Friday, September 4, 2009

Entering Stage Six

I just read an article from the Alzheimer Reading room  regarding the Seven Stages of Alzheimers.  Barry Reisberg, M.D., Clinical Director of the New York University School of Medicine’s Silberstein Aging and Dementia Research Center developed these criteria which may help families understand what the future may hold for their loved one.  Patients live an average of 8 years after diagnosis however this number obviously would vary based on when the diagnosis was made.  Not all patients are diagnosed in a timely manner and may be well  into the disease   before a diagnosis is made.

Lily was officially diagnosed in 2007 by Dr. Jackson a gerontologist in South Carolina.  However she had been showing symptoms for several years.  According the above article I feel Lily is entering Stage 6 of her disease process as I have outlined below.

Stage 5: Moderately severe cognitive decline (Moderate or mid-stage Alzheimer's disease)

Major gaps in memory and deficits in cognitive function emerge. Some assistance with day-to-day activities becomes essential. At this stage, individuals may:   yes

Be unable during a medical interview to recall such important details as their current address, their telephone number or the name of the college or high school from which they graduated.  yes

Become confused about where they are or about the date, day of the week or season.   yes

Have trouble with less challenging mental arithmetic; for example, counting backward from 40 by 4s or from 20 by 2s.    yes

Need help choosing proper clothing for the season or the occasion.    yes

Usually retain substantial knowledge about themselves and know their own name and the names of their spouse or children.   slipping (beginning to forget names of her own children)

Usually require no assistance with eating or using the toilet.    yes

Stage 6: Severe cognitive decline (Moderately severe or mid-stage Alzheimer's disease)

Memory difficulties continue to worsen, significant personality changes may emerge and affected individuals need extensive help with customary daily activities. At this stage, individuals may:

Lose most awareness of recent experiences and events as well as of their surroundings.   yes

Recollect their personal history imperfectly, although they generally recall their own name.   yes

Occasionally forget the name of their spouse or primary caregiver but generally can distinguish familiar from unfamiliar faces.    K
nows my name, although usually thinks I am her sister

Need help getting dressed properly; without supervision, may make such errors as putting pajamas over daytime clothes or shoes on wrong feet.    yes

Experience disruption of their normal sleep/waking cycle.  she still sleeps pretty well

Need help with handling details of toileting (flushing toilet, wiping and disposing of tissue properly).   no

Have increasing episodes of urinary or fecal incontinence.  rarely

Experience significant personality changes and behavioral symptoms, including suspiciousness and delusions (for example, believing that their caregiver is an impostor); hallucinations (seeing or hearing things that are not really there); or compulsive, repetitive behaviors such as hand-wringing or tissue shredding.   no

Tend to wander and become lost.  mom still has good sense of direction

Stage 7 is the final stage and hopefully Mom won't reach it for some time.

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