The Stages of Dementia and Alzheimer's
Dementia and Alzheimer's disease are complex conditions that can have a profound impact on the lives of those affected and their families. In this podcast episode, we delve into the intricacies of these conditions, discussing the stages of dementia, recognizing the early signs, and understanding when it's time to seek professional help.
The first stages of dementia often present as forgetfulness or minor memory lapses. It's crucial not to panic at this stage as these symptoms could simply be a normal part of aging. However, as dementia progresses, these early signs can evolve into heightened anxiety, behavioral changes, and increased difficulty with memory recall.
At this point, the person with dementia may start to withdraw socially and may require assistance with daily living activities. This is the stage where important details, like birthdays or addresses, start to slip, and the person may struggle to sleep at night - a common symptom known as sundowning. It's essential to ensure that your loved one has a regular routine, including brain-stimulating activities, to help slow down the progression of the disease.
By the time a person reaches the final stages of dementia, they may become non-verbal and require full-time care. This stage can be incredibly challenging for families to navigate. Having professional help and support at this time can be invaluable.
Another critical aspect of dementia and Alzheimer's care is the importance of family history. Knowing your family's health history can provide crucial insights into potential risks and can inform preventive strategies. Therefore, families are encouraged to have open and honest discussions about their health history and seek medical advice if they notice any worrying signs or symptoms.
Insomnia is a common plight among dementia patients, especially those in the later stages of the disease. There are numerous studies into why this occurs, but the general consensus is that the brain chemistry changes as the light diminishes, leading to increased confusion and delusional thoughts.
Understanding dementia and Alzheimer's disease can be overwhelming, but knowledge is power. By educating ourselves and staying informed, we can better support our loved ones through their journey.
Remember, it's okay to ask for help. Professional caregivers are trained to provide the necessary support and assistance to those living with dementia and their families. They can help manage symptoms, provide comfort, and ensure that your loved one is safe and well cared for.
Dementia and Alzheimer's disease are significant issues affecting millions globally. By shedding light on these conditions and raising awareness, we can all contribute to a more understanding and supportive society for those affected.
"4 Stages of Dementia and Alzheimer's" of Podcast Transcription
Speaker 1
Welcome to the Comfort Keepers Evansville podcast, where we elevate the human spirit. Here's your host, Kristi Gurule.
Jeremy
Hello everyone and welcome to episode number four of the Comfort Keepers Evansville podcast. I'm your co-host, Jeremy Wolf, and I'm joined with, of course, your host, Kristi Gurule Kristi.
Kristi
The one and only.
Jeremy
Hello, it's always a pleasure to be in your company, so how have you been since the last time we had the pleasure of crossing paths?
Kristi
It's been busy. I don't know about you, but kids are back to school, so there are a lot of scheduling changes that happen around that time of the year, A lot of changes that just you know happen in the home. A lot of new things, a lot of homework. There's a lot more homework these days than what I remember when I was in school, so they start them out younger and younger with the homework.
Jeremy
So yeah, yeah, homework is so fun. I love homework. I love sitting down with the kids and going through it. I mean my son's in fourth grade and I'm anticipating getting lost, as per usual when it comes to homework. I'm my daughter. She's in. She just started middle school. Thankfully, she does really well in school and she doesn't ask for help. But I fear that when she does ask for help I'm going to be completely checked out at this point. I don't know what's going on in sixth grade.
Kristi
Well, this is my first year of helping with Latin. So, there's that at our sixth-grade level, yeah.
Jeremy
Check, please. Yeah, no, thank you.
Kristi
Maybe I shouldn't complain, I'm just saying so, yes, I was not prepared for the Latin studying that this school year has a lot of things that I've always thought were brought, so it's an adventure always in the Grille household.
Jeremy
I hear you on that. So you told me it is National Alzheimer's Month, is that right?
Kristi
Yes, it's World.
Jeremy
Alzheimer's Month.
Kristi
So you'll find in the health field, anywhere that there are. There are days, there are months, there are seasons, no-transcript. Ultimately, the goal for anything, regardless of what it's called, is just to bring awareness to whatever that specific disease is. And, yes, September happens to be World Alzheimer's Awareness Month. There is a walk that happens on the 21st, which is World Alzheimer's Day, but throughout the year the National Alzheimer's Association holds different events to raise awareness and funding for research for Alzheimer's. So, I felt like it was a good opportunity to start talking about this disease that impacts many, many people and I've personally had an experience with my own family with this awful disease and just to ease us into a new topic of things that we encounter regularly with comfort keepers and the families that we help, yeah, for sure this is a real tricky one.
Jeremy
Right? The topic of Alzheimer's I also have had the unfortunate experience of seeing my grandmother go through the various stages of Alzheimer's and it was quite a frightening process. So, I think it's a good time for us to talk a little bit about this and I know obviously you're not a doctor so we can't really go into all the scientific stuff around Alzheimer's and what's going on in the medical community. But I think we can kind of keep in with the overarching theme that we've had so far on the show, which is this idea of signs to look for in your elderly loved ones that there could be something going on. I think this kind of is a natural progression of that. Let's talk a little bit about dementia to start off with, and maybe the stages of dementia, and kind of go from there.
Kristi
Yeah, definitely so. A lot of times people will hear the term dementia in Alzheimer's interchangeably, but I think it's important to realize that dementia is more of a general term for overall memory loss, which is often a symptom of Alzheimer's, which is a specific disease, and there are a lot of different Alzheimer diagnoses. So, dementia, and Alzheimer’s together dementia is more of the symptoms that families experience. I think it's also worth noting that Alzheimer's is ranked as one of the top six diseases that end in death and that's so sad to realize that here we are today and people are still battling this disease. So, it all comes down to the stages of dementia, and there are seven, and depending on where someone's loved one is in that stage, in those seven stages, will really depend on how we can help in the home, how we can provide additional assistance to that family. So, you ready to get into the stages.
Jeremy
Absolutely. I wanted to ask, before we get into the stages, something that, because I sit all the time, I'm getting older. I'm 43, I'm still young, but I'm not, you know, I'm not too young anymore. And as I get old, it's like I feel this happens to everybody as human beings. I think, like you lose your train of thought, you'll be doing some things, will just drop out and you'd be like, oh man, and then usually it comes back to you. But at what stage or what level? And I guess we could talk a little bit more about this, the whole idea of the stages. But at what level does that become a point of concern where you're like Wait a minute, because I mean it's kind of freaky if you think about it.
Kristi
Yeah, and I think that the most important thing is that every day, right there, we could just have our head in the clouds. One day, maybe we didn't sleep very good the night before because you're learning Latin with your sixth grader. I'm just saying that there are days that are harder than others, but we can't go into a full blend panic, yeah, yeah, yeah, yeah, yeah, yeah, and just assume that, oh gosh, my loved one, my mom, my dad, they're all of a sudden just forgetting, maybe this one time or two times. We don't want there to be this hysteria. There is this progression, and every single person experiences the stages differently.
So, a lot of times you'll see the memory loss as being in the pre-Dementia stage. So, when this starts to happen, this is like the very, very beginning of Dementia stage one through three. This is when we get the intermittent memory loss. We're not to the point of not remembering someone's name, but we're forgetting, maybe, where we placed something, we're forgetting specific details. Or you know, if I told you, Jeremy, that we had a plan last week and today I asked you to talk to me about that plan, and you forget it, like that kind of thing. So, memory recall starts to become trickier during that time too. It's also a time where there could be enhanced anxiety, both from the family and from that individual experiencing these symptoms. So sometimes you'll see someone start to have behavior changes where there may be a little bit more irritable nothing crazy, but just like on edge. So, stage one through three is really where we start to see some decline. But again, it's something that you and I would even experience, you know today, on a weekly basis and we can't panic about it, right.
Yeah So, I think that that's when most family members will start to make calls, because they get anxious If there is a family history of it. Sometimes I think that also heightens the awareness too. But really the most important thing that I could tell anyone is get your loved one into their primary care physician and have a really honest, honest conversation about some of the things that are happening. I think that it's hard with our pride sometimes to swallow that and admit that we have forgot things more easily. And when we leave our loved ones in their own care and they go to the doctor's appointment by themselves, sometimes the whole story isn't quite shared. So, it is nice and it's encouraged too. Join your loved one, you know, at the doctor's appointment. It definitely progresses from there.
Once we get to around stage four, we're getting into the mild dementia, and mild dementia is really where we start to see a person that used to love being around family, family gatherings outside in the backyard barbecue. Now they're more withdrawn, they're staying inside, they're not actively coming out to want to engage in different things, and truly it's because all of those symptoms that we talked about in the first one through three are now heightened and that anxiety is there. So, they're withdrawing so that they're not putting themselves in a position where they're going to be fearful or stressing anybody else out. So, with social withdrawal is really common in stage four. Stage five is all of what I just said, and then we have to now step in to help with all daily living activities. Okay, now I just want to keep this in mind that this is a general, but they're the seven stages, right? So, this is generally speaking. At this stage we're coming in to help them with cooking their meals. They can still take care of most of their personal care needs. They haven't lost the ability to do that. But we're going to help them organize, grab their mail, everything else that we would do on a daily basis, the housekeeping, making their bed, simple, things too, like making sure that spoiled food is thrown out of the refrigerator, all of those things we come in or a family member comes in and they're helping their loved one with more and more. It's also the stage where some of the more important details, like your birthday, your address, those things really start to slip and they're intermittent, so it becomes a lot more noticeable at this point. If a family hasn't discovered it, you know from the very, very beginning.
Stage five is really where additional assistance to the family and to this individual come into play. Stage six is just. Again, the progression is bad, but six is moderate to severe dementia and this is where our family members, our loved ones, start forgetting the names of their family loved ones. This is where there is definitely a social withdrawal. There may be a memory recall from old childhood memories that they're now mixing in with today's current events, confusing whether you know they're their spouse. Maybe have passed, hasn't passed A lot of just general confusion, which can also heighten and cause a lot more anxiety and emotional outbursts because they're becoming fearful. This is when most people with Alzheimer's will So, discover that sleeping, sleeping is very difficult. It's a term in our industry that we call sundowners, so people that have this stage will get up and start wandering around because they cannot sleep. They become. It really is a risk to themselves. This is where we come in and we're staying overnight with your loved one to make sure they don't leave the house because they're confused about where they're going.
Jeremy
Do you know I was gonna say I know, I know we promised not to talk too much about the science behind this, but I'm curious do you know what's behind that, why they have a hard time sleeping? I'm just trying to, because you would think that the mind would be more, I guess, more quiet, like if you can't recall anything, if you just detach yourself from that. You're kind of lost. That would be the hope, right, if you're in that position, that you're just not, you're not aware, so you're like ignorantly blissful of what's going on. But that would be the hope right, Disassociating and just.
But the terror. The other side of that would be that you kind of are you're in and out of that right. You're aware and you're constantly grasping for the thought and you can't get it, and that's terrifying, right.
Kristi
So, I'm not the expert right, but the term sundowners like truly is because of the light, and when the light goes out a lot of things will change chemically in the brain. There's a lot of really amazing studies that have been done about this, but it does have something to do with the delusional thoughts that an individual with this disease may have at this time and just the fact that they're not sleeping and without that light their activity level changes. I know from experience working with many families that have dealt with this that this is a time where your sweet, loving individual might actually become combative, like it's literally like a light switch. Your loved one can have an amazing day but have awful nights, and so the general term sundowners it's a very interesting thing to read into more and more. This is just the stage where that begins to happen, not to say that it can't start prior to this stage, but this is that general stage where you'll start to see just a complete change in your loved ones overall behavior, and nighttime just tends to be one of the worst. Honestly, at this time we step in because we're also starting to help with personal care. They can still get up, we can still help them into the restroom, but they're needing a lot more help with it.
And the final stage, stage seven, is just. It's sad because at this point most of the loved ones that we know that have this. They're now nonverbal, they're not speaking at all and there's just an overall sense of loss of their willpower. Right, we're doing everything for them, we're helping them with everything, because they physically cannot, they verbally cannot, and this is the saddest. The whole thing is sad. But this is the end stage of Alzheimer's. There's not coming back from that. We're keeping them as comfortable as we can at that point.
Jeremy
Yeah, as you walk through these various stages. I feel emotional connection to that Because, again, I witnessed my grandmother go through these various stages. I wasn't with her all the time but when I did go visit her, I would see things like her wandering around the house naked, not knowing where she was in the closet, and then, towards the end of the progression, when she was in assisted living care, like you said, nonverbal, she would just sit in bed and just mumble and it was just really, really frightening and depressing to see.
Kristi
It is. They call it the family disease because it impacts everybody that this person is involved with and also having a personal experience with this horrible disease. Yes, it does. It's hard to think that the last times you had with this loved one is that. And so, when we come in and we are helping a family get through this, it's just another way that I can confidently say that I can empathize with you and I can feel the confusion and the pain that you have, both emotionally and physically, and all the stress that comes around it. But rest assured, the people that I have on my team are trained and understanding and, remember, we hire for empathy, so it's not a frustrating thing. When your loved one is throwing a fit and they're really having a moment, we're able to come in gently to redirect, to be kind, to speak to them softly, to bring them back into the reality that they are and again to just provide that overall comfort for both you as the family member, and them who's going through this terrifying experience.
Jeremy
Yeah, for sure, and I got to imagine that, and again, I'm certainly. You said you're no expert in the science behind this. I'm certainly no expert, but just thinking out loud here, I have to imagine that a lot of this dementia I don't know about Alzheimer's can be combated somewhat to some degree by keeping an active mind as you go through life, constantly engaging, reading, eating good food, exercising. If you do all of those things, I'd imagine it's a lot less likely that you'll fall into this downward spiral of dementia.
Kristi
And also slowing it down. That's exactly what people would recommend, what the Alzheimer's Association recommends. It's just like any muscle your brain can't just not be active, and so word puzzles, coloring, art, word searches there's so many different things that we can introduce too, just as a part of your daily regimen. Like, maybe you don't like word searches, but it's really good to have you focus on something, even playing cards. Again, there's so many things that we can do to activate our brain on a daily basis, and as we age, it's just that much more important. You think about people who love to read, and as we age, our reading, our eyes tend to change, and reading doesn't become as easy or as enjoyable as it used to. So, again, finding something that we can do at the stage that we're in to keep us active both mentally and physically is the best. So, I know that's the approach that doctors and everyone in this field would say the earlier you start those regimens, the better, so that it is not a spiral like you just mentioned.
Jeremy
Yeah, and it seems to me anyway from what I'm looking at, we're on a slippery slope nowadays with social media and everything, because sitting all day and watching shorts on TikTok or YouTube of a mindless dribble that cannot ultimately help your mental capacity. I mean, it's just being fed instant bursts of dopamine and things like that. It's exact opposite of really what you need to be doing to stay sharp. So, it's so important to remain vigilant, trying to educate people to constantly take care of themselves and do things that are. Because I look at my daughter all the time, she's on her devices. I try to explain to her you need to do other things besides that to train your mind and engage your mind. Life is not going to get easier. It's going to be harder and harder the older we get, and if you just constantly supply yourself with quick fixes and instant gratification, you know when you do face challenges later on, it's gonna be very, very difficult.
Kristi
So, yeah, no, it's so true, being actively engaged, that is just the biggest thing. So, games can happen on phones, right. There's a lot of different things that technology can bring to us, but there's nothing like a good old fashioned, you know, paper and pen in front of you if you're going to actually do something, cause again, writing something out is. So powerful Is activating your brain too. Yes, it is so powerful.
Jeremy
Yeah, for sure. All right. Well, let's end there. We could talk about this all day. Obviously, we'll pick it up later on another episode. We'll talk a little bit more about these types of topics. So, unless there was anything else you wanted to share before we close, I think we could wrap it up.
Kristi
No, I mean, I think that this is a great segment into discussing this disease and things to look for and how to react when you may come, like you said, into the home and discover your loved one in a state that you've never seen them in.
Jeremy
All right, sounds good. Kristi, always a pleasure. Looking forward to seeing you next time and to our listeners. Thank you for tuning in and we'll see you guys next time in the next episode. Thank, you, the Comfort Keepers. Evansville podcast. Everyone has a great day.
Speaker 1
Thank you for listening to the Comfort Keepers Evansville podcast. For more information, visit comfortkeepers.com or call (812) 370-4956
