How Will Your Caregiving Role Change in the Middle Stages of Alzheimer’s and Dementia?


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Alzheimer’s and dementia are diseases that slowly strip away a person’s independence day by day. These are progressive diseases, which means that your loved one’s care needs will increase over time. It also means that your role as a caregiver will also change and become more involved over time.

Understanding the Transition from Early Stage to Middle Stage Alzheimer’s

Alzheimer’s and dementia are divided into three stages: Early, Middle, and Late. There is no succinct switch from one stage to the next. The transition is gradual, and each individual’s journey (and symptoms) will be different. However, eventually, your loved one will move from needing less care to needing more. What does that mean for you, and will you be ready to handle all the demands?

In the early stage of Alzheimer’s and dementia, your loved one may have difficulty remembering new names or appointments and may occasionally experience bouts of confusion, but they will largely be able to maintain their independence. As a family member, your role may be to check up on Mom or Dad or to provide an ear to help them come to terms with their diagnosis. However, as time passes and symptoms grow worse, you may feel pulled to step in and provide greater amounts of care. This likely means that Mom or Dad has moved from the early stage of dementia into the middle stage. Here is what to expect:

Living Alone and Driving

The transition into the middle stage of the disease will be highlighted by the loss of independence. Mom or Dad may no longer be able to drive or to live safely on their own.

When it becomes apparent that your loved one cannot drive on their own, you’ll have to find a way to help transport them. Public transportation could be an option, but if your loved one gets confused, they could end up getting off at the wrong bus stop or even getting lost after they leave the train. You may find yourself taking Mom to the grocery store every week or driving Dad to his doctor’s appointments.

Your life could change even more if your family member can no longer stay home alone. You may need to hire a home health care worker to watch Mom or even move her into your home. Some family members even leave their careers or curtail their job hours so they can care for a loved one.

Activities of Daily Living

At this stage in the disease, individuals also begin to lose the ability to care for themselves. Maybe Dad forgot his coat in the early stages of the disease, but now you find that you have to help him dress, bathe, and use the restroom. Taking on these responsibilities can be both physically and emotionally difficult for spouses and adult children. Your loved one may feel embarrassed, and you’ll likely find that it is much harder to dress an adult than your small one-year-old.

Mental Symptoms

Perhaps the most difficult change you will confront as your loved one slips into the middle stages of Alzheimer’s and dementia is the change in their personality. Communication will become more difficult as your loved one struggles to communicate and understands less and less of what you say.

You may also be shocked as your loved one’s personality changes. A mother who never had a cruel thing to say to anyone may become paranoid, petulant, aggressive, and even violent. She may become scared or fussy like a child, have trouble going to bed, or get confused and agitated easily. Caring for someone with Alzheimer’s and dementia means accepting personality changes with great patience, love, and acceptance.

What Do You Do?

The middle stage of Alzheimer’s and dementia is typically the longest stage of the disease. It can last for years, with the individual experiencing a slow degradation in mental abilities and understanding over time. As a caregiver, you must be honest with yourself about how much time and effort you can offer a loved one. As the disease asks more and more of you, at some point you may need to consider moving your loved one in to a memory care facility where they can receive the supervision and assistance they need in a facility that is tailored to their needs.

There is no shame in making the decision to place your loved one in a memory care home, especially if it means that they will be safer and will receive all the support that they need. As your loved one moves into the final stage of Alzheimer’s or dementia, it may be all but impossible for you to care for them unless you are willing to invest in round-the-clock nursing care at your residence.

If you are struggling with the growing care needs of your loved one, don’t suffer in silence. You are not alone! If you live in Poway or the San Diego Country area, we invite you to join us for our free monthly caregiver and family support group. Here, you can ask questions and hear stories from others who understand exactly what you are facing. We hope to see you at our next meeting!

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