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Alzheimer's disease - stage by stage

How an Alzheimer's caretaker's life and challenges may evolve as their loved one's disease progresses:

Early stage

•May notice patient is more anxious, forgets friends' names and telephone numbers, places everyday items in the wrong storage locations, leaves projects (laundry, meals) unfinished, has trouble making change and balancing a checkbook.

•May need to take over some household responsibilities — like bill-paying — if not already doing them.
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•If patient's work life is suffering, caregiver also may need to take on more financial responsibility.

Middle stage

•Patient will need more physical help: bathing, shaving, dressing, driving.

•Sometimes the healthy spouse or family member will try to protect a loved one as he declines, portray him as functioning at a higher level than he actually is, especially if the patient has had a prestigious or intellectual career.

•There may be behavioral changes in the patient's sleep-wake cycle and more apathy, which may disrupt caretaker's life and cause depression.

•More safety measures should be taken, including use of a device that tracks patient in case he wanders. It's a time to begin thiItalicnking about and planning for end-stage care in or outside the home and making sure finances are in order.

•It may be a good time to seek out emotional counseling, as well as additional help from other family members or professionals.

Late stage

•Patient behavior may vary drastically at this stage, from subdued to delusional and paranoid.

•Depending on family resources, a nursing home, day care center or in-home health aide may be needed. A social worker or state aging agency can send someone to the home to assess what is needed at this time.

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