Stages

sslabrador · December 16

Hi all. I'm new here. Caring for my Husband who was diagnosed about 4 years ago with early onset ALZ . I've been reading the messages and see some of you talking about stages. I'm not sure how do I determine what stage my husband is in? Thank you in advance for your help.

eaglemom · December 16

Welcome to the message board. I'm glad that you found us.

If you look at the top of the page you will see a category named ALZCnnnected Resources. If you click on that you will find numerous topic of discussion. One of them being stages. I don't think it specifically lists the stage numbers, but it will give you a good idea.

There are two rules of thought on the stages. The older method is a 1-7 stage. The newer label is mild - moderate-severe. That is the one most neurologists seem to be using.

Now, here is my thought on the stages. Personally I don't care to label what stage my LO is currently in. I feel that way because when he was first diagnosed I read about the stages and frankly he did things in several of the 1-7 stages. That's when I personally, decided he'd be wherever he was. Now that's a personal decision. Our neurologist doesn't stage until severe. I've found some tend to get hung up on the number and I didn't want that to be me.

eagle

Jeanne C. · December 16

Hello and welcome. One tool that's commonly used for staging is the DBAT. If you go to tamcummings.com/tools you'll find it, along with other useful information. We also have been collecting helpful posts, tool, and links in the new caregivers group. I hope these are helpful to you.

jsps139_ · December 16

https://alzconnected.org/discussion/comment/231265#Comment_231265

I think the same as you on the stages. I was so confused after reading them because my DH had behaviors all over the chart. I decided not to look at them anymore and just take it day by day. My husband’s PCP uses Mild-Moderate-Severe and that’s nice and simple for me.

ALCB · December 16

I personally do find the stages helpful, because they help me determine where my grandmother is and roughly where things are (probably) going in the near future so I can prepare; however, as mentioned already, it is important to note that not everyone fits into one stage. The stage your husband is deemed as should not completely direct your caregiving and instead only guide your next steps, because every person is different. Some people use a 1-7 stages chart, with 1 as 'less symptomatic' and 7 as 'more symptomatic', while others use a Mild-Moderate-Severe scale. Here is an image of the 1-7 scale:

There are also life expectancies and durations of all these stages, with the first 3 stages lasting roughly 7 years, 4 lasting 2 years, 5 and 6 lasting 2 years, and 7 lasting 3 years. Especially for those numbers, they all vary greatly along with the symptoms. If you need anything else, feel free to reach out.

harshedbuzz · December 17

sslabrador
It was explained to me that the 3-stage model used by professionals is based on treatment options while the 7-stage model is used by caregivers as it applies more towards safety and caregiving changes.

The general rule-of-thumb is that a PWD is considered to be in the latest stage for which they have a symptoms. Most of us would say out LOs seemingly straddles two or sometimes 3 stages. It's also important to recognize that these are fairly broad symptoms— not all PWD will lose skills in the same order.

ALCB
I'm curious, where is your chart from? Is it American? It is very different than most of the versions here— most folks rely on either DBAT (linked above) or FAST Staging.

Measure and Manage the course of AD using The Functional Assessment Staging Test (FAST)

These two don't align exactly but are more similar. Critically, they would describe both MCI and "severe" earlier on than your chart does.

HB

WIGO23 · December 17

My husband’s neurologist at a leading Memory Care Clinic in the US, does not feel staging is helpful. The progression of ALZ is so individualized, I don’t see value in it either. The lights blink off and on in what my DH can or can’t do day to day. Then a light does go out and stays out. An example is he can no longer make a phone call after being able to do so off and on for months. I doubt the ability will return—light out.

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