Staging

Malka

How do I know which stage my dad is in? From looking at articles online I would say 6, but I am not sure.

towhee

Malka, if you are using the staging model associated with Tam Cummings which is often referred to here, then you are probably correct is your assessment. Staging is not an exact science, you just hope to get somewhere in the ballpark.

harshedbuzz

@Malka

I found my dad's doctors often used the 3-Stage model-- mild, moderate and severe. I found the Tam Cummings and FAST Scales more useful for anticipating declines and behaviors. The Cognitive Age comparison was especially useful in making safety decisions. My mom was dad's caregiver and tended to be in serious denial about how impaired dad actually was which.

dementia---fast-scale.pdf (hartfordhealthcare.org)

That said, the generally rule of thumb is that a person is considered to be in the latest stage for which they have a symptom/behavior. If you live with dad or see him a lot, you will likely have a better sense than his medical team. I mention this because most folks sort of straddle stages at times. Dad, for instance lost the ability to smile (and developed aspiration issues) while he was still reasonably ambulatory and ridiculously verbal. I had a sense the end wasn't far off, but his death seemed to surprise his aides, DON and my mom.

HB

Malka

@harshedbuzz

Thank you. I have never seen that FAST scale before. I'm curious how long each phase might last. Right now I feel like I am living Groundhog Day.

M

bjohnsen3869

Malka,

lol. Meeeee tooooo. That’s what we call those moments around our house. You have to find some humor in it though.

harshedbuzz

@Malka

It is Groundhog Day.

The Tam Cummings one @towhee mentioned is here:

Tam-Cummings-LLC-Handouts.pdf (tala.org)

It does include an average length of duration for stages 3-7. That said, these are averages-- YMMV. Each PWD will have their own trajectory that seems unique to them. These charts are for Alzheimer's; other dementias have different timelines and many PWD have mixed dementia. How the person progresses can differ too. In FTD memory isn't as bad in the earlier stages. In VD, the individual will plateau for a time and then have a noticeable loss of skills and cognition.

My dad progressed slowly initially, onset and progression were subtle for 10 years until he had a psychotic episode in stage 5 related to his alcohol-related dementia which led to his diagnosis. From that point, he passed through stages 6 to 8 in 15 months. My favorite aunt with VD (and later ALZ) seemed destine to live forever, her journey from stage 5 to passing was about 8 years. Her nasty sister with VD was puttering around in stage 4-5 for a couple years, broke her hip and skipped stage 6 entirely and passed within a few months.

HB