia/. Accessed June 23, 2024.

“Alzheimer’s stages: How the disease progresses.” Mayo Clinic, June 7, 2023, https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers-stages/art-20048448. Accessed June 23, 2024.