Alzheimer's: Impact of Later Stages

As Alzheimer's disease progresses, the patient may face severe difficulties with communication, reasoning, and memory loss. Find out some ways to cope with that.

As their Alzheimer's advances, the person you are caring for will still be able to carry out some tasks that are very familiar to them. However, they will probably be more interested in the process of doing the activity than in the end result.

• Break directions for an activity into small, manageable chunks, and make sure each task is very simple.
• Try to think of activities that have just one step, such as sweeping, dusting or winding wool.

Sensory stimulation and Alzheimer's

During the later stages of their Alzheimer's, the person you are caring for may have severe difficulties with reasoning and language, but they will still have their sense of taste, touch and smell. Find ways of stimulating these senses.

• As their condition progresses, some people with Alzheimer's find comfort in touching or stroking pieces of fabric or cuddly toys.
• Try giving the person a hand massage, using a scented oil such as lavender. This can be very soothing.
• A fish tank, a mobile or a window with a nice view may have a calming effect.

Tips for finding an activity

• Look for activities that are stimulating but that don't involve too many challenges or choices. People with Alzheimer's can find it difficult to process options.
• A sense of humor survives in many people with Alzheimer's, so look for activities that you will both find entertaining. Having a good laugh will do you both good!
• Alzheimer's often affects people's concentration, so that they can't focus on what they are doing for very long; they may need to do activities in short bursts.
• Alzheimer's can affect a person's motivation, so you may have to help them get started - don't be disheartened.

Memory loss in Alzheimer's

If you are caring for a person with Alzheimer's you will want to find ways to help them cope with memory problems so that they can retain their confidence and independence for as long as possible. Here are some suggestions.

Loss of memory is often one of the earliest signs of Alzheimer's. In older people it may be mistaken for the normal forgetfulness people experience as they grow older or when they are very stressed. However, it will become apparent later that the person's memory problems are severe and persistent, and are accompanied by changes in thinking and feeling which make it more difficult for them to cope with everyday life.

Everyone is different

Memory has many different aspects and people with Alzheimer's will be affected in different ways. You may find, for example, that the person retains memory for certain skills until quite a late stage, or that they surprise you with particular facts or experiences that they can still recall, though they are very forgetful in other areas.

Try to be flexible and patient and encourage the person to remember what they can without putting pressure on them in any way.

Memory for the past

Most people with Alzheimer's remember the distant past more clearly than recent events. They may have difficulty in recalling what happened a few moments ago but can recall their life when they were much younger in great detail. However, even these long-term memories will eventually decline.

• The person may be anxious about their memory loss, particularly in the early stages of Alzheimer's. Opportunities to share memories of the past can help to restore their sense of coherence.
• Talking about the past can often be enjoyable and help a person retain their sense of who they are.
• Use photographs, souvenirs and other appropriate items to help jog the person's memories of the past.
• If certain memories from the past seem very upsetting, try to give the person the opportunity to express their feelings and show them that you understand.

Sources:

• Activities: A Guide For Carers of People With Dementia (booklet), Debbie King, Alzheimer's Scotland, 2007.
• Alzheimer's Society - UK.