Can neurologist tell what stage of Alzheimer's by initial exam?

Since the pace of decline is so different in different people, I'm not certain that the actual stage of the disease is terribly important other than in a general sense.

It seems to me that this is more of a medical model since in all of life it seems necessary to put labels on where people are in a certain scale.

If we do our best for our loved ones, no matter their stage, allowing them to be our guide (in may things that we do), the stage is just a vague guideline.

Caregivers note the decline, try - often with a professional's help - to see what can be done to help the person without causing undue frustration or anxiety, and then move forward with love.

I'm not discounting the value of numbers and stages for certain ratings, but I'm placing the individual above that.

Terrific input as always from the community.
Carol

I know that most of us initially are very interested in finding out what stage our loved one is in. But with more experience we come to understand that knowing the "stage" is not a helpful to a care plan as we'd hoped.

Let us say there was some simple blood test that would reveal that your loved one had just entered stage 3. Then what? That would tell you he was on his way to stage 4 -- but whether that will happen in two years or two months is still a mystery. And whether his stage 4 will closely match the standard description or be a very custom version is a big unknown.

So whether you can get a good professional guess or not, you still have to deal with one day at a time. Progressive dementia always gets worse, but it is not possible to predict how fast or slowly that will happen, and which symptoms will be the most intense.

Certainly you can ask the neurologist for an educated guess about stage.

As an occupational therapist, I can tell one's stage by the level of one's activity and the level of assistance they need from doing things like dressing, bathing, brushing their teeth. A Dr who is well versed could also make these estimated guess. Testing also depends on what some one will do, may do and can do.......all about motivation and abilities. However our daily activities are not so much.
Jeannne Gibbs is right about "what would you do", however if you had an occupational therapist do an eval they could also give you ideas of how to set up the environment for the best performance, as well as giving your loved ones the best supports so that she does not have too much or too little help. As we all know we get frustrated with too much or too little in our own lives. Good luck

Watching my dad decline is heartbreaking, but I came to the conclusion that his stage really doesn't matter at this point. Every day he exhibits something new. What I do is treat the new problem. The end result is to make his life as comfortable as possible. It certainly isn't easy, is it, but if we have their best interest in mind and take it a day at a time, it seems to fall into place. So far anyway!

Gpa013, you have pressed one of my hot buttons, lucky you.

Your MIL is displaying some deficiencies. Accept those. This is not "attention-getting" behavior. It is illness. It is not "manipulation" -- it is damage within the brain.

One of the really puzzling and confusing things about dementia is that it can be very irregular. Sometimes the person can remember how to tell time, and sometimes she can't. Sometimes he makes a sandwich when he is hungry and sometimes he forgets to eat. Some kinds of dementia are particularly known for inconsistencies, but all kinds of dementia have a degree of irregularity.

It is simply cruel to assume a person who is developing brain problems is "just playing us."

Figuring out that my Mom jumped from Stage 4 to Stage 6 in three days after a fall and broken arm HAS helped me understand where she is. To see such decline quickly has been very disheartening but has allowed us to be more realistic is our expectations. She may retrieve some of her previous self care abilities but we are seeking help now in case she does not. The stage is just a guideline, but it is helpful to me. Just like following the stages of development for my children..

There is a reason to know what stage of dementia the person is in. Some people suffer from other mental conditions that cause them to seem as though they have more severe dementia. A person with depression or anxiety will be less responsive. As a result of the dementia diagnosis, the depression or anxiety will not be seen and treated for what it is and the patient will not partake in life as fully as they might if they did receive proper treatment for the conditions. I am not an MD, I am the daughter of such a person and must explain this to each new member of the medical staff, the rehab nurses, and the care facility.

After my husband's first stroke, the neurologist explained his brain would function like swiss cheese: sometimes he'd initiate amazing conversations about our history, but the next hour he'd not be sure where his bed was. I've just learned to go with the flow. He's not pretending anything. I help him when I can. It's been almost 17 years now, and hospice is excellent support now.

Is there a more specific reason why you want to know the stage? Are you wondering what's next, or how to deal with a specific behavior? As the previous folks have indicated, knowing the specific stage gives limited information. If there is another reason you want to know, it might be more helpful to ask that question or those questions.

Clarification: Obviously what is needed is a careful assessment that looks for other contributing conditions. Here, the family who knows the patient best needs to inform the medical staff of the personality of the patient. I have seen mom fool her rehab nurse and MD into thinking that she was near comatose. The MD looked again and more closely and agreed with me and had the order for rehab reinstated after the nurse determined that Mom was not a patient that could benefit from physical rehab. Got that corrected. It was one more win in a long series of events in which my input clarified the confusion brought on my Mom playing opossum.