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Cheat Sheet

Alzheimer’s For Dummies

From Alzheimer's For Dummies by Patricia B. Smith, Mary M. Kenan, PsyD, Mark Edwin Kunik, MD, MPH, Leeza Gibbons (Foreword by)

Medical professionals have developed a set of stages to describe the progression and symptoms of Alzheimer’s disease. After you assess the needs of the Alzheimer’s patient and explore the care choices, then you can decide on the best option for care.

Alzheimer's Disease Stages

Alzheimer’s Disease and its progression are described by doctors and medical researchers through stages, and symptoms that can occur in each stage. Alzheimer patients are categorized by their level of cognitive and functional impairment – mild, moderate, severe, and profound. This outline describes the stages and possible symptoms:

Mild

  • Forgetfulness

  • Difficulty with complex math problems, such as balancing the checkbook, doing taxes

  • Inability to plan and execute a complex series of actions, such as that required to prepare a three-course meal

  • Inability to stick to a complex schedule, such as that required by certain prescriptions, 2 tablets 3 times a day

  • Confusion or disorientation about time, date or place, wandering toward a specific goal, such as a friend’s house that, results in getting lost

Moderate

  • More pronounced memory problems that may interfere with normal daily activities

  • Difficulty with simple food preparation, such as brewing a cup of tea or coffee

  • Inability to perform routine household chores and yard work

  • Decline in personal hygiene, possibly requiring reminders or assistance to use the bathroom, shave, fasten clothing correctly, and choose appropriate clothing

  • Increased wandering behavior that’s not goal-directed, getting lost

  • Agitation, pacing, increased irritability more likely

  • Confusion that often becomes worse in evening

The following symptoms can occur in both the moderate and severe stages, and may become more noticeable as the patient enters the severe stage.

  • Increased irritability and agitation, verbal and physical aggression

  • Symptoms of psychosis, including delusions, paranoia, and hallucinations

Severe

  • Need for extensive assistance with personal care, including eating, hygiene, grooming and toileting

  • Increased irritability and agitation, verbal and physical aggression

  • Symptoms of psychosis, including delusions, paranoia, and hallucinations

  • Unsteadiness and reduced ability to walk

  • Incontinence

  • Disorientation

Profound

  • Complete lack of awareness of surroundings

  • Total dependence on caregivers for feeding, hygiene, and everything else

When AD patients reach what’s known as the terminal stage of the disease, they may become bedridden and will certainly require around-the-clock care. At this stage, many Alzheimer’s patients succumb to opportunistic infections, such as pneumonia.

Deciding on Care for Alzheimer’s Patients

Choosing care for an Alzheimer’s patient involves many factors: the needs of the patient, money restrictions, desire to keep the patient in his or her own home, and availability of family and friends to help. Some options when looking into care for an Alzheimer’s patient are

Care Choice Care Provider Location Cost
In-home care You or another family member Your home or your loved one’s home No out of pocket cost other than medical bills, but you may have to give up your job to provide care
In-home care Home health aide Your home or your loved one’s home U.S. Department of Labor reports average is $8.17 per hour. Agency referred $12 to $25 per hour
In-home care Visiting nurse Your home or your loved one’s home $25 to $50 per hour
Adult day care On site staff and volunteers Day Care Center or Senior Center $35 per day and up; may include transportation; services such as bathing cost extra
Day health care On site staff and volunteers Day Care Center or Senior Center $50 per day and up
Respite Care On site staff and volunteers Day Care Center or Senior Center $8 to $30 per hour
Assisted living On site staff and volunteers, family members Assisted Living Center $18,000 a year and up, most affordable overall
Licensed residential care home On-site non-medical staff, Residential Care Center $850 to $4,000 per month, depending upon location
Dedicated Alzheimer care center On-site medical and non-medical staff, visiting medical staff Alzheimer Care Center $115 per day and up
Nursing home On-site medical and non-medical staff, visiting medical staff Nursing Home $36,000 to $100,000 annually, depending upon location
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