Many caregivers will find that their patient doesn’t fit neatly into any one of these stages. Another helpful way to categorize the progression of the disease is to understand that patients progress from needing supervision, to needing custodial care, to needing nursing care. It is critical to remember that each stage brings with it unique challenges for the caregiver. It is essential to take it one day at a time, to take time for yourself, and to do what is good for your patient and best for you. In other words, give yourself permission to utilize all the help you can muster, take frequent breaks, and even when faced with this difficult disease, reach deep inside yourself and find joy, humor and laughter. You’ll feel better for it.

Mild Alzheimer's

• Asking the same questions repeatedly
• Getting lost in conversations and having problems finding the right word
• Not being able to complete familiar tasks, such as following a recipe
• Having problems with abstract thought
• Not remembering recent events
• Misplacing items in inappropriate places, such as putting a wallet in the refrigerator
• Undergoing sudden changes in mood or behavior for no apparent reason
• Inability to concentrate or showing initiative
• Having less interest in their surroundings
• Showing indifference to their personal appearance
• Failure to show normal courtesies to others
• Disorientation to time and place
• Becoming lost while in familiar surroundings

Moderate Alzheimer’s

• Forgetting to turn off appliances, like the iron or stove
• Consistently forgetting to take medications
• Having difficulty with tasks involving calculation and planning, like balancing the checkbook, paying bills, going grocery shopping or preparing a meal
• Having difficulty with tasks that require skilled movements, like tying shoelaces or using utensils
• Problems with communication, including reading and writing
• Exhibiting behaviors such as aggressiveness, outburst of anger, or withdrawal
• Behaving inappropriately in public
• Feeling increasingly agitated and restless, particularly at night
• Sleeping for long periods of time or hardly sleeping at all (some patients may sleep 10 to 12 hours at night and still nap during the day, others may only sleep 2 to 4 hours at night)
• Having hallucination or delusions

Severe Alzheimer's

• Having little or no memory
• Having difficulty speaking and understanding words
• Expressing little or no emotion
• Grasping objects or people and not letting go
• Having difficulty recognizing others, or even themselves in the mirror
• Needing assistance for all personal care, including bathing, dressing, grooming, toileting, eating and moving around
• Experiencing frequent incontinence
• Increasing weakness and being susceptible to infections
• Having difficulty chewing and swallowing, losing interest in food, losing weight
• Increasingly spending time in the bed or chair