Stages

jomarie1951 · October 5

Who determines the stages and how are they determined? The most frustrating p pop art of this disease for me is not knowing exactly what my DH has Dementia or Alzheimer’s). And what stage? His primary referred to his disease as Dementia and the neurologist referred to it as Alzheimer’s. They have him on 29mg of Memantine twice daily along with Doxycycline 60 mg. When I asked about what stage he is in I’m only told “progressive!” He has had the hallucinations of thinking I’m someone else and that there are other women who come in to cook and clean. He also keeps asking me what shift I’m on and who pays me. I explain, as patiently and calm as possible, that I retired 4 years ago and my only job is him, cooking, cleaning, shopping, and his Uber driver! No pay! He has been unable to drive since my retirement due to his neuropathy and numbness in his legs and feet. He also keeps asking me where his mother went (she passed away in 1986) and gets confused as to who his various doctors are. He also has had several incontinence episodes which has made my washing of bedding and clothes endless.

trottingalong · October 5

https://alzconnected.org/discussion/74287/stages

Often times stages cross over. It’s never exact, but gives you an idea. My husband tends to straddle 4, 5 and 6. He has better days and poor days. He thought I was a Russian spy recently. He likes spy movies and asked if I was a nice spy. I assured him I was. I can remain very calm, but it’s hard to know exactly what they are looking for, besides reassurance. I use the Tam Cummings tools for assessing. https://www.tamcummings.com/tools
I tend to think only those living with the person day to day can more correctly identify a stage. What the doctor sees and hears in a 15 minute visit is very different from what I see all day every day. If he asks what shift you are on you can always tell him your shifts change and you are a volunteer. Sometimes that can help, sometimes you have to repeat it.

blacksparky · October 5

Welcome to this forum. So sorry you have to be here though.

Dementia is a general term for a group of symptoms that affect memory, thinking, and social abilities severely enough to interfere with daily life. It’s not a single disease — it’s a syndrome caused by different brain disorders.

Alzheimer’s disease is the most common cause of dementia. It accounts for about 60–80% of all dementia cases.
Here’s a description of the various stages to help you determine where your LO is at.

The 7 stages of Alzheimer’s disease come from the Global Deterioration Scale (GDS), which outlines the progression of symptoms from normal memory function to severe dementia.

Stage 1: No Impairment

No memory problems.
Normal behavior, independence, and function.
Alzheimer’s not detectable.

Stage 2: Very Mild Decline

Occasional forgetfulness (like misplacing keys, forgetting names).
Still functions independently.
Symptoms often dismissed as “normal aging.”

Stage 3: Mild Decline (Early-Stage Alzheimer’s)

Noticeable memory problems:
- Trouble remembering names of new people.
- Difficulty organizing tasks or planning.
- Trouble finding the right words.
Family/friends may begin to notice changes.
Person may cover up symptoms.

Stage 4: Moderate Decline (Mild Alzheimer’s)

Clear difficulty with:
- Managing finances and paying bills.
- Remembering recent events.
- Traveling alone to new places.
Mood changes (withdrawal, denial).
Still oriented to time and place, but memory lapses are obvious.

Stage 5: Moderately Severe Decline (Moderate Alzheimer’s)

Increasingly dependent on others.
May forget personal details (phone number, address).
Needs help choosing proper clothing.
Can still eat, toilet, and bathe independently (mostly).

Stage 6: Severe Decline (Moderately Severe Alzheimer’s)

Requires help with daily living: dressing, bathing, toileting.
Significant personality and behavior changes:
- Suspicion, delusions, or wandering.
- Anxiety, agitation, or aggression.
Forgetting spouse/close family names.
Incontinence may develop.

Stage 7: Very Severe Decline (Late-Stage Alzheimer’s

Loss of ability to speak coherently.
Needs assistance with all daily activities.
Loses motor skills: difficulty walking, sitting, eventually swallowing.
No recognition of family.
Requires 24/7 care.

Hoping this works for you. Remember we are all here for you.

H1235 · October 5

Here is a couple of staging tools that might be helpful. I wouldn’t expect the doctor to give you a stage. If they do they would probably use the three stages, which really isn’t helpful. To be honest you are probably a better judge of his stage than his doctor anyway. Even with the staging tools you still just don’t know. Some people skip over symptoms some stay in stages considerably longer than expected while others almost skip a stage. I still find it helpful to know what might be coming next.

DBAT.pdf

https://www.alzinfo.org/understand-alzheimers/clinical-stages-of-alzheimers/

SDianeL · October 6

I found that doctors are no help except the Geriatric Psychiatrist who managed my DHs anti psychotic meds. My husband was on Memantine. It was supposed to help his attention and focus. I saw no difference but I left him on it because he didn’t have any side effects. Ask for a referral to a Geriatric Psychiatrist and make a list of his behaviors from the staging lists above. And give the list to the doctor. They put my husband on Risperidone which helped with anxiety and hallucinations. There are bedmaking tips for incontinence that I found online. There are depends for men and liners that might help.

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