My family member has Alzheimer’s, what changes should I expect as the disease progresses?

By: Fructuoso Irigoyen, MD, DLFAPA
DHR Health Behavioral Hospital

Alzheimer’s disease characteristically progresses very slowly. In most cases it is not possible to see changes from one day to the next. The initial changes are very subtle and, many times, the affected person may try to conceal them, which is called confabulation. It then becomes apparent to family and caretakers that the person is having much trouble remembering what happened that morning or the day before. By that time the person is experiencing growing difficulties finding words, even very common ones: a spoon becomes “the thing for food” and so on. This stage of the disease may last a long time, and caretakers may have the impression that it is not progressing or even, in some cases, that there is improvement when the patient seems to be able to do some things that he could not do the day before. At this time it is important to realize that the person’s long-term memory is still grossly intact. It is a precious time to ask questions about the family or events that he or she participated in. By this time too, the person begins to “get lost”, disorientation that progresses until it occurs even in more familiar places. This is when the person cannot drive any longer, and most likely will be unable to take care of duties such as understanding the bank reports, writing checks, etc. Note that a minimal change in the disposition of furniture in a room may lead to the person getting lost. Then comes the time when the person cries “take me home” not realizing that they are precisely there, at home. Failure to recognize people, who were until then familiar, follows. At this time, caretakers and family need to introduce themselves each time they are in contact with the patient. The language becomes poor in content and variety and eventually disappears. Many times in this advanced stage the person may experience behavioral disturbances such as agitation, depression or apathy.

It is important to understand that the available treatments do not cure the disease, but, in most cases can delay its progress.
If you or someone you know would like more information on Alzheimer ’s disease, please call the DHR Health Behavioral Hospital at (956) 362- HELP (4357).