Alzheimer's Stages: How to Recognize and Deal with Them

Understanding the typical progression of the Alzheimer’s stages can help caregivers, friends and family members prepare for a senior’s current and future physical and emotional needs, as well as reduce their own anxiety about the future.

While there are no set rules for the exact progression of the disease, some common patterns are associated with the progression of symptoms.

The following Alzheimer’s stages were developed by Barry Reisberg, MD, Clinical Director of the New York University School of Medicine’s Silberstein Aging and Dementia Research Center.

Alzheimer’s Stage 1: No Cognitive Impairment

Common Behaviors: During stage 1, the person shows no outward signs or symptoms of the disease and functions at a level consistent with his or her previous lifestyle.

Alzheimer’s Stage 2: Very Mild Decline

Common Behaviors: During stage 2, the person may begin to be aware that he or she is forgetting words and the locations of common items, but no symptoms are detected by medical professionals or those close to the person.

Notes for Caregivers: Grief is common for people during Alzheimer’s stages 2 and 3. The awareness of the disease can be greatly emotional and accompany a sense of fear. It is important to communicate with the patient to learn about his or her wishes for future care and medical intervention.

Alzheimer’s Stage 3: Mild Cognitive Decline

Common Behaviors: During stage 3, the person experiences noticeable difficulty using or remembering the right words or a person’s name, experiences increased difficulty performing routine social or work tasks, has impaired short-term memory.

Notes for Caregivers: It is very important to remain sensitive to the person as the Alzheimer’s progresses. The patient is most likely aware of his or her cognitive decline and experiencing frustration, confusion and fear. If the person still drives, it may be time to discuss alternative transportation options, as well as making the living environment as safe as possible.

Alzheimer’s Stage 4: Moderate Cognitive Decline

Common Behaviors: During stage 4, the person frequently forgets recent events, has difficulty performing complex tasks and may begin to forget their personal history.

Notes for Caregivers: As a person’s cognitive skills deteriorate, your need for increased patience will rise. The person may experience more anxiety, so it may be helpful to identify things that decrease the anxiety levels. For example, avoiding questions that require the person to recall something specific and redirecting are proven methods for decreasing anxiety.

Alzheimer’s Stage 5: Moderately Severe Cognitive Decline

Common Behaviors: During this stage, the person often forgets his or her address and/or telephone number, experiences confusion regarding the day of the week, has difficulty performing simple arithmetic and requires help when picking out appropriate clothing.

Notes for Caregivers: This stage is often when a person with Alzheimer’s requires outside care. Skilled nursing facilities and memory care facilities are frequently used at this point. Their secure buildings and 24-hour staff enable people with Alzheimer’s to remain safe, properly medicated, well fed and socially involved.

Alzheimer’s Stage 6: Severe Cognitive Decline

Common Behaviors: During stage 6, the person is less aware of recent happenings, can distinguish between familiar and unfamiliar people but has difficulty with names of a spouse, children, etc., tends to wander or get lost, needs help dressing, experiences incontinence or bathroom issues, experiences personality shifts and experiences sleep pattern disruptions.

Notes for Caregivers: Consider providing the patient with photographs from his or her youth or early adulthood. It provides potential memory sparks and talking points for visitors.

Alzheimer’s Stage 7: Very Severe Cognitive Decline

Common Behaviors: During stage 7, the person requires others to perform activities of daily living (feeding, bathing, toileting, and so forth), may also lose muscular control or experience muscle rigidity, can no longer can carry on conversations and experiences difficulty swallowing.

Notes for Caregivers: Don’t neglect yourself. The Alzheimer’s stages are difficult for the patient, but also for the loved ones. Find people to talk with friends, a counselor or a local Alzheimer’s support group. 

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No matter how your loved ones progress through the Alzheimer’s stages, there is a memory care community out there that can give them the support they need. Browse our national directory to Find Memory Care near you.

Written by senior care writer Meredith Olson.

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