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Understanding Middle-Stage Alzheimer’s and Dementia

Caring For HusbandFor families caring for a loved one with Alzheimer’s, the middle stage of the disease often seems the longest. Caregiving becomes significantly more challenging. The person with memory loss may need assistance with daily activities. Personality changes may occur and difficult behaviors – such as aggression, paranoia, or agitation – may begin.

WHAT IS “MIDDLE-STAGE” DISEASE?

In the middle stages of Alzheimer’s disease, damage occurs in areas of the brain that control language, reasoning,
sensory processing, and conscious thought. Gaps in memory and thinking are noticeable as the person grows more
confused and forgetful. At this stage of the disease, families and caregivers will increasingly need to provide care.

Common mid-stage symptoms may include increased memory loss and confusion; problems recognizing family
and friends; inability to learn new things; difficulty carrying out tasks that involve multiple steps (such as getting
dressed); problems coping with new situations; hallucinations, delusions, and paranoia; and impulsive behavior.

In the middle stages of dementia, people are likely to become confused about where they are or what day it is. They
may be unable to recall basic facts, such as their own address or telephone number, or the name of the college or
high school they attended.

As the person with Alzheimer’s disease gradually loses his or her ability to express thoughts and follow conversations,
this can create difficulties for everyone involved. Sometimes, behavior may serve as the only form of communication.
A person who cannot find the words to say that she needs to go to the bathroom, for example, might begin pacing or
tugging on her clothing.

HOW CAN I HELP?

Here are some key ways in which you can provide care and support to a loved one in the middle stages of
Alzheimer’s or dementia.

Gentle reminders. Your loved one may need help with memory. For example, he or she may recognize familiar
faces but have difficulty recalling names. Offer cues to help fill in the gaps, such as: “Hi Dad, it’s me, Marion. I’ve
brought your grandson, Jason, to visit you.”

Keep it simple. Stick with clothing that is easy to put on and simple hairstyles. Speak slowly and clearly, and use
physical gestures to reinforce your message. Stick to concrete rather than abstract ideas.

Reduce distractions. Large crowds, loud noises, or a blaring TV can easily distract and even upset a person with
dementia. Establishing a daily routine and maintaining some regularity will also help calm and reassure your
loved one.

Don’t disagree. Avoid arguing or trying to convince the person that what he or she believes is untrue or inaccurate.
Choose your words carefully. When communicating with a person with dementia, always identify yourself and
approach the person from the front and from eye level. This will help orient the person and get his or her attention.

Learn to ‘read’ difficult behavior. Remember that it’s the disease, not the person, that’s being difficult. Try
to remain calm and offer reassurance and comfort. If your loved one’s behavior changes quickly, look for an
underlying cause. Could the person be hungry, or cold, or need to use the bathroom?

Recall the past. Sometimes, remembering events or people from the past may help calm the person. Many
people with memory loss will retain long-term memories even though short-term memory is lost.
For more information, download the Alzheimer’s Association’s free Tips for Middle-Stage Caregivers booklet here.

CARING FOR THE CAREGIVERS

When someone has Alzheimer’s or dementia, the entire family is affected. Take steps now to care for everyone
in the family in the days ahead.

Have a plan for the future. If you haven’t already done so, make plans to care for your loved one should the day
come when caring at home is no longer an option. Keep in mind that the needs of a person with dementia can
change very suddenly. If the person begins wandering outside of the home, or if the primary caregiver becomes
ill or otherwise incapacitated, you may need to find a care situation quickly. Don’t be caught off guard.

Get help for the caregiver. This is especially important when the primary caregiver is also a senior. People
caring for a spouse with Alzheimer’s or dementia are more likely to become ill, due to the physical demands and
emotional stress of caregiving. At a minimum, make sure the caregiver gets regular breaks for rest and renewal.

Cherish the moments. Remember there will be good days and bad days. Try to live in the moment and enjoy the
good days when they come.

Finally, know that we at Autumn Leaves are always ready to help. Please call or stop by an Autumn Leaves near you