I think my husband has moved from a combination stage 4/5 to a solid stage 5. I had been sensing some changes but didn't realize it until after I had a small get away trip. My SIL agreed to take DH while I gone. She's a nurse and has worked with a lot of elderly throughout the years. My SIL's daughter is getting married next week in Denver and we will be going to the wedding. She wanted to make sure everyone was prepared when they saw Mark. Here's what she had to say:
It will become noticeable in conversation that something isn't quite right. Mark is well into the moderate stages of Alzheimer's Disease, and fortunately is on two medications for this. He has very little sense of direction. I have to consistently show him where the bathroom is, where his pills are, where the basement door is (He doesn't "see" the door if it is closed.), and which way to turn at the bottom of the basement stairs to get to the bedroom. He frequently checks what day it is, what time it is (Well, that one isn't too bad, because our time zone is 3 hrs later than where his body clock is at, and he did change the time on his watch yesterday.), where his jacket and sunglasses are. If I leave the room for a minute (I always tell him where I'm going.), he says "Oh, there you are!" when I reappear. He is somewhat aware that his short-term memory is not good. Also, he does get a little "fuzzier" after sunset, when cues of daylight disappear. On the good side, he is very pleasant and is enjoying that he is having time to visit a relative. He also has a good artistic eye, as evidenced by the big fun we had yesterday decorating the front porch and door for Halloween. It will be enjoyable visiting with him, but he may need to be reminded more than once who you are.
After reading her assessment, I went to the the Alzheimers site to read up on stages. Vicky's observations + my observations lead me to believe Mark is now in solid stage 5. What triggers you to konw when your LO's have made significant enough changes to move to another stage of this disease?
Hello Diane T, I'm going to be reading with great interest, what more experienced others here have to offer. It really helps to have someone outside the daily doings to give us feedback. I don't know where my DH fits either All I know is that he could NOT manage here alone very well. His social skills are somewhat 'off' so that when he's interacting for longer than the customary greeting period, it is possibly obvious that something is wrong. We too are going to our grandson's wedding in a couple of weeks. As long as we are doing the routine things of the event itself everything is usually ok. Its the unstructured time that keeps us on our toes.
I basically started reading the stages. Once I got to one where my husband had NONE of the symptoms, I knew which stage he was in. Because my husband has more verbal and cognitive problems than physical ones, the stages at the Alzheimer's Association look like he is not in stage 6. But in other places I've found symptoms that show me that actually he is in early stage 6. He has ALL of the stage 5 symptoms and I think that once someone has all of the symptoms of a stage, you probably ought to be looking into symptoms for the next stage because you will begin to see them pretty soon.
My husband sometimes does the "oh, there you are" thing too. I'm not sure if he knows my name, but I think he does know who I am.
Diane T, You have described my husband. We returned recently from visiting our daughter in Texas, one time zone away. While there we had the change from day light savings time to standard. His watch was 2 hours off.While visiting our daughter, he kept asking why we were there. One morning he woke up and said"where am I". We had planned to go to NJ for a wedding in December. He seems very apprehensive about it. He cannot remember my niece or get his mind on the reason we want to go. I really do want to go because these occasions are the only time I see my extended family, and would do it by myself, but is very "attached" to me. If I leave the room he follows me. Another thing I have noticed recently is that while he does hear what I say, he cannot process it.
I've never been too concerned with stages. My husband,s decline was so rapid it didn't matter what he could or couldn't do because it would change the next day. No point in either of us being frustrated.
maryd - Maybe the "not processing it" is what happens when we tell them over and over again and they still say "why didn't you tell me" That happens to my husband.
I really value others experiences too Judy. My husband has been able to stay by himself but he's on the verge now so I prefer him not to be alone. He loves to interact with people and I see hear the same stories over and over again. I have to go through his closet to pull all the dirty clothes out of it. He wears the same shirts and pants and talks as if he is still working.
I sure hope my husband does well on this next trip for his nieces wedding. He doesn't remember who she is but she is aware of this. He used to be her 'favorite uncle' and I know it will be tough on her. I keep getting the feeling that this will be the last trip that he will have where he remembers people. I sure hope I am wrong but my insides tell me something different. My husband depends on me for everything, similar to you Mary. He also follows me everywhere. It is difficult to get time for me. I think he is also having the same problem processing information, or at least starting to have problems. He had stopped reading prior to the Namenda and Aricept being prescribed. Now he reads but who knows what tomorrow will bring.
I know everyone is different and stages are probably more for us to guage where our LO's are. It gives me a little bit of knowledge on what to expect. I guess I am just trying to prepare myself.
I try not to look at the Alzheimer's Assoc. staging criteria more than once a year. Otherwise, I read too much into her behavior. At one year intervals, I find that I see very clear differences in her signs and symptoms.
In my case, living 24/7 with my DH i know exactly when something is off. i am so intune with his psyche its like being tied at the umbilical. i can look at his face and k now if hes sick or not feeling well. so when he declines even the slightest i know -DH lulled in the 5mid stage range for several yrs doing pretty well and I became complacent and thought we'd stay like that and not move forward. he started having urinary tract infections very often and his immune system seemd affected. that led to more decline and mental alertness was less after that. maybe all the antiobiotics he was one affected his wellbeing. anyway we are dead on in late stage 6 now, and seems to be moving faster nowdays. when you see physical and mental changes they are usually already in the next stage. divvi
My husband had FTD. I have often wondered while reading this site and others speaking of their spouse's phases if FTD has phases also. I can't seem to find much on the internet, but then again I don't have much time to search.
ehamilton you make a very good point. My husband also has FTD and the usual staging doesn't work. Perhaps that is why I'm not impressed with it. Never thought about it that way.
ehamilton, my husband also has FTD and his geriatric psychiatrist (the one who developed the stages)told us the stages for FTD are similar to the ones for alzheimer's. Husband was diagnosed this year at age 58 and is declining rapidly, however his decline is "unbalanced" mostly stage 5 but some early stage 6.
LFL, I've got a question. Does your husband have all of the stage 5 symptoms, or only some of them? I'm trying to figure out what "unbalanced" means in your case.
My husband has an event driven vascular dementia. It isn't a classic stroke driven dementia, but he still basically is following the Alzheimer's stages. He is unusually high functioning physically, taking long walks daily and doing all of his own showering, toileting, etc. But he has all of the stage 5 symptoms and some stage 6 symptoms just as your husband does. But I don't think he is "unbalanced". I think he is just an early stage 6.
I'm guessing he's mid-5 now. In Aug 2006 DH was diagnosed with MCI--Mild Cognitive Impairment. In August 2007 there had been no change. By November 20007, he was diagnosed (same doctor) with moderate to severe AD and put on the Exelon patch. In May 2008, the MME was not repeated but Namenda was added. I can see a slow but steady decline. It is obvious to people talking to him that there is a problem. He doesn't stant straight anymore. Sort of shuffles. Puts his dirty clothes back in the drawer or closet. I noticed just tonight that the muscles in his face are slacker than they've been before. Forgets to shave-but NEVER forgets to brush his teeth or floss. Go figure.
I do leave him for brief periods but prefer him to go with me when I take the bus. I tell him it's safer for me as I don't see too well. He's fine with that but he'd rather not go. He only goes to take care of me. He was always so warm and comfortable. I wish he could take care of me now and I could just go to bed and sleep for 10-12 hours.
In response to the question, he hasn't had anything dramatic to mark changing from one stage to another--yet.
Dirty clothes put back on the hangers or in drawers and redressing in them is a common theme around here. Its helpful to hear that this is not that unusual.
I sometimes think the washing machine gets more use now than it did when all four children were here. DH goes out to 'work', mostly pulling weeds and etc, gets hot, comes in and showers, changes clothes..goes back out to work some more. Some days its 3 showers/changes.
Anyway, I looked up the stages and can pretty well say that he is at stage 5 if one considers finding the stage where he seems to fit most of the descriptors of that stage. The daily routine is not that different with exception of various issues of anger or irritability here on the farm so I haven't thought about progression in a good while. I have thought, though, about what is BEST for him and our family because farm things are such sources of agitation. I'm a little tired these days and it seems harder to keep my own spirits up. We have a lot to be thankful for. I'm thankful that someone else knows about gathering dirty clothes from closets and drawers!
Judy, yes, my husband will re-dress in some of his clothes if I don't grab them when I go to bed and put them into the hamper. He doesn't hang anything up, which actually makes things easier.
I think your way of finding the stage works. Basically when I first started I found the stage where he had all of the symptoms and then looked at the next one and sure enough he had some of those too. I called that mid-stage 5 because he had some of the symptoms. I call where he is now early stage 6 because I've seen some stage 6 symptoms and all of the stage 5 symptoms have appeared.
My DH doesn't put his dirty clothes back on hangers or in the bureua drawers....However he does fold the dirty clothes up ever so neatly which drives me crazy because I have to stand there shaking them out before putting them in the washer.
Jean21, LOL........ I wish my Dh neatly folded his cloths, he drops them whereever, he gets hot he takes the sweatshirt and drops it on the patio, hangs sweats, jeans, shirts on doors, door knobs, chairs etc. Now that makes me nutty! LOL. Has anyone had issues with them double dressing? Example pulling a pair of jeans over a pair of jeans their already wearing? I knew what he was contemplateing yet he ignored my warning and proceeded to pull up the second pair of jeans, only when he got them up did he realize what he was doing. It was like his brain was working so hard to get the pants on, he didn't hear me ask him, honey are you sure you want two pair of pants on? He's done it a couple of times. Rk
Oh yeah, RK, my husband came downstairs one day and was swearing like a sailor...he kept muttering that all his clothes were shrinking...well, when I went to see what the fuss was about I saw that he had put three pair of pants on and about six shirts....he didn't get the idea that he had "overdressed", he was just angry that the clothes were too small.
And, believe it or not, that was one of the better stages because after that he refused to ever change clothes....my oh my, the "fun" never ceases with this disease.
My husband is late stage 5. He wears 2 sets of underwear and carries several handkerchiefs but doesn't layer other clothing - yet. On some days, he showers and changes clothes 2 or more times. On other days, he doesn't shower at all. He puts his dirty slacks and shirts - and sometimes his socks - on hangers. I told him to put his clothing in the hamper recently and realized that he didn't know what/where the hamper was. His OCD issues include making sure that his hangers are evenly spaced. If it looks too crowded to him, he moves some items into our coat closet in another room. He removes all "extra" hangers and places (hides) them elsewhere.
Can't figure out his stage as it changes from day to day and I don't really worry too much about that. As to clothes! He is very neat - hangs his clothes up dirty. So every night after he's in bed, I go get them to put in laundry; then lay out fresh clothes for the next day. He will ALWAYS wear what I put out for him. He showers, shaves, brushes teeth daily, etc. I feel so bad for all of you who have so much more to go through daily. Mine mostly is repetitive questioning - particularly about "what's for dinner"!
My husband went through the changing shirts several times a day stage...seems like forever ago now! He recently spent three days wearing his jeans backwards; not even sure how he managed it (had to be uncomfortable) but he insisted that is how he has always worn them...the zipper needs to be in the back in case you need to use the bathroom. Huh?
Clothing is becoming more and more of a mystery to him. I have found him putting his shirt on for pants, things inside out and backwards. It is very sad to see.
It was interesting to see the more expanded, detailed version of the stages that someone here gave a link to. I would have never known that being unable to adjust the water temp for his shower was a hallmark sign of stage six. He is definitely there.
I envy you guys. For the last year I have essentially dressed him as I would a three year old: here are the clothes you are going to wear, now put your right sock on; I'll help you with the left one which gets the compression stocking; now let's pull on your trousers... here's your left shoe, see the L in it? Here's your shirt, that's right creep in from the bottom.. he'd be totally lost trying to figure out what to put on. Every now and again he looks for a jacket and puts it on himself then forgets why he has it on and gets hot.
Yes, the water temp in the shower.. but mine can do that now; he went through a stage when he couldn't but then I made sure that even if he couldn't get it right he couldn't scald himself so he's coped since then.
I also have to dress my husband. He gets the shirt on backwards and can't get the socks on at all and has been known to wear 2 pairs of pants at one time. However, if he decides it is time to get up at 3:00 a.m. he manages to get dressed just fine. Just can't do it at 7:00 when I am getting ready to go to work. Today his caregiver told me that he tried to peel an apple withe the scissors
The stages are not meant to be clearly divided. I think of them as blended at the edges with one another. Some will have more symptoms in one stage than the next but eventually, they all pass through all of them. The only time I have found it useful was knowing the timelines, it is like a ball rolling down the hill, the it just gets faster and faster going through the stages. I just want to cry because I cannot stop the train and get off.
The four short videos link on Joan's home page helped me understand the stages and what's happening to the brain at each stage. I emailed those to both of our children.