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Jodi,
My mom had the same problem with the shower. She was very good about it until all of a sudden she absolutely refused to go near the shower. We think she may have forgotten how to adjust the water temp at one point and it either got too hot or too cold. Too late we learned about this possibility from the Alzheimer's Association. They recommend starting the use of a bathtub chair and wand shower as soon as the Alzheimer's patient is willing to accept being bathed by a caregiver. The sooner this happens, the easier it is for her to adjust to the caregiver and to the new method of taking a shower. Once an Alzheimer's patient has a bad experience with something they instinctively stay away from it.
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I really appreciate the information you all have given to these questions. I particularly appreciate the 7 stages Pamela mentioned. I recognize some of the stages my mother has moved from and into. I see her now in a combination of 3, 4, and 5. I think she may get frustrated trying to read, but she won't say so. One thing I read here too that made me feel a whole lot better, is that I may have to accept it when my mom refuses to take a shower. A co-worker said I must make her take a shower at least twice a week. I felt awful, because my mom is very stubburn! Anyway, thanks again!
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A swallowing study can be done easily by a dietician in one nursing home my husband was in every new pt. even those for rehab had a simple swallowing study done by the dietician and if needed a more complex study can be done if a pt. can not swallow then a feeding tube has to be placed.
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They may aspirate food into their lungs. That took out a friend's mother. Mom has problems swallowing, probably due to dentures at this point.
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Here's something for you Lori. I'm not experienced with Alzheimers but plenty of people here are. Perhaps this will help a little.

Alzheimer's Disease at Age-Matters
Behavior of Alzheimer's Patients

Thanks to Beth Creason at about.com

The Seven Stages of Alzheimer's Symptoms

Do you know what to expect during the course of Alzheimer's disease? There are seven stages that describe each phase of this debilitating disease. Not everyone who has AD will have all of these symptoms, nor will they necessarily have the symptoms in the order I have listed, but, by using this guide, you can get an idea of the progressive decline of the patient's cognitive functions.

Alzheimer's disease usually lasts from three to 20 years. During this time, cognitive function steadily decreases. In many cases, patients do not die of Alzheimer's itself, but other complications, such as pneumonia, heart failure or infections.

Let's examine the seven stages:

Stage One: There are no symptoms at all. The patient has no memory impairment nor does he have any visible signs of other cognitive decline.

Stage Two: The patient will notice some mild memory loss. He or she will usually start by misplacing objects or forgetting names that are well known to them. He or she may wonder about the memory loss, but will usually blame it on aging.

Stage Three: The victim will notice an increase in memory impairment. They may make a trip to the store and forget how to get back home. Their work performance may suffer because the patient may forget important details while working on a project. They may start trying to think of what a particular object is called, and the frequency of forgetting names of people they should know well will probably increase. Reading may become a problem, as the patient cannot remember what he or she has just read. At this point, the patient may lose or misplace something valuable, not remembering where they put it. Concentration will become very difficult. Most victims will go into denial during this stage, and will tend to have problems with anxiety.

Stage Four: In this stage, some long term memory loss will be seen. When asked about news headlines or current events, they may have difficulty in recalling what is happening. Travel becomes difficult because of the anxiety it causes. The person may not be able to handle their finances any longer because of confusion. The victim will usually start to withdraw from anything that presents a challenge. Denial is still prominent.

Stage Five: The patient now has to have assistance with some activities of daily living. They usually need help in selecting the clothes they wear, as during this stage they tend to dress inappropriately. They can still feed themselves and use the restroom without assistance. They may have trouble remembering some family members names, especially grandchildren or siblings, but can usually tell you their own names or the names of their spouse or children. They have trouble recalling such things as their address, or phone number.

Stage Six: The victim may now start forgetting the name of their spouse or children. They usually cannot recall any recent events in their lives. They may be able to recall things that have happened in the past, but cannot go into detail about the events. They are disoriented to time and place. When asked to count from ten, they will usually not be able to do this. They may even have difficulty in counting from one to ten. They may become incontinent, and will require help with most activities of daily living, such as bathing, toileting, dressing and sometimes eating. Delusions and paranoia may be a problem. They may start having some difficult behavior problems. Anxiety, agitation or violent behavior may occur.

Stage Seven: Most communication skills are lost. Speech is non-existent. The patient is incontinent. They will need help with feeding and toileting. They will become unable to walk or control other motor functions. During this stage, the person usually becomes bedfast.

It's been my experience that many patients will stay in stage five or six for a long period of time. Some patients that I met several years ago that were in these stages are still in the same stage. Not every patient is the same, so the stages and length of time in each stage will vary.

You can help the patient by showing him or her a lot of love and patience. Learning the different stages and knowing what to expect, will help you, the caregiver.
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