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Contrary to some beliefs, Alzheimer’s is not a normal part of aging.  Although we may all, have what we “loosely” refer to as “senior moments,” Alzheimer’s is a disease, and not everyone has it or will get it!

Before you conclude that a loved one’s memory loss and confusion stem from an irreversible disease process, get a thorough medical evaluation, including a review of medications. A complete dementia diagnostic evaluation includes:

• Physical and neurological examinations.

• Patient and family interviews (including a detailed lifestyle and medical history).

• Neuropsychological and mental status tests.

The patient’s functional ability, attention, language, visuospatial skills, memory, and executive functioning are assessed. In addition, brain imaging (CT or MRI scans), blood tests, and other laboratory studies may be performed. The evaluation will provide a clinical diagnosis. Currently, a conclusive diagnosis of dementia can be obtained only from a postmortem autopsy, for which arrangements should be made in advance. Participating in research studies is an excellent way to benefit others with dementia.

After eliminating treatable causes of memory loss, physicians will consider irreversible dementias, such as Alzheimer’s, as a possible diagnosis. 

Even if the evaluation uncovers no underlying condition that, with treatment, can reverse dementia, options may be available for easing its symptoms. 

Knowing the likely cause of dementia, however, is the essential first step toward managing it appropriately.

Early stage

The early stage is often overlooked and incorrectly labeled by

professionals, relatives, and friends as ‘old age’ or a normal part of aging. Because the onset of the disease is gradual, it is difficult to identify the exact time it begins. The person may:

• Show difficulties with language
• Experience significant memory loss – especially short-term
• Be disoriented in time
• Become lost in familiar places
• Display difficulty in making decisions
• Lack initiative and motivation
• Show signs of depression and aggression
• Show a loss of interest in hobbies and activities

Middle stage

As the disease progresses, problems become more evident and

restricting. The person with dementia has difficulty with day-to-day living, and:

• May become very forgetful – especially of recent events and people’s names
• Can no longer manage to live alone without problems
• Is unable to cook, clean or shop
• May become extremely dependent
• Needs assistance with personal hygiene, i.e. toilet, washing, and dressing
• Has increased difficulty with speech
• Shows problems with wandering and other behavioral abnormalities
• Becomes lost at home and in the community
• May experience hallucinations

Late stage

This stage is one of total dependence and inactivity.  Memory disturbances are very serious and the physical side of the disease becomes more obvious.  The person may:

• Have difficulty eating
• Not recognize relatives, friends, and familiar objects
• Have difficulty understanding and interpreting events
• Be unable to find their way around in the home
• Have difficulty walking
• Have bladder and bowel incontinence
• Display inappropriate behavior in public
• Be confined to a wheelchair or bed

Presently, there is no curative treatment for Alzheimer’s disease. However, there are some drugs available that may temporarily slow down the progression of symptoms of Alzheimer’s disease in some people.

Even with no known cure, there is a great deal that can be done for the person with Alzheimer’s, as well as things to ease the burden on the caregiver. Consult your physician, social worker, or health professional for more information.

“To love a person is to learn the song in their heart, and sing it to them when they have forgotten.” — Arne Garborg

— Vickie C. Wacaster is a Patient and Hospice Advocate for Aveanna Hospice (formerly Comfort Care Hospice).