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11 Apr

How Alzheimer’s Evolves from Early to Late Stages

alzheimer_brainAuthor: Jennifer Wegerer

Alzheimer’s progresses through several different stages, though it’s effects vary from individual to individual. Learn the common symptoms and changes that occur throughout each Alzheimer’s stage.
In the United States, around 5 million seniors have Alzheimer’s disease. That number equates to one in nine (or 11%) of all people age 65 and over.
Currently, experts have identified three major stages of Alzheimer’s: preclinical, mild to moderate, and severe. Here’s a breakdown of the symptoms that occur within each of these major stages, according to information from the National Institute on Aging, WebMD and the Alzheimer’s Association.

Stage 1: Preclinical Alzheimer’s
Symptoms present: None to very mild cognitive decline.
Changes that may occur: Mild memory lapses, such as forgetting everyday words or where things are kept. A medical exam shows no signs of dementia. Studies indicate that brain changes precipitating Alzheimer’s occur during this stage, which may begin as many as 20 years before symptoms are present. So researchers are working to validate biomarker tests that can detect mild cognitive impairment due to Alzheimer’s before the onset of symptoms.

Stage 2: Mild to Moderate Cognitive Decline
Symptoms present: Noticeable difficulty with memory and concentration that progresses over the course of several years.
Changes that may occur: Trouble remembering words and names; greater difficulty performing tasks at work or in social settings; losing or misplacing valuable objects; increasing problems planning and organizing; and personality changes.
A doctor’s exam detects clear-cut Alzheimer’s symptoms, such as challenges remembering recent events or performing math tasks. Individuals in this stage may also forget their own personal history and address, make poor judgments with their health or money, and become moody or withdrawn, particularly in social situations.
As this stage evolves, the person’s struggles with memory and language will worsen more and more. He or she may require a trained caregiver at home or a residential care setting during this stage. 

Stage 3: Severe Cognitive Decline
Symptoms present: Inability to communicate or perform personal care; a decline in physical abilities.
Changes that may occur: Loss of coherent speech; trouble controlling bowels and bladder; wandering or getting lost; groaning or moaning; increased sleeping; forgetting how to swallow; and weight loss.
During severe Alzheimer’s, the brain seems no longer able to tell the body what to do. Individuals become entirely dependent on others for care, including bathing, dressing, eating and other daily tasks. They may recognize familiar faces but not know names and suffer major personality and behavior changes, including delusions and paranoia.
People in this stage typically require assistance walking and may be unable to sit up, smile or hold up their head. Wringing hands and shredding tissues are also common as are abnormal reflexes and rigid muscles.
Eventually, the person may spend the majority of time in bed as the disease reaches its most severe phase.

 Rate of Alzheimer’s Progression
Each case of Alzheimer’s is different. On average, people age 65 and over survive four to eight years after Alzheimer’s diagnosis. However, some live for as many as 20 years. The bulk of that time (around 40%) will be spent in the most severe Alzheimer’s stage.
Researchers continue to try to unravel Alzheimer’s stages, and great strides have been made in early detection and treatments that can slow the disease’s progress. Some of these treatments have the potential to extend earlier Alzheimer’s stages when symptoms are less severe.

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04 Apr

Activities of Daily Living: Recreational Activities

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People with dementia can still engage in familiar activities—although caregivers may have to adjust them in some way to match the person’s remaining strengths. Participating in various types of recreational activities—from art to poetry—can also be an effective way to help manage behavioral symptoms of Alzheimer’s disease. Many can be done one-on-one in the home setting; other can involve additional family members, including various generations.Here are some steps to get started:

  • Prepare any necessary supplies in advance.
  • Find pastimes that were meaningful to the person prior to the disease.
  • Engage in activities that pose a reasonable chance of success, by taking into consideration a person’s current abilities.
  • Tap into over-learned skills, such as appropriate household chores or work-oriented activities.
  • Plan activities that are short in length and age-appropriate.
  • Keep the environment free of distractions.
  • Include activities with a sense of structure, which provides reassurance.
  • Give directions that are simple and one step at a time, and include non-verbal cues.
  • Limit choices. If you’re going for a walk around the block, allow the person to decide whether you start to the left or right, for instance.
  • Keep conversations structured and families, such as holiday celebrations and music icons.
  • Adjust the activity, based on a person’s verbal and non-verbal responses.
  • Validate any frustrations and try restructuring the activity.
  • Take a multi-sensory approach, especially as sensory functions start to decline.
  • Plan intergenerational activities that foster helping behaviors and are developmentally appropriate for the child and engaging for the person with dementia, and choose a time when both participants will be at their best (for example, after a meal).
  • Be patient and flexible.
  • Focus on enjoyment, not achievement.

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30 Mar

How You Can Help Facilitate Family Communication


It’s no secret that your clients are aging, and with their aging comes the aging of their parents. A few families anticipate this eventuality but the majority hope that the issue will look after itself because they cannot face this painful fact of life – losing those who gave them life.

However, clients ignore the issue at their peril; if parents need financial support in their later years it’s wise to accept the reality now and if possible integrate this need into their own financial planning.

In addition, there may be other reasons adult children need to intercede:

  • Medical conditions that need attention and care
  • The inability to perform the Activities of Daily Living or ADLs – bathing, eating, toileting, dressing, continence, mobility
  • A change in behavior or cognitive ability
  • Medication mismanagement
  • The inability to drive safely

Even though there may be a clear need for assistance, many parents refuse to either discuss the need or accept the help. Why? The main reason is the fear of losing whatever independence remains, and the need to retain their dignity and control over a situation that may be spiraling out of control. Aging parents can feel increasingly vulnerable and try to protect themselves by shutting others out.

As an advisor you may be struggling with how to help your clients communicate with aging parents, so here are some suggestions to enable your clients to be proactive.

Before beginning, however, encourage clients to remember the three rules:

  • Don’t treat parents like children
  • Start slowly
  • Make parents part of the decision process

1. Expect and accept that parents will grow old. Aging is not a disease; it is part of the life cycle

2. Put yourself in their shoes by trying to understand the losses that often accompany aging – loss of family, friends, physical or cognitive abilities

3. Remember the 40/70 rule; when adult children are about the age of 40 and parents the age of 70, it’s time to start the conversation, a conversation that could continue for months, even years before it is concluded and all decisions made

4. Encourage clients to have a family meeting BEFORE A CRISIS OCCURS and ask parents questions such as:

  • How do you see yourself aging?
  • What would you like to achieve with your estate?
  • Where are the legal and other documents?
  • Do you want to stay at home if possible? What can I do to help you maintain your independence?
  • How much money is available for your care?

5. Then encourage clients to respond positively:

  • Offer to set up automatic bill payments if parents have trouble remembering to pay bills
  • Research some options – home care, home modification, day programs – so adult children can offer concrete care suggestions
  • Become familiar with new devices or technologies that may help a senior maintain independence

6. If parents are reluctant to communicate, or children do not know where to start, begin with some ‘what ifs’:

  • Dad, what if you have another heart attack?
  • What if mum falls again and breaks a hip?
  • What if something happens to me and I cannot be there for you?
  • What is there is not enough money for your care?

Talking about money is fraught with difficulty at the best of times. Aging children need to remember how hard parents have worked for their money and that for many money means security, independence and a way to help family. Money is something – maybe the last thing – that parents can control, and they may not relinquish this control easily.

It is also wise to remember that having money does not make clients immune to:

  • Having a dysfunctional family
  • The consequences of poor family communication
  • The consequences of poor planning…”not me”
  • To the emotional chaos of caring or being cared for

In the end, it comes down to this: The vast majority of adult children want to help their parents age with grace and dignity, and if there is one question that may enable this it is:

Mum, dad do I know everything I need to know, so that if something happens, I can do what you want me to do?

Enabling your clients to help aging parents can give you many rewards, including the chance to really connect with your clients, the opportunity to build client loyalty and new referrals, and the ability to care for your own family when the time comes.

As the saying goes: Just do it!

Ken Dychtwald, Psychologist/Gerontologist, author of Age Power


By Karen Henderson
Speaker, Educator, Author, Consultant, Living Benefits Expert
Founder/CEO Long Term Care Planning Network



21 Mar

3 Important Duties To Perform When Caring for Your Parents


1. Keeping track of their medications can be done by maintaining a list which includes each medication including the date it was prescribed, by which physician, how often they are to take it. This list should be taken to each doctor’s appointment in order for every physician to be aware of all the medications they are taking. On occasion patients have been prescribed similar medications when the doctor was not aware of all of the medications being taken. It is very important that you always being all medications or a complete list of the medications to each appointment.

2. Caring for parents will also include managing physician appointments. This can be done by keeping a large desk calendar available for them to keep track of the appointments. When an appointment is made it can be documented on the calendar. This is especially important if memory problems are an issue. They can always refer to the calendar if they have any question. The calendar can also be utilized for other important dates such as birthday’s and anniversary dates. Of course, you will also need to keep your own calendar for their appointments if you will be required to accompany them to the appointment or to just give a reminder call to make sure they will make the appointment. Some parents may elect to go to appointments alone. This is mainly to ensure their privacy and is another way they maintain control and independence. It is highly recommended that you go with them if at all possible especially if they have memory problems and may not recall important information.

3. Keeping track and paying their bills is another task required when caring for parents. Utilizing the desk calendar will be helpful. As bills arrive in the mail, the date they are due can be written on the calendar. It is also helpful if a designated place is used to place the mail. This will help avoid any mail being misplaced causing a bill not to be paid. This will be helpful to both your parents and yourself. As the bills are paid, you can indicate that on the calendar and even write down a confirmation number. This way they will continue to feel involved in the financial matters by being able to check the calendar and confirm that it has been taken care of.

As you can see there is much involved when caring for parents. Perhaps the best suggestion I can make to you is to maintain good records. Whether it is keeping up with medications, scheduling physician appointment or simply paying the bills, everything is important and good organization will help make everything run smoothly.

Article Source:,_LVN,_CWCA

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