Not as much is written about late Stage or Severe AD. Patients and caregivers don’t like to think about it.  But Severe AD is part of the dementia process. In order to prepare for the future, it is important to understand all parts of the disease.

According to the Alzheimer’s Association*, Severe AD is characterized by:

    -Very severe cognitive decline

    -This is the final stage of the disease when individuals lose the ability     

    to respond to their environment, the ability to speak and, ultimately,

    the ability to control movement.

      -Frequently individuals lose their capacity for recognizable speech,        

    although words or phrases may occasionally be uttered

  

      -Individuals need help with eating and toileting and there is general

      incontinence of urine

   

      -Individuals lose the ability to walk without assistance, then the    

    ability to sit without support, the ability to smile, and the ability to

    hold their head up. Reflexes become abnormal and muscles grow rigid.

    Swallowing is impaired.

In addition, the ADEAR Center/National Institute on Aging**, identifies that patients often:

    -lose their ability to recognize family members as well as themselves

    -experience weight loss

    -experience seizures

    -have skin infections

    -sleep more

    -lose control of bowel as well as bladder.

    -the most frequent cause of death is aspiration pneumonia.

Clinicians often use testing scores (MMSE=0-12) or the patient’s functional status to identify late stage or severe disease.  The use of this information is to assist in prescribing appropriate medication. It also helps clinicians provide patient’s and families with the information and support they need.

Care of the late stage patient, as you can see by the list of symptoms, is not all about improving cognition. The patient becomes more dependent, requiring more or even total assistance in their needs. Their medical problems may become increasingly complicated.  Their ability to eat, chew and swallow regular table food may become a challenge. The caregiver’s demands may become so great, so stressful, that care away from home, such as in a long term care facility may be at the fore front.

This particular brief article addresses the issues. In future sessions, I will begin to explore, issue by issue, how to deal or cope with the demands of late stage disease.  It is crucial that you, as the patient and/or caregiver are able to talk with your care provider. Click the link “your doctor” for more information.

Beth

*link to the Alzheimer’s Association

** link to the ADEAR Center/National Institute on Aging