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This video was posted to Facebook. I thought it was really good.

blog.thealzheimerssite/understanding-alzheimers-in-three-minutes/
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JoAnn29, thank you so much for sharing that! What a great 3-minute overview. In case the automatic url deletion process on this site deletes the url, anyone can find it easily by searching "understanding alzheimer's disease in 3 minutes."

Since this post is originally about "stages" I'd like to point out that this quick overview helps us understand how Alzheimer's does progress in stages -- that corresponds to how the damage in the brain progresses.

Other types of dementia may not progress in a similar way. The concept of "stages" just does not apply to Lewy Body Dementia, for example. Like ALZ, LBD does involve damage to the brain, and where the damage occurs is related to the symptoms displayed. But it is quite different than ALZ. For example, in this little video hallucinations tend to happen in a late stage in ALZ, but in LBD hallucinations may be the very first symptom noted. In ALZ, toward the end the ability to recognize people is lost. That typically is not not lost at all in LDB.

So, this specific pattern applies only to Alzheimer's. But other kinds of dementia share some characteristics:

1) Dementia behaviors are a result of physical damage to the brain. The cause might not be tangles and plaques but it is something that does damage, and that damage can be seen clearly upon autopsy.
2) The losses and behaviors and impairments of dementia are caused by physical damage. This is not psychological or willful. The person with dementia has no control over this damage.
3) A little less than half of elders with dementia has something other than ALZ. That means their patterns wouldn't look like ALZ patterns, but they are still caused by damage to the brain.
4) A significant number of persons with dementia have more than one kind of damage in their brains, complicating the progression they present.
5) At this point in science, a significant number of persons are diagnosed with the wrong kind of dementia when compared to autopsy of the brain.

Again, although this video is about ALZ, it can be very useful to persons interested in other kinds of dementia, as long as you realize the damage mechanism, progression, impairments, and intensities may vary from one kind of dementia to another.
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I think most families are concerned with figuring how to identify what "stage", so they can figure out what to expect, and how best to cope, at each "stage" a person is in with their dementias.
Sadly, there is a wide disparity between Docs, even neurologists, evidently, as to what stage an elder's dementia has reached. There aren't standardized tests used.
But more problematic:
==Care systems [those in USA] are run by insurance companies, which pay less for care, based on lower-level diagnoses or severity of symptoms, than for higher-level ills. A patient who is under-evaluated in the severity of their illness, gets smaller reimbursements, and also can get under-treated, under-cared-for, both in facilities, and in their homes.
==Extended care facilities need to know, more accurately, what's up with patients!
Assisted living homes, etc., can be stuck with higher-level-care patients, by families
going to Internist Doctor #1 and getting the elder evaluated, then going to Neurologist Doctor #2 and also getting evaluated for same; the results can be startlingly different!
They then use the lower-level diagnosis to get the elder into a lower-level, cheaper care facility than they need, to pay markedly less per month. Then they use the higher-level diagnosis at the lawyer's office, to manipulate who can be a POA on the elder's estate, and get the estate paperwork blocked to any further changes.

Placing an elder who is farther progressed into their dementia, in a too-low level of care, is potentially dangerous for the elder's actual level of deteriorating mental capacity. Some elders can kind of fly under the radar on that, as long as they are good at "show-timing" even the staff, until their symptoms get too advanced.
==In some things, the elder's should _not_ be allowed to keep doing things they are used to doing, even if they can still carry salient conversations....for instance: stopping them driving when they start having problems that could cause accidents, before they have accidents; preventing them ruining their estate or accounts needed to fund their care and needs.

It's all about making sure the elder is safe, and decently taken care of.
As much as I'd also like to stop making labels and boxes to put people in, with the systems we currently have, the labels and boxes might be a necessary evil.
Somewhere in the middle, hopefully we can still just give the care needed, based on observing what they are experiencing on any given day.
They are not doing it to cause problems, only trying to get their needs met, and help calming their fears at the changes in themselves.
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I, like the others don't feel "stages" is anything more than a set of guidelines. An action today might lead one to believe a certain stage, tomorrow, an action might be defined as "another" stage. Deal with what is going on in the present moment, as behavior can change within a moment.
One other thing I find when a loved one is taken for a check up, please involve the person in the conversation. Don't talk to the health care professional behind your loved one's back. Just that simple conversation or discussion could make the patient slip into a different behavior and if they are still early in their dementia, they have the right to have some I put. If it is not appropriate to the discussion keep going. That could also give you an idea of where their thought processes are. Go with the flow...and VALIDATE their voice. Good luck to all
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First i have no idea what stage my husband is in. It is very slow in 8 yrs. He eats, goes to barhroom
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Got cut off..needs prompting when dressing or reminder that he was eating when he took break to pee. When this all appeared like something isnt right like asking same questions, repeating same stories yet all else was normal, played cards & games but slowly things chgd. I read all i can. Need to ck out memory care places now while he doesnt need them so when panic time comes i'll know where to go. We know we'll all die but their chances may be sooner. Think if my spouse, parent died tonight what would be the steps i must take now. First call? Much to think about assuming all legal DPOA etc have been done at first sign, no later or its too late. God be with us all!
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Yes, there is a reasoning behind a caregiver wanting to know the stage. Each time my relative went to the hospital I balled my eyes out wondering if they would live through their ailment. To find out it wasn't life threatening at the time was helpful. For me as a caregiver, the stage matters, and doctors who don't seem to think we need to know seem insensitive~and I have been known to let them know so in a polite manner.
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downerdebbie, do you understand that "stages" apply to ALZ, but not to other types of dementia?
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jeannegibbs,
Yes I do understand that. It has also been my experience that knowing the alz stage is uplifting enough to give me the strength and peace to handle being the ONLY caregiver. (others are around, but only pop in a handful of times per year. Nope, haven't figured out how to make people care!) ...also I think my mother has ALZ rather than LBD because she is accustomed to doing handiwork while sitting and I think she still reaches for things she can no longer do, like knitting or crocheting, mending, etc. I won't argue with the docs any, I wont win anything and the meds seem appropriate for now. Thanks jeannegibbs, for the reminder that ALZ is different. :)
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To the person who posted that dementia is present 5 years before signs, could you please let me know how you know this? My son had my dad sign what dad thought were divorce papers, when they were actually papers to use dads house as collateral on a mortgage. This was Aug of 2012, dad was diagnosed 2 years later. I had to sell dads house in Dec because he's now in AL memory care and had to pay off that mortgage. Dads elder care attorney has prepared a court case but gave my son the option to make good on the mortgage without going to court. So far he's done nothing. $73,000 will go a ways to care for dad. If I had some proof that dementia is present 5 years before symptoms, it may help me! Oh yes, and the son has not seen dad in 2 years, since I took dad to his office and confronted him about the mortgage.
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Lucysmom - Dementia isn't present, but some early symptoms are noticeable long before diagnosis. Unfortunately for your situation, a person who has been diagnosed may still be competent to sign legal documents. I'm sorry your son has let you down so badly. It sounds like your lawyer has a good plan. Good luck.
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Jinx4740, thank you for the information. My son didn't let me down as he never had any respect for me, but in my dads eyes, he could do no wrong. It was my dad that he really took advantage of. And now dad never mentions his name. I never bring it up. Better something he forgets. Sad part for me is that he's keeping me from my grandchildren. I guess we're all being punished. It's in the hands of the lawyer now.
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Lucy, I just searched: "Alzheimer's starts years before symptoms" [without parentheses], and got this first:, https://www.alzinfo.org/articles/brain-detected-20-years-alzheimers-symptoms/ , https://www.nlm.nih.gov/medlineplus/magazine/issues/fall10/articles/fall10pg19.html , which all say:
Alzheimer's deficits can start 20 years prior to showing overt symptoms. Scientists tested well over 2000 people.
They could see lower mental health test scores from those who went on to develop Alzheimer's.
And that was only on the first page of the search....so guessing that, and also that the NIH is now putting that on their site, means it's accepted knowledge, and, it's been known for a relatively long time.
For your case, though, you will need corroboration that she was not firing on all her pistons, when brother got her to sign away her house.
IF she now needs Welfare help to fund her care, the State will surely come looking for whoever took her house and, where the money went or is going.
It doesn't sound too good that the bro. has not stepped-up to make things right. He could get into some trouble with State, if they know he took her major asset, within the 5-year look-back period, which otherwise could have been used to fund her care.
Hope this helps!
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Chimonger....thank you so much! You can be sure I will print everything out. I don't think thiscwill get to court as both my son's business and the bank who approved the mortgage are both in the county dad lived in and where dad was a very well respected elected official for many years. The court complaint also states that David ------ is the grandson of Mr ---------. All not very good for his business. I think between he and the bank they will give him a loan of the money, plus legal fees. As for Medicaid, dad is private pay. Thankfully he has about 8 years (as long as he stays where he is) before I have to apply. His elder care attorney also mentioned the mortgage we paid and Medicaid coming after him.
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After my father had a fall and a cscan showed a small pool of blood on his brain, I took him to a neurologist for dementia testing. The same test was done for the 4 times we had appointments. The last test I knew was the last, simply because of my Father's anxiety and stress while answering these questions. He knew this stuff was easy, but yet he didn't know how to answer them. He told me in the conversation I initiated immediately after. I certainly do agree to see the Dr. to determine what is causing the problems, though.
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I agree that testing is a good idea but there is also a time to stop the tests because of the stress and the fact that little more is determined. Good call Bigski.
Carol
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