Post by norbert1 on Jan 21, 2005 11:49:55 GMT -5
This is from a Fact Sheet entitled "Alzheimer's Disease: Progression" that appeared briefly on the Alzheimer's Association website. I cannot find it there anymore, perhaps because it is more of a detailed description of behavior changes than a description of disease progression. I think it is a very good list of things that may be seen in the person with Alzheimers.
The changes are not uniform in every person with Alzheimers.
The list for the mild Alzheimers serves as a good list of warning signs.
Common Changes in Mild Alzheimers Disease
- Loses spark or zest for life – does not start anything.
- Loses recent memory without a change in appearance or casual conversation.
- Loses judgement about money.
- Has difficulty with new learning and making new memories.
- Has trouble finding words – may substitute or make up words that sound like or mean something like the forgotten word.
- May stop talking to avoid making mistakes.
- Has shorter attention span and less motivation to stay with an activity.
- Easily loses direction when going to familiar places.
- Resists change or new things.
- Has trouble organizing and thinking logically.
- Asks repetitive questions.
- Withdraws, loses interest, is irritable, not as sensitive to others’ feelings and/or is uncharacteristically angry when frustrated or tired.
- Won’t make decisions. For example, when asked what she wants to eat, says “I’ll have what she is having.”
- Takes longer to do routine chores and becomes upset if rushed or if something unexpected happens.
- Forgets to pay, pays too much or forgets how to pay – may hand a checkout person a wallet (or too much money) instead of the correct amount of money.
- Forgets to eat, eats only one kind of food or eats constantly.
- Loses or misplaces things by hiding them in odd places or forgets where things go, such as putting clothes in the dishwasher. (Misplacing items may cause the person to acuse others of stealing things)
- Constantly checks, searches or hoards things of no value.
Also (my addition)
-loses concept of time, cannot tell time from a clock with hands.
- eventually has trougle using the telephone, and dialing phone numbers
Common Changes in Moderate Alzheimer’s Disease
- Changes in Behavior, concern for appearance, hygiene and sleep become more noticeable.
- Mixes up identity of people, such as thinking a son is a brother or a wife is a stranger.
- Poor judgment creates safety issues when left alone – may wander and risk exposure, poisoning, falls, self neglect or exploitation.
- Has trouble recognizing familiar people and own objects; may take things that belong to others.
- Continuously repeats stories, favorite words, statements or motions like tearing tissues.
- Has restless and repetitive movements late afternoon and evening, such as pacing, trying doorknobs, or fingering draperies.
- Cannot organize thoughts or follow logical explanations.
- Has trouble following written notes or completing tasks.
- Makes up stories to fill in gaps in memory. For example might say, “Mama will come for me when she gets off work.”
- May be able to read, but cannot formulate the correct response to a written request.
- May accuse, threaten, curse, fidget or behave inappropriately, such as kicking, hitting or grabbing.
- May become sloppy or forget manners.
- May see, hear, smell or taste things that are not there.
- May accuse spouse of an affair or family members of stealing.
- Naps frequently or awakes at night believing it is time to go to work.
- Has more difficulty positioning the body to use the toilet or sit in a chair.
- May think mirror image is following him or television story is happening to her.
- Needs help finding the toilet, using the shower, remembering to drink, and dressing for the weather or occasion.
- Exhibits inappropriate sexual behavior, such as mistaking another individual for a spouse. Forgets what is private behavior, and may disrobe or masturbate in public. (This is not common, perhaps 3% have this behavior)
Common Changes in Severe Alzheimer’s Disease
- Doesn’t recognize self or close family
- Speaks in gibberish, is mute or is difficult to understand. (Geri Hall describes “word salad”)
- May refuse to eat, chokes or forgets to swallow.
- May repetitively cry out, pat or touch everything.
- Loses control of bladder and bowel.
- Loses weight and skin becomes thin and tears easily.
- May look uncomfortable or cry out when transferred or touched.
- Forgets how to walk, or is too unsteady or weak to stand alone.
- May have seizures, frequent infections, falls.
- May groan, stream or mumble loudly.
- Sleeps more.
- Needs total assistance for all activities of daily living.
This info was also found on the web at
www.nia.nih.gov/NR/exeres/6739F4B3-C1A9-4564-8AC3-77DC1315974E.htm
*Adapted from Caring for People with Alzheimer's Disease: A Manual for Facility Staff (2nd edition), by Lisa P. Gwyther, 2001. Published by the American Health Care Association (1201 L Street, NW, Washington, DC 20005) and the Alzheimer's Association (919 N. Michigan Ave., Suite 1100, Chicago, IL 60611).
-------------------------------
someone suggested the following article:
"Behavioral Problems in Dementia" written by doctor
www.postgradmed.com/issues/2004/06_04/smith.htm
Covers - Agitation (and Catastrophic reaction), Delusions, Hallucinations, Resistiveness to care, Disinhibition, Wandering, Sleep disturbance, and Apathy and depression.
A good article but not great. Provides a quick review of behaviors and treatment. It does deal nicely with the non-drug recommendations that are made for the various behaviors.
However - Regarding table 1 and drug recommendations.
Some of the recommended dose ranges exceed normal recommendations for dementia. Some of the drug recommendations are based on anecdotal information or very preliminary study information. Table 1 lists the use of ativan which we know is bad for dementia patients.
Norbert
The changes are not uniform in every person with Alzheimers.
The list for the mild Alzheimers serves as a good list of warning signs.
Common Changes in Mild Alzheimers Disease
- Loses spark or zest for life – does not start anything.
- Loses recent memory without a change in appearance or casual conversation.
- Loses judgement about money.
- Has difficulty with new learning and making new memories.
- Has trouble finding words – may substitute or make up words that sound like or mean something like the forgotten word.
- May stop talking to avoid making mistakes.
- Has shorter attention span and less motivation to stay with an activity.
- Easily loses direction when going to familiar places.
- Resists change or new things.
- Has trouble organizing and thinking logically.
- Asks repetitive questions.
- Withdraws, loses interest, is irritable, not as sensitive to others’ feelings and/or is uncharacteristically angry when frustrated or tired.
- Won’t make decisions. For example, when asked what she wants to eat, says “I’ll have what she is having.”
- Takes longer to do routine chores and becomes upset if rushed or if something unexpected happens.
- Forgets to pay, pays too much or forgets how to pay – may hand a checkout person a wallet (or too much money) instead of the correct amount of money.
- Forgets to eat, eats only one kind of food or eats constantly.
- Loses or misplaces things by hiding them in odd places or forgets where things go, such as putting clothes in the dishwasher. (Misplacing items may cause the person to acuse others of stealing things)
- Constantly checks, searches or hoards things of no value.
Also (my addition)
-loses concept of time, cannot tell time from a clock with hands.
- eventually has trougle using the telephone, and dialing phone numbers
Common Changes in Moderate Alzheimer’s Disease
- Changes in Behavior, concern for appearance, hygiene and sleep become more noticeable.
- Mixes up identity of people, such as thinking a son is a brother or a wife is a stranger.
- Poor judgment creates safety issues when left alone – may wander and risk exposure, poisoning, falls, self neglect or exploitation.
- Has trouble recognizing familiar people and own objects; may take things that belong to others.
- Continuously repeats stories, favorite words, statements or motions like tearing tissues.
- Has restless and repetitive movements late afternoon and evening, such as pacing, trying doorknobs, or fingering draperies.
- Cannot organize thoughts or follow logical explanations.
- Has trouble following written notes or completing tasks.
- Makes up stories to fill in gaps in memory. For example might say, “Mama will come for me when she gets off work.”
- May be able to read, but cannot formulate the correct response to a written request.
- May accuse, threaten, curse, fidget or behave inappropriately, such as kicking, hitting or grabbing.
- May become sloppy or forget manners.
- May see, hear, smell or taste things that are not there.
- May accuse spouse of an affair or family members of stealing.
- Naps frequently or awakes at night believing it is time to go to work.
- Has more difficulty positioning the body to use the toilet or sit in a chair.
- May think mirror image is following him or television story is happening to her.
- Needs help finding the toilet, using the shower, remembering to drink, and dressing for the weather or occasion.
- Exhibits inappropriate sexual behavior, such as mistaking another individual for a spouse. Forgets what is private behavior, and may disrobe or masturbate in public. (This is not common, perhaps 3% have this behavior)
Common Changes in Severe Alzheimer’s Disease
- Doesn’t recognize self or close family
- Speaks in gibberish, is mute or is difficult to understand. (Geri Hall describes “word salad”)
- May refuse to eat, chokes or forgets to swallow.
- May repetitively cry out, pat or touch everything.
- Loses control of bladder and bowel.
- Loses weight and skin becomes thin and tears easily.
- May look uncomfortable or cry out when transferred or touched.
- Forgets how to walk, or is too unsteady or weak to stand alone.
- May have seizures, frequent infections, falls.
- May groan, stream or mumble loudly.
- Sleeps more.
- Needs total assistance for all activities of daily living.
This info was also found on the web at
www.nia.nih.gov/NR/exeres/6739F4B3-C1A9-4564-8AC3-77DC1315974E.htm
*Adapted from Caring for People with Alzheimer's Disease: A Manual for Facility Staff (2nd edition), by Lisa P. Gwyther, 2001. Published by the American Health Care Association (1201 L Street, NW, Washington, DC 20005) and the Alzheimer's Association (919 N. Michigan Ave., Suite 1100, Chicago, IL 60611).
-------------------------------
someone suggested the following article:
"Behavioral Problems in Dementia" written by doctor
www.postgradmed.com/issues/2004/06_04/smith.htm
Covers - Agitation (and Catastrophic reaction), Delusions, Hallucinations, Resistiveness to care, Disinhibition, Wandering, Sleep disturbance, and Apathy and depression.
A good article but not great. Provides a quick review of behaviors and treatment. It does deal nicely with the non-drug recommendations that are made for the various behaviors.
However - Regarding table 1 and drug recommendations.
Some of the recommended dose ranges exceed normal recommendations for dementia. Some of the drug recommendations are based on anecdotal information or very preliminary study information. Table 1 lists the use of ativan which we know is bad for dementia patients.
Norbert